W-8 IMY Instructions for Form W-8 IMY

Instructions for Form W-8IMY
(Rev. June 2017)

Department of the Treasury
Internal Revenue Service

Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S.
Branches for United States Tax Withholding and Reporting
Section references are to the Internal Revenue Code unless
otherwise noted.

General Instructions
Future developments. For the latest information about
developments related to Form W-8IMY and its instructions,
such as legislation enacted after they were published, go to
www.irs.gov/Formw8imy.

What’s New
Qualified derivatives dealers (QDDs). This form and
these instructions have been updated to reflect final and
temporary regulations published in January 2017 as well as
the Qualified Intermediary Agreement published in Rev.
Proc. 2017-15, available at IRS.gov/irb/2017-03_IRB/
ar15.html, with respect to the requirements of a QDD. A QDD
that receives payments for which the QDD is entitled to a
reduced rate of withholding under an income tax treaty may
use its Form W-8IMY to both certify its status as a qualified
intermediary (QI) acting as a QDD and to claim treaty
benefits with respect to such payments. To make a claim for
treaty benefits in such a case, the QDD should provide a
withholding agent with a statement associated with its Form
W-8IMY that contains the information required in Part III of
Form W-8BEN-E.
U.S. branch certification. Final regulations under chapter 4
published in January 2017 changed certain requirements for
U.S. branches of foreign entities. This form has been
updated to include the certification required of U.S. branches
of foreign financial institutions (FFIs) that are not treated as
U.S. persons. For payments made on or after July 1, 2017,
those branches must certify that they are applying the rules
described in Regulations section 1.1471-4(d)(2)(iii)(C) in
order to avoid being withheld upon under chapter 4. The final
regulations also provide that U.S. branches of FFIs that are
treated as U.S. persons no longer have to be branches of
FFIs with specified chapter 4 statuses. These instructions
reflect that change by allowing such branches to leave lines 5
and 9 blank.
Limited FFIs and limited branches. Limited FFI and
limited branch statuses expired on December 31, 2016, and
have been removed from the form and instructions.
Sponsored FFIs and sponsored direct reporting non-financial foreign entities (sponsored direct reporting
NFFEs). As of January 1, 2017, a sponsored FFI that is a
registered deemed-compliant FFI or sponsored direct
reporting NFFE is required to obtain its own GIIN to be
provided on this form and can no longer provide its
sponsoring entity’s GIIN. This form has been updated to
reflect this requirement.
Nonreporting IGA FFIs. This form and these instructions
have been updated to reflect the requirements for
withholding agents to document nonreporting IGA FFIs in the
Treasury regulations. These instructions also clarify that
nonreporting IGA FFIs that are sponsored entities should
Jun 23, 2017

provide their own GIIN (if required) and should not provide
the GIIN of the sponsoring entity. See the instructions to Part
XIX. In addition, these instructions provide that a trustee of a
trustee-documented trust that is a foreign person should
provide the GIIN it received when it registered as a
participating FFI (including a reporting Model 2 FFI) or
reporting Model 1 FFI.

Purpose of Form

Under chapter 3, foreign persons are generally subject to
U.S. tax at a 30% rate on income they receive from U.S.
sources that consists of interest (including certain original
issue discount (OID)), dividends, rents, premiums, annuities,
compensation for, or in expectation of, services performed,
or other fixed or determinable annual or periodical (FDAP)
gains, profits, or income. This tax is imposed on the gross
amount paid and is generally collected by withholding under
section 1441 or 1442 on that amount. A payment is
considered to have been made whether it is made directly to
the beneficial owner or to another person, such as an
intermediary, agent, trustee, executor, or partnership, for the
benefit of the beneficial owner.
Under chapter 4, withholding agents must withhold at a
30% rate under sections 1471 and 1472 on withholdable
payments made to nonparticipating FFIs (including when the
nonparticipating FFI is a flow-through entity or is acting as an
intermediary), certain other foreign entities, and certain
account holders of FFIs. For example, if a U.S. withholding
agent makes a payment of portfolio interest described in
section 871(h) to an account maintained by a
nonparticipating FFI, the payment will be subject to a 30%
withholding tax under section 1471 even if the
nonparticipating FFI is an intermediary or flow-through entity
and the beneficial owner for whom the intermediary or
flow-through is acting is a foreign individual who provides a
valid Form W-8BEN.
Foreign persons are also subject to tax at graduated rates
on income they earn that is considered effectively connected
with a U.S. trade or business. If a foreign person invests in a
partnership that conducts a U.S. trade or business, the
foreign person is considered to be engaged in a U.S. trade or
business. The partnership is required to withhold tax under
section 1446 on the foreign person’s distributive share of the
partnership’s effectively connected taxable income. The
partnership may generally accept any form submitted for
purposes of section 1441 or 1442, with few exceptions, to
establish the foreign status of the partner. See Regulations
sections 1.1446-1 through 1.1446-6 to determine whether
the form submitted for purposes of section 1441 or 1442 will
be accepted for purposes of section 1446.
For purposes of section 1446, Form W-8IMY may
only be submitted by an upper-tier foreign
CAUTION partnership or a foreign grantor trust, both of which
must furnish additional documentation for their owners.

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Additional information. For additional information and
instructions for the withholding agent, see the Instructions for

Cat. No. 25904R

A foreign partnership or a foreign simple or grantor trust to
establish that it is a nonwithholding foreign partnership or
nonwithholding foreign simple or grantor trust to certify to its
chapter 4 status (if required), to represent that the income is
not effectively connected with a U.S. trade or business, and
to certify that the form is being used to transmit withholding
certificates and/or documentary evidence and that it has
provided or will provide a withholding statement as required.
A foreign partnership or foreign grantor trust to establish
that it is an upper-tier foreign partnership or foreign grantor
trust for purposes of section 1446 and to represent that the
form is being used to transmit withholding certificates and/or
documentary evidence and that it has provided, or will
provide, a withholding statement, as required.
A flow-through entity (including a foreign reverse hybrid
entity) transmitting withholding certificates and/or other
documentary evidence to claim treaty benefits on behalf of its
owners, to certify its chapter 4 status (if required), and to
certify that it has provided, or will provide, a withholding
statement, as required.
A nonparticipating FFI acting as an intermediary or that is a
flow-through entity using this form to transmit a withholding
statement and withholding certificates or other
documentation for exempt beneficial owners described in
Regulations section 1.1471-6.
Prior to January 1, 2018, a qualified securities lender
(QSL) certifying to a withholding agent that it is acting as a
QSL with respect to U.S. source substitute dividends
received from the withholding agent pursuant to a securities
lending transaction (as described in Notice 2010-46).
A foreign intermediary or flow-through entity not receiving
withholdable payments or reportable amounts that is holding
an account with a participating FFI or registered
deemed-compliant FFI providing this form for purposes of
documenting its chapter 4 status as an account holder. No
withholding statement is required to be provided along with
Form W-8IMY in this case. The entity may instead provide
Form W-8BEN-E to document its chapter 4 status as an
account holder of an FFI when it is not receiving withholdable
payments or reportable amounts.

the Requester of Forms W-8BEN, W-8BEN-E, W-8ECI,
W-8EXP, and W-8IMY.

Who Must Provide Form W-8IMY

Except as otherwise provided, you should provide Form
W-8IMY when receiving a reportable amount or withholdable
payment on behalf of another person or as a flow-through
entity. When receiving a withholdable payment, your
chapter 4 status is generally required to be included on the
form unless otherwise provided in accordance with these
instructions. Form W-8IMY must be provided by the following
persons.
A foreign person, or a foreign branch of a U.S. person, to
establish that it is a QI that is not acting for its own account,
to represent that it has provided or will provide a withholding
statement, as required, or, if applicable, to represent that it
has assumed primary withholding responsibility under
chapters 3 and 4 of the Code (excluding section 1446) and/or
primary Form 1099 reporting and backup withholding
responsibility.
A foreign person, or a foreign branch of a U.S. person, to
establish that it is a QI acting as a QDD or assuming primary
withholding responsibility with respect to payments of
substitute interest, as permitted by the QI agreement. A
foreign person should also provide a Form W-8IMY to
establish that it is a qualified intermediary that has a foreign
branch that is acting as a QDD. A QDD that receives
payments for which the QDD is entitled to a reduced rate of
withholding under an income tax treaty may use its Form
W-8IMY to both certify to its status as a QI acting as a QDD
and to claim treaty benefits with respect to such payments.
A foreign person to establish that it is a nonqualified
intermediary that is not acting for its own account, to certify
its chapter 4 status (if required), to certify whether it reports
U.S. accounts under chapter 4 (if required), and to indicate, if
applicable, that it is using the form to transmit withholding
certificates and/or other documentary evidence and has
provided, or will provide, a withholding statement, as
required.
A U.S. branch that is acting as an intermediary to
represent that the income it receives is not effectively
connected with the conduct of a trade or business within the
United States and either that it is using the form (1) to
evidence it is treated as a U.S. person under Regulations
section 1.1441-1(b)(2)(iv)(A) with respect to any payments
associated with the Form W-8IMY, or (2) to transmit the
documentation of the persons for whom it receives a
payment and has provided, or will provide, a withholding
statement, as required, and to certify it is applying the rules
described in Regulations section 1.1471-4(d)(2)(iii)(C) when
receiving a withholdable payment.
A financial institution incorporated or organized under the
laws of a U.S. territory that is acting as an intermediary or is a
flow-through entity to represent that it is a financial institution
(other than an investment entity that is not also a depository
institution, custodial institution, or specified insurance
company) and either that it is using the form (1) to evidence it
is treated as a U.S. person under Regulations section
1.1441-1(b)(2)(iv)(A) with respect to any payments
associated with the Form W-8IMY, or (2) to certify that it is
transmitting documentation of the persons for whom it
receives a payment and has provided, or will provide, a
withholding statement, as required.
A foreign partnership or a foreign simple or grantor trust to
establish that it is a withholding foreign partnership or
withholding foreign trust.

This form may serve to establish foreign status for
purposes of sections 1441, 1442, and 1446. However, any
representations that items of income, gain, deduction, or loss
are not effectively connected with a U.S. trade or business
will be disregarded by a partnership receiving this form for
purposes of section 1446 as the partnership will undertake its
own analysis.
Do not use Form W-8IMY if you are described below.
You are the beneficial owner (other than a QDD acting in
its QDD capacity) of U.S. source income (other than income
that is effectively connected with the conduct of a trade or
business within the United States), and you need to establish
that you are not a U.S. person, establish your chapter 4
status (if required), or claim a reduced rate of withholding on
your own behalf under an income tax treaty (if applicable).
Instead, submit Form W-8BEN or Form W-8BEN-E.
You are a hybrid entity claiming treaty benefits on your
own behalf (unless you are a QDD acting in your QDD
capacity). Instead, provide Form W-8BEN-E to claim treaty
benefits. However, if you are receiving a withholdable
payment you may also be required to provide Form W-8IMY
to establish your chapter 4 status (unless you are a
disregarded entity) and the chapter 4 status of each of your
partners, beneficiaries, or owners. See the instructions for
Form W-8BEN-E for more information about hybrid entities
claiming treaty benefits.
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Instructions for Form W-8IMY (Rev. 6-2017)

You are a foreign reverse hybrid entity (unless you are a
QDD acting in your QDD capacity) that is not claiming treaty
benefits on behalf of your interest holders. Instead, provide
Form W-8BEN-E on your own behalf.
You are the beneficial owner of income that is effectively
connected with the conduct of a trade or business within the
United States. Instead, provide Form W-8ECI.
You are a nonresident alien individual who claims
exemption from withholding on compensation for
independent or certain dependent personal services
performed in the United States. Instead, provide Form 8233
or Form W-4.
You are a disregarded entity, other than a hybrid entity that
is a disregarded entity claiming treaty benefits on your own
behalf (see above bullet). Instead, the single owner (if a
foreign person) should provide the appropriate Form W-8
based on the single owner's status. If you are a disregarded
entity that is a QDD acting in your QDD capacity, your single
owner (whether or not a QDD) should provide Form W-8IMY
if it is a QI.
You are a QI that has QDD status but are receiving
payments of U.S. source income that you beneficially own
that are not payments in respect to potential section 871(m)
transactions or underlying securities (that is, you are
receiving payments that you beneficially own that are not
covered by your QI agreement). Instead, provide the
appropriate Form W-8 based on your status for those
payments you beneficially own.
You are a foreign government, international organization,
foreign central bank of issue, foreign tax-exempt
organization, foreign private foundation, or government of a
U.S. possession claiming the applicability of section 115(2),
501(c), 892, 895, or 1443(b), and, if required, claiming an
exemption from chapter 4 withholding. Instead, provide Form
W-8EXP. However, these entities should use Form
W-8BEN-E instead if they are claiming treaty benefits or are
providing the form only to claim exempt recipient status for
Form 1099 and backup withholding purposes.

Expiration of Form W-8IMY. Generally, a Form W-8IMY
remains valid until the status of the person whose name is on
the certificate is changed in a way relevant to the certificate
or there is a change in circumstances that makes the
information on the certificate no longer correct. The indefinite
validity period does not extend, however, to any other
withholding certificates, documentary evidence, or
withholding statements associated with the certificate. If you
are a QDD, the attachment associated with your Form
W-8IMY used to claim treaty benefits (if applicable) is treated
as a beneficial owner withholding certificate that is not valid
indefinitely.
Change in circumstances. If a change in circumstances
makes any information on the Form W-8IMY (or any
documentation or withholding statement associated with the
Form W-8IMY) you have submitted incorrect for purposes of
chapter 3 or chapter 4 (when relevant), you must notify the
withholding agent within 30 days of the change in
circumstances and provide the documentation required in
Regulations section 1.1471-3(c)(6)(ii)(E)(2). You must
update the information associated with Form W-8IMY as
often as is necessary to enable the withholding agent to
withhold at the appropriate rate on each payment and to
report such income.
See Regulations sections 1.1441-1(e)(4)(ii)(D) for the
definition of a change in circumstances for purposes of
chapter 3 and Regulations section 1.1471-3(c)(6)(ii)(E) for
the definition of a change in circumstances for purposes of
chapter 4.
With respect to an FFI claiming a chapter 4 status
under an applicable IGA, a change in circumstances
CAUTION includes when the jurisdiction where the FFI is
organized or resident (or the jurisdiction where a disregarded
entity or branch of an FFI is organized, identified in Part II of
the form) was included on the list of jurisdictions treated as
having an intergovernmental agreement in effect and is
removed from that list or when the FATCA status of the
jurisdiction changes (for example, from Model 2 to Model 1).
The list of agreements is maintained at www.treasury.gov/
resource-center/tax-policy/treaties/Pages/FATCAArchive.aspx.

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Giving Form W-8IMY to the withholding agent. Do not
send Form W-8IMY to the IRS. Instead, give it to the person
who is requesting it. Generally, this will be the person from
whom you receive the payment, the person who credits your
account, or a partnership that allocates income to you. If you
are an account holder of an FFI, the FFI may request this
form from you to document the status of your account for
chapter 4 purposes.

Definitions
Account. With respect to QI, including a QI acting as a
QDD, an account is defined in section 2.01 of the QI
Agreement.

You may provide a single Form W-8IMY if you have

TIP multiple branches receiving payments from the same

Account holder. An account holder is generally the person
listed or identified as the holder or owner of a financial
account (other than an agent or nominee that is not an FFI).
For example, if a partnership is listed as the holder or owner
of a financial account, then the partnership is the account
holder rather than the partners of the partnership. However,
an account that is held by a disregarded entity is treated as
held by the person owning the entity. With respect to a QI
acting as a QDD, see section 2.02 of the QI Agreement for
the definition of account holder.

withholding agent rather than separate Forms
W-8IMY to identify each branch receiving payments
associated with the form. In such a case, you should provide
a schedule that includes all required information for each
branch. See the instructions for Part II.

When to provide Form W-8IMY to the withholding agent.
Give Form W-8IMY to the person requesting it before income
is paid, credited, or allocated to your account. If you do not
provide this form, the withholding agent may have to withhold
at the 30% rate (for an amount subject to withholding under
chapter 3 or a withholdable payment under chapter 4),
backup withhold, or withhold at the applicable rate for net
effectively connected taxable income allocable to a foreign
partner in a partnership under section 1446. Generally, a
separate Form W-8IMY must be submitted to each
withholding agent from whom you receive a payment.
Instructions for Form W-8IMY (Rev. 6-2017)

Amounts subject to withholding. Generally, an amount
subject to chapter 3 withholding is an amount from sources
within the United States that is fixed or determinable annual
or periodical (FDAP) income. FDAP income is all income
included in gross income, including interest (as well as OID),
dividends, rents, royalties, and compensation. Amounts
subject to chapter 3 withholding do not include amounts that
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are not FDAP, such as most gains from the sale of property
(including market discount and option premiums), as well as
other specific items of income described in Regulations
section 1.1441-2 (such as interest on bank deposits and
short-term OID).
Amounts subject to chapter 4 withholding are payments of
U.S. source FDAP income that are withholdable payments as
defined in Regulations section 1.1473-1(a) and to which no
exception under Regulations section 1.1473-1(a)(4) applies
(for example, certain nonfinancial payments are excepted
from the definition of withholdable payment). The exemptions
from withholding provided for under chapter 3 are not
applicable when determining whether withholding applies
under chapter 4.
For purposes of section 1446, the amount subject to
withholding is the foreign partner’s share of the partnership’s
effectively connected taxable income.

Chapter 3 withholding rate pool. A chapter 3 withholding
rate pool is a payment of a single type of income, based on
the categories of income reported on Form 1042-S (for
example, interest or dividends), that is not subject to
withholding under chapter 4 but is subject to a single rate of
withholding for chapter 3 purposes and is paid to foreign
persons or, in the case of a zero-percent pool, U.S. exempt
recipients not included in a separate pool of exempt
recipients.
Chapter 4. Chapter 4 means chapter 4 of the Internal
Revenue Code (Taxes to Enforce Reporting on Certain
Foreign Accounts). Chapter 4 contains sections 1471
through 1474.
Chapter 4 status. The term chapter 4 status means a
person’s status as a U.S. person, specified U.S. person,
foreign individual, participating FFI, deemed-compliant FFI,
restricted distributor, exempt beneficial owner,
nonparticipating FFI, territory financial institution, excepted
NFFE, or passive NFFE.

Beneficial owner. For payments other than those for which
a reduced rate of, or exemption from, withholding is claimed
under an income tax treaty, the beneficial owner of income is
generally the person who is required under U.S. tax
principles to include the payment in gross income on a tax
return. A person is not a beneficial owner of income,
however, to the extent that person is receiving the income as
a nominee, agent, or custodian, or to the extent the person is
a conduit whose participation in a transaction is disregarded.
In the case of amounts paid that do not constitute income,
beneficial ownership is determined as if the payment were
income.
Foreign partnerships, foreign simple trusts, and foreign
grantor trusts are not the beneficial owners of income paid to
the partnership or trust. The beneficial owners of income paid
to a foreign partnership are generally the partners in the
partnership, provided that the partner is not itself a
partnership, foreign simple or grantor trust, nominee, or other
agent. The beneficial owners of income paid to a foreign
simple trust (that is, a foreign trust that is described in section
651(a)) are generally the beneficiaries of the trust, if the
beneficiary is not itself a foreign partnership, foreign simple
or grantor trust, nominee, or other agent. The beneficial
owners of income paid to a foreign grantor trust (that is, a
foreign trust to the extent that all or a portion of the income of
the trust is treated as owned by the grantor or another person
under sections 671 through 679) are the persons treated as
the owners of the trust. The beneficial owner of income paid
to a foreign complex trust (that is, a foreign trust that is not a
foreign simple trust or foreign grantor trust) is the trust itself.
The beneficial owner of income paid to a foreign estate is
the estate itself.

Chapter 4 withholding rate pool. The term chapter 4
withholding rate pool means a pool identified on a
withholding statement provided by an intermediary or
flow-through entity with respect to a withholdable payment
that is allocated to payees that are nonparticipating FFIs. The
term chapter 4 withholding rate pool also includes a pool
identified on an FFI withholding statement provided by a
participating FFI or registered deemed-compliant FFI with
respect to a withholdable payment that is allocated to a class
of recalcitrant account holders as described in Regulations
section 1.1471- 4(d)(6) (or with respect to an FFI that is a QI,
a single pool of recalcitrant account holders without the need
to subdivide into each class of recalcitrant account holder),
including a pool of account holders to which the escrow
procedures for dormant accounts apply. Finally, a chapter 4
withholding rate pool also includes a pool of U.S. persons
included in a U.S. payee pool described in Regulations
section 1.6049-4(c)(4) provided by a participating FFI
(including a reporting Model 2 FFI), a registered
deemed-compliant FFI (including a reporting Model 1 FFI), or
a QI.
Deemed-compliant FFI. Under section 1471(b)(2), certain
FFIs are deemed to comply with the regulations under
chapter 4 without the need to enter into an FFI agreement
with the IRS. However, certain deemed-compliant FFIs are
required to register with the IRS and obtain a GIIN. These
FFIs are referred to as registered deemed-compliant FFIs.
See Regulations section 1.1471-5(f)(1) and also an
applicable IGA for entities treated as registered
deemed-compliant FFIs.

Note. A payment to a U.S. partnership, U.S. trust, or U.S.
estate is treated as a payment to a U.S. payee that is not
subject to 30% withholding for purposes of chapter 3 and
chapter 4. A U.S. partnership, trust, or estate should provide
the withholding agent with a Form W-9. For purposes of
section 1446, a U.S. grantor trust or disregarded entity shall
not provide the withholding agent a Form W-9 in its own right.
Rather, the grantor or other owner shall provide the
withholding agent the appropriate form.

Disregarded entity. A business entity that has a single
owner and is not a corporation under Regulations section
301.7701-2(b) is disregarded as an entity separate from its
owner. A disregarded entity does not submit Form W-8IMY to
a withholding agent or FFI. Instead, the owner of such entity
provides the appropriate documentation (for example, a
Form W-8BEN-E if the owner is a foreign entity that is not a
QDD). However, if a disregarded entity receiving a
withholdable payment is an FFI outside the single owner’s
country of organization or has its own GIIN, see the
instructions to Part II of Form W-8IMY for when to provide the
chapter 4 status of the disregarded entity receiving the
payment.

Chapter 3. Chapter 3 means chapter 3 of the Internal
Revenue Code (Withholding of Tax on Nonresident Aliens
and Foreign Corporations). Chapter 3 contains sections 1441
through 1464.

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Instructions for Form W-8IMY (Rev. 6-2017)

Certain entities that are disregarded for U.S. tax purposes
may nevertheless be treated as treaty residents for purposes
of claiming treaty benefits under an applicable tax treaty (see
the definition of hybrid entity, later). See Form W-8BEN-E
and the accompanying instructions for more information
about a hybrid entity claiming treaty benefits on its own
behalf as a resident of a treaty jurisdiction.

Hybrid entity. A hybrid entity is any person (other than an
individual) that is treated as fiscally transparent (rather than
as a beneficial owner) under the Code but is not treated as
fiscally transparent by a country with which the United States
has an income tax treaty. Hybrid entity status is relevant for
claiming treaty benefits for purposes of chapter 3. A hybrid
entity, may, however, be considered the payee for purposes
of chapter 4 (see Regulations section 1.1471-3(a) defining
who is a payee of a withholdable payment). See the special
instructions for hybrid entities, later, and Regulations section
1.1471-3(d) for the documentation requirements with respect
to entities receiving withholdable payments.

Financial account. A financial account includes:
A depository account maintained by an FFI;
A custodial account maintained by an FFI;
Equity or debt interests (other than interests regularly
traded on an established securities market) in investment
entities and certain holding companies, treasury centers, or
financial institutions;
Certain cash value insurance contracts; and
Annuity contracts.
For purposes of chapter 4, exceptions are provided for
accounts such as certain tax-favored savings accounts, term
life insurance contracts, accounts held by estates, escrow
accounts, and certain annuity contracts. See Regulations
section 1.1471-5(b)(2). Accounts may also be excluded from
the definition of financial account under an applicable IGA.

Intergovernmental Agreement (IGA). An IGA means a
Model 1 IGA or a Model 2 IGA. For a list of jurisdictions
treated as having in effect a Model 1 or Model 2 IGA, go to
www.treasury.gov/resource-center/tax-policy/treaties/Pages/
FATCA-Archive.aspx.
A Model 1 IGA means an agreement between the United
States or the Treasury Department and a foreign government
or one or more agencies to implement FATCA through
reporting by FFIs to such foreign government or agency
thereof, followed by automatic exchange of the reported
information with the IRS. An FFI in a Model 1 IGA jurisdiction
that performs account reporting to the jurisdiction’s
government is referred to as a reporting Model 1 FFI.
A Model 2 IGA means an agreement or arrangement
between the United States or the Treasury Department and a
foreign government or one or more agencies to implement
FATCA through reporting by FFIs directly to the IRS in
accordance with the requirements of an FFI agreement,
supplemented by the exchange of information between such
foreign government or agency thereof and the IRS. An FFI in
a Model 2 IGA jurisdiction that registered with the IRS to
obtain a GIIN and agreed to comply with the terms of an FFI
agreement with respect to a branch is treated as a
participating FFI but may be referred to as a reporting
Model 2 FFI.
The term reporting IGA FFI refers to both reporting
Model 1 FFIs and reporting Model 2 FFIs.

Financial institution. A financial institution generally
means an entity that is a depository institution, custodial
institution, investment entity, or an insurance company (or
holding company of an insurance company) that issues cash
value insurance or annuity contracts. See Regulations
section 1.1471-5(e).
Fiscally transparent entity. An entity is treated as fiscally
transparent with respect to an item of income to the extent
that the interest holders in the entity must, on a current basis,
take into account separately their shares of an item of income
paid to the entity, whether or not distributed, and must
determine the character of the items of income as if they
were realized directly from the sources from which realized
by the entity. For example, partnerships, common trust funds,
and simple trusts or grantor trusts are generally considered
to be fiscally transparent with respect to items of income
received by them.

Intermediary. An intermediary is any person that acts as a
custodian, broker, nominee, or otherwise as an agent for
another person, regardless of whether that other person is
the beneficial owner of the amount paid, a flow-through
entity, or another intermediary.
Qualified intermediary (QI). A QI is a person that is a
party to a withholding agreement with the IRS (described in
Regulations section 1.1441-1(e)(5)(iii)) and is:
A foreign financial institution (other than a U.S. branch of
an FFI) that is a participating FFI (including a reporting Model
2 FFI), a registered deemed-compliant FFI (including an FFI
treated as a deemed-compliant FFI under an applicable IGA
subject to due diligence and reporting requirements similar to
those applicable to a registered deemed-compliant FFI under
Regulations section 1.1471-5(f)(1), including the requirement
to register with the IRS), or any other category of FFI
identified in the QI agreement;
A foreign person that is a home office or has a branch that
is an eligible entity (as described in Regulations section
1.1441-1(e)(6)(ii), without regard to the requirement that the
person be a qualified intermediary);
A foreign branch or office of a U.S. financial institution or a
foreign branch or office of a U.S. clearing organization; or
A foreign entity not described above that the IRS accepts
as a qualified intermediary.

Flow-through entity. A flow-through entity is a foreign
partnership (other than a withholding foreign partnership), a
foreign simple or foreign grantor trust (other than a
withholding foreign trust), or, for payments for which a
reduced rate of withholding is claimed under an income tax
treaty, any entity to the extent the entity is considered to be
fiscally transparent with respect to the payment by an interest
holder’s jurisdiction.
Foreign financial institution (FFI). A foreign financial
institution (FFI) generally means a foreign entity that is a
financial institution.
Foreign person. A foreign person includes a nonresident
alien individual, a foreign corporation, a foreign partnership, a
foreign trust, a foreign estate, and any other person that is
not a U.S. person. It also includes a foreign branch or office
of a U.S. financial institution or U.S. clearing organization if
the foreign branch is a qualified intermediary. Generally, a
payment to a U.S. branch of a foreign person is a payment to
a foreign person.
Global intermediary identification number (GIIN). A
GIIN is the identification number assigned to an entity that
has registered with the IRS for chapter 4 purposes.

Instructions for Form W-8IMY (Rev. 6-2017)

-5-

redemption) of a short-term obligation that is effected outside
the United States. It also does not include amounts of original
issue discount arising from a sale and repurchase transaction
completed within a period of 2 weeks or less, or amounts
described in Regulations section 1.6049-5(b)(7), (10), or (11)
(relating to certain obligations issued in bearer form).

Qualified derivatives dealer (QDD). A QDD is a
qualified intermediary that is an eligible entity that agrees to
meet the requirements of Regulations section 1.1441-1(e)(6)
(i) and the QI agreement. An eligible entity is defined in
Regulations section 1.1441-1(e)(6)(ii).
To act as a QDD, the home office or branch, as
applicable, must qualify and be approved for QDD status and
must represent itself as a QDD on its Form W-8IMY and
separately identify the home office or branch as a recipient
on a withholding statement (if required). Each home office or
branch that obtains QDD status is treated as a separate
QDD.
Qualified securities lender (QSL). Notice 2010-46,
available at IRS.gov/irb/2010-24_IRB/ar09.html, provided
rules for QSLs acting with respect to payments of substitute
dividends. A QSL should certify to its QSL status in Part III of
this form, even if it is not a qualified intermediary. An entity
will no longer be able to claim QSL status as of January 1,
2018.
Nonqualified intermediary. A nonqualified intermediary
is any intermediary that is not a U.S. person and that is not a
qualified intermediary.

Reverse hybrid entity. A reverse hybrid entity is any
person (other than an individual) that is not fiscally
transparent under U.S. tax law principles but that is fiscally
transparent under the laws of a jurisdiction with which the
United States has an income tax treaty.
Territory financial institution. The term territory financial
institution means a financial institution that is incorporated or
organized under the laws of any U.S. territory. However, an
investment entity that is not also a depository institution,
custodial institution, or specified insurance company is not a
territory financial institution. A territory financial institution
acting as an intermediary or that is a flow-through entity may
agree to be treated as a U.S. person under Regulations
section 1.1441-1(b)(2)(iv)(A).
Withholdable payment. The term withholdable payment is
defined in Regulations section 1.1473-1(a).

Nonreporting IGA FFI. A nonreporting IGA FFI is an FFI
that is a resident of, or located or established in, a Model 1 or
Model 2 IGA jurisdiction that meets the requirements of:
A nonreporting financial institution described in a specific
category in Annex II of the Model 1 or Model 2 IGA;
A registered deemed-compliant FFI described in
Regulations section 1.1471-5(f)(1)(i)(A) through (F);
A certified deemed-compliant FFI described in
Regulations section 1.1471-5(f)(2)(i) through (v); or
An exempt beneficial owner described in Regulations
section 1.1471-6.

Withholding agent. Any person, U.S. or foreign, that has
control, receipt, custody, disposal, or payment of U.S. source
FDAP income subject to chapter 3 or a withholdable payment
under chapter 4 is a withholding agent. The withholding
agent may be an individual, corporation, partnership, trust,
association, or any other entity, including (but not limited to)
any foreign intermediary, foreign partnership, and U.S.
branches of certain foreign banks and insurance companies.
For purposes of section 1446, the withholding agent is the
partnership conducting the trade or business in the United
States. For a publicly traded partnership, the withholding
agent may be the partnership, a nominee holding an interest
on behalf of a foreign person, or both. See Regulations
sections 1.1446-1 through 1.1446-6.

Nonwithholding foreign partnership, simple trust, or
grantor trust. A nonwithholding foreign partnership is any
foreign partnership other than a withholding foreign
partnership. A nonwithholding foreign simple trust is any
foreign simple trust that is not a withholding foreign trust. A
nonwithholding foreign grantor trust is any foreign grantor
trust that is not a withholding foreign trust.

Withholding foreign partnership (WP) or withholding
foreign trust (WT). A WP or WT is a foreign partnership or
a foreign simple or grantor trust that has entered into a
withholding agreement with the IRS in which it agrees to
assume primary withholding responsibility for purposes of
chapter 4 and under sections 1441 and 1442 for all payments
that are made to its partners, beneficiaries, or owners, except
as otherwise provided in the withholding agreement. A WP
also includes a foreign reverse hybrid entity that has entered
into a withholding agreement.

Participating FFI. A participating FFI is an FFI that has
agreed to comply with the terms of an FFI agreement with
respect to all branches of the FFI, other than a branch that is
a reporting Model 1 FFI or a U.S. branch. The term
participating FFI also includes a reporting Model 2 FFI and a
QI branch of a U.S. financial institution, unless such branch is
a reporting Model 1 FFI.

Withholding statement. A withholding statement provides
an allocation (by income type) to each payee (or withholding
rate pool, if applicable, or other pool of payees to the extent
permitted under the chapter 3 or 4 regulations) of each
payment an intermediary or flow-through entity receives. The
withholding statement forms an integral part of the
withholding certificate, and the penalties of perjury statement
provided on the withholding certificate shall apply to the
withholding statement. The withholding statement may be
provided in any manner upon which the intermediary or the
flow-through entity and the withholding agent mutually agree,
including electronically if certain safeguards concerning
electronic transmission are met. A withholding statement also
provides information required for purposes of chapter 4 if the
intermediary or flow-through entity is receiving a withholdable
payment, in which case the entity must provide an FFI
withholding statement, chapter 4 withholding statement, or

Payee. A payee is generally a person to whom a payment is
made, regardless of whether such person is the beneficial
owner. For a payment made to a financial account, the payee
is generally the holder of the financial account. However,
under certain circumstances a person who receives a
payment will not be considered the payee. For purposes of
chapter 3, see Regulations section 1.1441-1(b)(2) and for
chapter 4, see Regulations section 1.1471-3(a)(3).
Reportable amount. Solely for purposes of the statements
required to be attached to Form W-8IMY, a reportable
amount is an amount subject to withholding under chapter 3,
U.S. source deposit interest (including original issue
discount), and U.S. source interest or original issue discount
on the redemption of short-term obligations. It does not
include payments on deposits with banks and other financial
institutions that remain on deposit for 2 weeks or less or
amounts received from the sale or exchange (other than a
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Instructions for Form W-8IMY (Rev. 6-2017)

exempt beneficial owner withholding statement (as
applicable). See Regulations section 1.1471-3(c)(3)(iii)(B).
Additional information is required for a withholding statement
from a QDD.

Form W-8IMY may be provided to satisfy

TIP documentation requirements for purposes of

withholding on certain partnership allocations to
foreign partners under section 1446. Section 1446 generally
requires withholding when a partnership is conducting a
trade or business in the United States and allocates income
effectively connected with that trade or business (ECI) to
foreign persons that are partners in the partnership. Section
1446 can also apply when certain income is treated as
effectively connected income of the partnership and is so
allocated.

Specific Instructions
Part I — Identification of Entity
Line 1. Enter your name. By doing so, you are representing
to the payer or withholding agent that you are not the
beneficial owner of the amounts that will be paid to you
(unless you are acting as a QDD or QSL for certain payments
associated with this form or you are a QI acting with respect
to payments of substitute interest, as permitted by the QI
agreement). If you are a disregarded entity, do not enter the
business name of the disregarded entity here. Instead, enter
the legal name of the entity that owns the disregarded entity
(looking through multiple disregarded entities, if applicable).

An upper-tier partnership that is allocated ECI as a partner in
a partnership may, in certain circumstances, have the
lower-tier partnership perform its withholding obligation.
Generally, this is accomplished by the upper-tier partnership
submitting withholding certificates of its partners (for
example, Form W-8BEN) along with a Form W-8IMY, which
identifies itself as a partnership, and identifying the manner in
which ECI of the upper-tier partnership will be allocated to the
partners. For further information, see Regulations section
1.1446-5. A foreign grantor trust that is allocated ECI as a
partner in a partnership should provide the withholding
certificates of its grantor (for example, Form W-8BEN) along
with its Form W-8IMY which identifies the trust as a foreign
grantor trust. See Regulations section 1.1446-1(c)(2)(ii)(E)
for the rules requiring it to provide additional documentation
to the partnership.

Line 2. If you are a corporation, enter the country of
incorporation. If you are another type of entity, enter the
country under whose laws you are created, organized, or
governed.
Line 3. If you are a disregarded entity receiving a payment,
enter your name (if required). You are required to complete
line 3 if you are a disregarded entity receiving a withholdable
payment or hold an account with an FFI requesting this form
and you:
Have registered with the IRS and been assigned a GIIN
associated with the legal name of the disregarded entity; and
Are a reporting Model 1 FFI or reporting Model 2 FFI .

Line 5. Check the one box that applies to your chapter 4
status. You are only required to provide a chapter 4 status if
you are acting as an intermediary with respect to a
withholdable payment, you are a flow-through entity receiving
a withholdable payment on behalf of your owners (including a
reverse hybrid entity providing documentation on behalf of its
owners to claim treaty benefits), you are providing a
withholding statement associated with this form that allocates
a portion of the payment to a chapter 4 withholding rate pool
of U.S. payees with respect to your direct account holders
(as described in Regulations section 1.6049-4(c)(4)), you are
providing this form to an FFI requesting this form to
document your chapter 4 status, or you are a QI (including a
QDD), WP, or WT. If you are a U.S. branch that does not
agree to be treated as a U.S. person and that does not make
the certification on line 19c, you should check
nonparticipating FFI; otherwise, leave line 5 blank. By
checking a box on this line, you are representing that you
qualify for this classification.

If you are not required to provide the legal name of
the disregarded entity, however, you may want to
CAUTION notify the withholding agent that you are a
disregarded entity receiving a payment or maintaining an
account by indicating the name of the disregarded entity on
line 10.

!

Line 4. Complete this line to establish your entity status for
purposes of chapter 3. Check the one box that applies. If you
are a foreign partnership receiving the payment on behalf of
your partners, check the “Withholding foreign partnership”
box or the “Nonwithholding foreign partnership” box,
whichever is appropriate. If you are a foreign simple trust or
foreign grantor trust receiving the payment on behalf of your
beneficiaries or owners, check the “Withholding foreign trust”
box, the “Nonwithholding foreign simple trust” box, or the
“Nonwithholding foreign grantor trust” box, whichever is
appropriate. If you are a foreign partnership (or a foreign
trust) receiving a payment on behalf of persons other than
your partners (or beneficiaries or owners), check the
“Qualified intermediary” box or the “Nonqualified
intermediary” box, whichever is appropriate. A foreign
reverse hybrid entity that is providing documentation from its
interest holders to claim a reduced rate of withholding under
a treaty should check the appropriate box (including
“Withholding foreign partnership” or “Withholding foreign
trust” if the entity has entered into a withholding agreement).
A partnership or grantor trust submitting Form W-8IMY solely
because it is allocated income effectively connected with a
U.S. trade or business as a partner in a partnership should
check the box for nonwithholding foreign partnership or
nonwithholding foreign grantor trust and, if it is submitting or
will submit documentation for its partners or owners, it should
complete Part VIII.
Instructions for Form W-8IMY (Rev. 6-2017)

For most of the chapter 4 classifications, you are

TIP required to complete additional certifications found in

Parts IX through XXVIII. Complete the appropriate
part of this form certifying that you meet the conditions of the
status indicated on line 5 (as defined under Regulations
sections 1.1471-5 or 1.1471-6). Complete the required
portion of this form before signing and providing it to the
withholding agent.

FFIs Covered by IGAs and Related Entities

A reporting FFI resident in, or established under the laws of,
a jurisdiction covered by a Model 1 IGA should check
“Reporting Model 1 FFI.” A reporting FFI resident in, or
established under the laws of, a jurisdiction covered by a
Model 2 IGA should check “Reporting Model 2 FFI.” If you
are treated as a registered deemed-compliant FFI under an
applicable IGA, you should check “Nonreporting IGA FFI”
rather than “registered deemed-compliant FFI” and provide

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country of residence) on line 9. If you are a trustee of a
trustee-documented trust and you are a foreign person, you
should provide the GIIN that you received when you
registered as a participating FFI or reporting Model 1 FFI. In
addition, you must provide your GIIN on line 9 if you are a
nonreporting IGA FFI that is (1) treated as registered
deemed-compliant under Annex II to an applicable Model 2
IGA or (2) a registered deemed-compliant FFI under
Regulations section 1.1471-5(f)(1).
If you are a QI acting as a QDD, you must provide your
GIIN on line 9 if you have one.
If you are a certified deemed-compliant FFI described in
Part XIV of this form, provide the GIIN of your sponsoring
entity on line 9.

your GIIN. See the specific instructions for Part XIX. In
general, if you are treated as a nonreporting IGA FFI under
an applicable IGA, you should check “Nonreporting IGA FFI”
even if you meet the qualifications for deemed-compliant
status under the chapter 4 regulations. In such a case, you
need not also check your applicable status under the
regulations but should provide your GIIN on line 9. However,
an owner documented FFI that is treated as a nonreporting
IGA FFI under an applicable IGA must check
“Owner-documented FFI” and complete Part XI. An FFI that
is related to a reporting IGA FFI and that is treated as a
nonparticipating FFI in its country of residence should check
nonparticipating FFI in line 5. An FFI that is related to a
reporting IGA FFI and that is a participating FFI,
deemed-compliant FFI, or exempt beneficial owner under the
U.S. Treasury regulations or an applicable IGA should check
the appropriate box depending on its chapter 4 status rather
than the box for nonparticipating FFI.

If you are in the process of registering with the IRS as

TIP a participating FFI, registered deemed-compliant FFI

(including a sponsored FFI), reporting Model 1 FFI,
reporting Model 2 FFI, direct reporting NFFE, sponsored
direct reporting NFFE, or nonreporting IGA FFI but have not
received a GIIN, you may complete this line by writing
“applied for.” However, the person requesting this form from
you must receive and verify your GIIN within 90 days.

If you are an FFI in a jurisdiction treated as having an IGA
in effect, you should not check “Participating FFI” and should
check “Reporting Model 1 FFI” or “Reporting Model 2 FFI” as
applicable.
See www.treasury.gov/resource-center/tax-policy/treaties/
Pages/FATCA-Archive.aspx for a list of jurisdictions treated
as having an IGA in effect.

If you are a disregarded entity that completed Part I, line 3,
do not enter your GIIN on line 9. Instead, enter it on line 13.
Line 10. You, or a withholding agent, may use this line to
include any referencing information that is useful to the
withholding agent in carrying out its reporting and withholding
obligations. For example, a withholding agent who is required
to associate a particular Form W-8BEN or Form W-8BEN-E
with this Form W-8IMY may use line 10 for a referencing
number or code that will make the association clear.

Line 6. Enter the permanent address of the entity identified
on line 1. Your permanent residence address is the address
in the country where you claim to be a resident for purposes
of that country's income tax. Do not show the address of a
financial institution (other than yourself), a post office box, or
an address used solely for mailing purposes unless such
address is the only permanent address you use and it
appears in your organizational documents (that is, your
registered address). If you do not have a tax residence in any
country, the permanent residence address is where you
maintain your principal office.

Part II — Disregarded Entity or
Branch Receiving Payment

Complete Part II for a disregarded entity that has its own GIIN
and is receiving a withholdable payment or for a branch
(including a branch that is a disregarded entity that does not
have its own GIIN) operating in a jurisdiction other than the
country of residence identified in line 2. For example, assume
ABC Co., which is a participating FFI resident in Country A,
operates through a branch in Country B (which is a Model 1
IGA jurisdiction) and the branch is treated as a reporting
Model 1 FFI under the terms of the Country B Model 1 IGA.
ABC Co. should not enter its GIIN on line 9, and the Country
B branch should complete this Part II by identifying itself as a
reporting Model 1 FFI and providing its GIIN on line 13. If the
Country B branch receiving the payment is a disregarded
entity, you may be required to provide its legal name on
line 3.

Line 7. Enter your mailing address only if it is different from
the address you show on line 6.
Line 8. You must provide an employer identification number
(EIN) if you are a U.S. branch or territory financial institution,
an upper-tier partnership that is allocated ECI as a partner in
a partnership, or a foreign grantor trust that is allocated ECI
as a partner.
If you are acting as a qualified intermediary (including a
QDD), withholding foreign partnership, or withholding foreign
trust, check the appropriate box and enter the EIN that was
issued to you in such capacity (your “QI-EIN,” “WP-EIN,” or
“WT-EIN”). If you are not acting in that capacity, you must
use your U.S. taxpayer identification number (TIN), if any,
that is not your QI-EIN, WP-EIN, or WT-EIN.
A nonqualified intermediary, a nonwithholding foreign
partnership, or a nonwithholding foreign simple or grantor
trust is generally not required to provide a U.S. TIN.
However, a QSL providing this form with respect to a U.S.
source substitute dividend must provide an EIN (including a
QI-EIN if the QSL is a QI).

If the disregarded entity receiving a withholdable

TIP payment has its own GIIN, Part II should be

completed regardless of whether it is in the same
country as the single owner identified in Part I.
If you have multiple branches/disregarded entities
receiving payments from the same withholding agent and the
information in Part I is the same for each branch/disregarded
entity that will receive payments, you may provide (and a
withholding agent may accept) a single Form W-8IMY with a
separate schedule attached that includes all of the Part II
information for each branch/disregarded entity rather than
separate Forms W-8IMY to identify each branch receiving
payments associated with the form. You must also provide

Line 9. If you are a participating FFI (including a reporting
Model 2 FFI), registered deemed-compliant FFI (including a
reporting Model 1 FFI and a sponsored FFI described in
Regulations section 1.1471-5(f)(1)(i)(F)), direct reporting
NFFE (including a sponsored direct reporting NFFE), or
trustee of a trustee documented trust that is a foreign person,
you are required to enter your GIIN (with regard to your
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Instructions for Form W-8IMY (Rev. 6-2017)

Complete line 15 only if you are acting as a QI that is not a
QDD. To the extent you are a QI acting as a QDD, see the
instructions for line 16.

the withholding agent with sufficient information to associate
the payments with each branch/disregarded entity.
If you are a QDD home office or you are a QI and have
one or more QDD branches, do not complete Part II for any
branches that are acting in their QDD capacities. Instead,
provide the relevant branch information that you would
otherwise provide on Part II (including the information
required for chapter 4 purposes, as required) on your
withholding statement.

Check box 15a if you have assumed primary withholding
responsibility under both chapter 3 and chapter 4 with
respect to the account(s). This box may be checked
regardless of which boxes you check for boxes 15b through
15f for any accounts identified on a withholding statement.
Check box 15b if you have assumed primary Form 1099
reporting and backup withholding responsibility with respect
to the accounts identified in a withholding statement
associated with this form or if you are a participating FFI or
registered deemed-compliant FFI that meets the
requirements to report only under Regulations sections
1.6049-4(c)(4)(i) and (c)(4)(ii). For accounts for which you
check this box 15b, you should not check boxes 15c through
15f.

Line 11. Check the one box that applies. If no box applies
to the disregarded entity, you do not need to complete Part II.
If you check reporting Model 1 FFI, reporting Model 2 FFI, or
participating FFI, you must complete line 13. If you are a
branch of a reporting IGA FFI that cannot comply with the
requirements of an applicable IGA or the regulations under
chapter 4, you must check branch treated as nonparticipating
FFI. If you are a QI that is an NFFE and a withholding agent
requests your chapter 4 status, you may provide a statement
certifying to your chapter 4 status as an NFFE.

If you checked boxes 15a and 15b with respect to

TIP any accounts, you do not have to provide a

Line 12. Enter the address of the branch or disregarded
entity.

withholding statement for payments made to those
accounts.

Line 13. If you are a reporting Model 1 FFI, a reporting
Model 2 FFI, or a participating FFI, you must enter on line 13
the GIIN of your branch that receives the payment. If you are
a disregarded entity that completed Part I, line 3 of this form
and are receiving payments associated with this form, enter
your GIIN. Do not enter your GIIN (if any) on line 9. If you are
a U.S. branch, do not enter a GIIN on line 13.

Check box 15c if you have not assumed primary Form
1099 reporting and backup withholding responsibility. If you
check box 15c, check the applicable certification(s) in 15d or
15e.
If you are allocating any portion of the payment on a
withholding statement to a chapter 4 withholding rate pool of
U.S. payees in lieu of providing Forms W-9, you must certify
by checking boxes 15d and/or 15e (as applicable):
For each account holder included in a chapter 4
withholding rate pool of U.S. payees who holds an account
that you maintain, you are permitted to provide this pool
under Regulations section 1.6049-4(c)(4)(iii) (including for
payments of income other than interest for which reporting
would be required under chapter 61 but for a coordination
rule similar to that provided in Regulations section
1.6049-4(c)(4)(iii)); and/or
For a withholding rate pool of U.S. payees that includes
account holders of another intermediary or flow-through
entity, you have obtained or will obtain documentation to
establish that the intermediary or flow-through entity is a
participating FFI, registered deemed-compliant FFI, or a
qualified intermediary. See Regulations sections 1.1471-3(d)
(4) and 1.1471-3(e) for more information on the requirements
for documenting such chapter 4 statuses.

If you are in the process of registering your branch

TIP with the IRS but have not received a GIIN, you may

complete this line by writing “applied for.” However,
the person requesting this form from you must receive and
verify your GIIN within 90 days.

Certification of Chapter 3 Status:
Parts III Through VIII

You should only complete one part from Parts III through VIII.
Generally, if you are acting in multiple capacities, you should
provide separate Forms W-8IMY for each capacity. For
example, if you are acting as a qualified intermediary for one
account, but a nonqualified intermediary for another account,
you should provide one Form W-8IMY in your capacity as a
qualified intermediary and a separate Form W-8IMY in your
capacity as a nonqualified intermediary.
You may, however, provide a single Form W-8IMY that
covers more than one category of QI provided that you
properly identify the accounts and/or transactions, as
required, on a withholding statement. For example, if you are
a QI that acts as both a QI and a QDD, you may provide a
single Form W-8IMY with a withholding statement
designating each type of account or transaction.

A payment that is subject to chapter 3 withholding or
that should be subject to chapter 4 withholding may
CAUTION not be included in a U.S. payee pool that is described
in Regulations section 1.6049-4(c)(4)(ii).

!

Although, as a QI, you obtain withholding certificates or
appropriate documentation from beneficial owners or
payees, as specified in your QI agreement, you do not need
to attach the certificates or documentation to this form.
However, to the extent you have not assumed primary Form
1099 reporting or backup withholding responsibility and are
not permitted to allocate the payment to a chapter 4
withholding rate pool of U.S. payees under Regulations
section 1.6049-4(c)(4)(iii), you must disclose the names of
those U.S. persons for whom you receive reportable amounts
and that are not exempt recipients (as defined in Regulations
section 1.6049-4(c)(1)(ii) or under section 6041, 6042, 6045,
or 6050N). You should make this disclosure by attaching to

Part III — Qualified Intermediary

Check box 14 if you are a qualified intermediary (QI)
(whether or not you assume primary withholding
responsibility) for the payments for which you are providing
this form. By checking the box, you are certifying to the
applicable statements contained on line 14. See the QI
agreement for the definition of “account” for purposes of Part
III.

Instructions for Form W-8IMY (Rev. 6-2017)

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Form W-8IMY the Forms W-9 (or substitute forms) of
persons that are U.S. non-exempt recipients. If you do not
have a Form W-9 for a non-exempt U.S. payee, you must
attach to Form W-8IMY any information you do have
regarding that person’s name, address, and TIN for a
withholding agent to report the payment.

QDD branch of a U.S. person. If you are a foreign branch
of a U.S. person that is acting as a QDD and you receive a
payment that otherwise would be subject to withholding
except for the U.S. person’s status as a U.S. person, you
may associate this Form W-8IMY with a Form W-9 from the
U.S. person.

Check box 15f to certify that you are a QI that is acting as
a QSL with respect to all payments associated with this form
that are U.S. source substitute dividends made by a party to
a securities lending transaction (as described in Notice
2010-46) for payments made before January 1, 2018.

Withholding statement of a QI. As a QI, you must provide
a withholding statement to each withholding agent from
which you receive reportable amounts or withholdable
payments if you have not assumed primary withholding
responsibility under chapter 3 and chapter 4 with respect to
the payment and, if you are receiving a reportable amount on
behalf of a U.S. non-exempt recipient, you have not assumed
primary Form 1099 reporting and backup withholding
responsibility for the payment. The withholding statement
becomes an integral part of the Form W-8IMY and, therefore,
the certification statement that you sign in Part XXIX of the
form applies to the withholding statement as well as to the
form.

Check line 15g to certify that you are a QI that is assuming
primary withholding responsibility under chapter 3 and
chapter 4 and primary Form 1099 reporting and backup
withholding responsibility with respect to all payments
associated with this form that are U.S. source interest and
substitute interest payments, as permitted by (and described
in) the QI agreement. You may act as a QI with respect to
such substitute interest payments under the QI agreement
regardless of whether you are acting in a principal or
intermediary capacity with respect to payments of interest
and substitute interest you receive that are associated with
this form.

A QI withholding statement must:
Designate those accounts for which you act as a QI,
Designate those accounts for which you are assuming
primary withholding and reporting responsibility under
chapter 3 and chapter 4 of the Code,
If applicable, designate those accounts or payments for
which you are acting as a QSL with respect to any U.S.
source substitute dividends, and
Provide information to allocate the payment, as applicable,
to chapter 3 withholding rate pools, chapter 4 withholding
rate pools, or other pools of payees permitted under the
chapter 4 regulations. See Regulations section 1.1471-3(c)
(3)(iii)(B)(2).
For chapter 4 purposes. If you are a QI and you receive
a withholdable payment, you must provide a withholding
statement which satisfies the requirements of an FFI
withholding statement or chapter 4 withholding statement (if
you are not an FFI) when you do not assume primary
withholding responsibility under chapter 3 and chapter 4 and
Form 1099 reporting and backup withholding responsibility
for the payment.
If you are a QI that is an FFI you may provide an FFI
withholding statement to allocate the payment to chapter 4
withholding rate pools (as applicable) or other pool of payees
permitted on an FFI withholding statement under the
chapter 4 regulations. See Regulations section 1.1471-3(c)
(3)(iii)(B)(2). You may also provide on the withholding
statement a single pool of nonparticipating FFIs, a single pool
of recalcitrant account holders of yours or of or another
intermediary that is a participating FFI or registered
deemed-compliant FFI, and, if you do not assume primary
Form 1099 and backup withholding responsibility, a
chapter 4 withholding rate pool of U.S. payees. A chapter 4
withholding rate pool of U.S. payees may include:
If you are a reporting Model 1 FFI, an account holder that
is not withheld on under chapter 3, chapter 4, or section 3406
that you report as a U.S. account pursuant to the Model 1
IGA because the account has U.S. indicia and you have not
obtained appropriate documentation to treat the account as
held by other than a specified U.S. person;
If you are a reporting Model 2 FFI, an account holder that
is not withheld on under chapter 3, chapter 4, or section 3406
that you report as an account holder of a non-consenting
U.S. account as described in the Model 2 IGA;
If you are a non-U.S. payor (as described in Regulations
section 1.6049-5(c)(5)) that is a participating FFI (including a

Line 16a. Check the box in line 16a to certify that each QDD
identified on the form or on the withholding statement that is
acting as a QDD meets the requirements to act as a QDD in
Regulations section 1.1441-1(e)(6) and assumes primary
withholding and reporting responsibilities under chapters 3,
4, and 61, and section 3406 with respect to potential section
871(m) transactions.
A QI that is acting as a QDD should provide this
Form W-8IMY only for payments in respect of
CAUTION potential section 871(m) transactions and underlying
securities. To certify your foreign status for any other
payment of U.S. source income you beneficially own, see
Who Must Provide Form W-8IMY, earlier.

!

Line 16b. Check the box to indicate your status, including if
you are a QDD that is a disregarded entity claiming treaty
benefits. If the QDD is a branch other than a disregarded
entity (that is, a branch that is not a separate legal entity from
its home office), check the box to indicate the status of the
entity identified in Part I.
Claim of treaty benefits. If you are acting as a QDD, you
may be entitled to claim treaty benefits for certain payments
that are subject to withholding that you receive in your
principal capacity (for example, interest payments or
payments of dividends beginning in 2018). To make a claim
for treaty benefits in such a case, you may provide your
withholding agent a statement associated with your Form
W-8IMY that contains the information required in Part III of
Form W-8BEN-E, including (if applicable) a treaty claim by a
hybrid entity that is a disregarded entity that is identified on a
QDD's withholding statement described in the instructions to
Part II. Alternatively, a Form W-8BEN-E may be used for this
purpose.
If you are acting as a QDD and fiscally transparent in
your jurisdiction of organization, do not claim treaty
CAUTION benefits as described in these instructions. Instead,
you must include the withholding certificates or documentary
evidence of the owners claiming treaty benefits and provide
an allocation on the withholding statement.

!

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Instructions for Form W-8IMY (Rev. 6-2017)

$20 to NPFFI, a nonparticipating FFI that is an account
holder of the QI;
$10 each on behalf of two recalcitrant account holders of
the QI ($20 total), each with U.S. indicia (as described in
Regulations section 1.1441-7(b)(5)) associated with the
account;
$5 each on behalf of A and B, U.S. individual account
holders of the QI that the QI reports as U.S. accounts
pursuant to its chapter 4 reporting obligations as a
participating FFI ($10 total);
$10 on behalf of C, a U.S. exempt recipient that is not a
specified U.S. person and is an indirect account holder of the
QI (who beneficially owns the payment through an account
with another participating FFI);
$20 on behalf of D, a U.S. non-exempt recipient that is a
specified U.S. person who is an indirect account holder of the
QI (that beneficially owns the payment through an account
with a certified deemed-compliant FFI described in
Regulations section 1.1471-5(f)(2)); and
$10 each on behalf of two nonresident alien individuals
who are account holders of the QI, one of whom is entitled to
a 15% rate of withholding under an applicable income tax
treaty.
The dividend payment is both a withholdable payment
under chapter 4 and a reportable amount under chapter 3.
The QI assumes primary withholding and reporting
responsibility under chapter 3 and chapter 4 as well as
primary Form 1099 reporting and backup withholding
responsibility. As a result, the QI is not required to provide a
withholding statement allocating the payment to specific
payees or withholding rate pools. The QI will provide Form
W-8IMY and check boxes 14, 15a, and 15b.

reporting Model 2 FFI), registered deemed-compliant FFI, or
reporting Model 1 FFI, an account holder not withheld on
under chapter 4 or section 3406 who you report under
chapter 4 or an applicable IGA (including the account
holder’s TIN).
An FFI withholding statement must also identify each
intermediary or flow-through entity that is receiving a
payment on behalf of a payee and include such entity’s
chapter 4 status and GIIN (if applicable), excluding any
intermediary or flow-through entity that is an account holder
or interest holder in another QI, WP, or WT. An FFI
withholding statement of a QI may combine withholding rate
pool information provided by such an entity to the QI with
withholding rate pools comprised of accounts that the QI
maintains.
If you are a QI that is not an FFI and that does not assume
primary withholding responsibility under chapter 3 and
chapter 4, you must provide, for a withholdable payment, a
chapter 4 withholding statement that contains the name,
address, TIN (if any), entity type (if applicable), and chapter 4
status of each payee, the amount allocated to each payee, a
valid withholding certificate or other documentation sufficient
to establish the payee’s chapter 4 status. However, a
chapter 4 withholding statement may include pooled
information for payees that are nonparticipating FFIs that
hold accounts that you maintain or hold accounts with an
intermediary or flow-through entity receiving the payment
from you. You may also provide another pool of payees as
permitted under the chapter 4 regulations for a chapter 4
withholding statement. See Regulations section 1.1471-3(c)
(3)(iii)(B).
For chapter 3 purposes. In the case of a reportable
amount that is a withholdable payment, any portion of the
payment for which you are acting as a QI that is not allocated
to a chapter 4 withholding rate pool or a U.S. non-exempt
recipient (including for backup withholding purposes) must
be allocated to a chapter 3 withholding rate pool or pool of
U.S. exempt recipients, if it is not required to be separately
reported. The chapter 3 withholding rate pool may be
established by any reasonable method agreed upon by you
and the withholding agent. For example, you may agree to
establish a separate account for a single chapter 3
withholding rate pool or you may agree to divide a payment
made to a single account into portions allocable to each
chapter 3 withholding rate pool. You must provide the
chapter 3 withholding rate pool information that is required for
the withholding agent to meet its withholding and reporting
obligations. A withholding agent may request any information
reasonably necessary to withhold and report payments
correctly.
Form 1099 reporting. If you do not assume primary Form
1099 reporting and backup withholding responsibility, you
must provide payee specific information for each U.S.
non-exempt recipient account holder (other than those U.S.
payees included in a chapter 4 withholding rate pool of U.S.
payees (described in Regulations section 1.6049-4(c)(4)(iii))
or when the alternative procedure is used. The pools are
based on valid documentation that you obtain or, if a
payment cannot be reliably associated with valid
documentation, the applicable presumption rules.

Example 2. The facts are the same as Example 1,
except QI is a non-U.S. payor under Regulations section
1.6049-5(c)(5) and does not assume primary Form 1099 and
backup withholding responsibility but reports the accounts of
A and B as U.S. accounts under Regulations section
1.1471-4(d).
The QI must provide a withholding statement allocating
$20 of the payment to D, $10 to C, and $10 to a chapter 4
withholding rate pool of U.S. payees. The QI need not
allocate any portion of the payment specifically to A or B
because the QI is a non-U.S. payor that is permitted to
include A and B in a chapter 4 withholding rate pool of U.S.
payees under Regulations section 1.6049-4(c)(4)(i). For
payments made on or after April 1, 2017, see the instructions
to Part IV of this form for when a withholding statement
includes an allocation of a payment of an amount subject to
chapter 3 withholding that is made to a pool of U.S. payees.
The QI must also provide a Form W-9 (or alternatively, name
and TIN) for D. A Form W-9 is not required for C. The QI will
provide Form W-8IMY and check boxes 14, 15a, and 15d.
Example 3. The facts are the same as Example 1, except
the QI is a U.S. payor and does not assume primary Form
1099 and backup withholding responsibility.
Because the QI is a U.S. payor, it is not permitted, under
Regulations section 1.6049-4(c)(4)(i) and (iii), to include A
and B in a chapter 4 withholding rate pool of U.S. payees.
The QI must provide a withholding statement allocating $5 of
the payment to A, $5 of the payment to B, $10 of the payment
to C, and $20 of the payment to D along with Forms W-9 (or
name and TIN) for A, B, and D. The QI will provide Form
W-8IMY and check boxes 14 and 15a.

Example 1. A QI that is a participating FFI receives a
$100 payment of U.S. source dividends on an account for
which it acts as a QI held with the withholding agent for the
following recipients:

Instructions for Form W-8IMY (Rev. 6-2017)

-11-

potential section 871(m) transactions or underlying securities
(as defined in Regulations section 1.871-15(a)(15)),
respectfully, as a QDD;
Designate the accounts for which the QDD is receiving
dividend equivalents with respect to potential section 871(m)
transactions as a QDD (and that are not underlying
securities) for which withholding is not required;
Designate the accounts for which the QDD is receiving
payments with respect to underlying securities for which
withholding is required as a QDD; and
Identify the home office or branch that is treated as the
owner for U.S. income tax purposes.
If you are acting as a QDD that meets the conditions
described below, you must provide on your QDD withholding
statement your taxpayer identification number (TIN) issued
by the jurisdiction in which you are tax resident identified on
line 6, unless you were not issued a TIN (including if the
jurisdiction does not issue TINs). If you do not provide your
TIN, you must provide on your QDD withholding statement
an explanation of why you have not been issued a TIN. For
this purpose, an explanation is a statement that you are not
legally required to obtain a TIN in your jurisdiction of tax
residence. Do not write “not applicable.” If you are acting as a
QDD, you are required to provide your TIN or an explanation
of why you have not been issued a TIN if:
You are providing this Form W-8IMY to document yourself
as an account holder (as defined in Regulations section
1.1471-5(a)(3)) with respect to a financial account (as
defined in Regulations section 1.1471-5(b)) that you hold at a
U.S. office of a financial institution (including a U.S. branch of
an FFI);
You receive U.S. source income reportable on a Form
1042-S associated with this form; and
This form is treated as a beneficial owner withholding
certificate under Regulations section 1.1441-1(e)(2)(i).

Example 4. The facts are the same as Example 1,
except the QI is a non-U.S. payor that does not assume
primary withholding and reporting responsibility under
chapter 3 and chapter 4. The QI also does not assume
primary Form 1099 and backup withholding responsibility.
If the QI does not assume primary withholding and
reporting responsibility under chapter 3 and chapter 4 as well
as primary Form 1099 reporting and separate backup
withholding responsibilities, the QI will provide an FFI
withholding statement with the following pools:
Nonparticipating FFI Pool — $20 (which is subject to
chapter 4 withholding);
Recalcitrant Account Holder Pool — $20 (which is subject
to chapter 4 withholding and which is aggregated in a single
pool of recalcitrant account holders rather than each class
described in Regulations section 1.1471-4(d)(6));
Chapter 4 Withholding Rate Pool of U.S. Payees — $10
(for the portion of the payment allocable to A and B);
Chapter 3 30% Rate Pool — $10;
Chapter 3 15% Rate Pool — $10; and
0% Rate Pool — $10 (for the portion of the payment
allocable to C).
The QI will also be required to allocate $20 to a separate
withholding rate pool for D because D is a U.S. non-exempt
recipient who cannot be included in a chapter 4 withholding
rate pool of U.S. payees (because D’s account is maintained
by a certified deemed-compliant FFI). The QI will provide
Form W-8IMY and check boxes 14, 15c, and 15d.
Alternative procedure for U.S. non-exempt recipients.
If approved by the withholding agent, you can establish:
A single pool (not subject to backup withholding) for all
U.S. non-exempt recipient account holders for whom you
have provided Forms W-9 or are includible in a chapter 4
withholding rate pool of U.S. payees prior to the withholding
agent making any payments. Alternatively, you may include
such U.S. non-exempt recipients in a zero rate withholding
pool that includes U.S. exempt recipients and foreign
persons exempt from non-resident alien withholding provided
all the conditions of the alternative procedure are met; and
A separate pool for all U.S. non-exempt recipient account
holders subject to backup withholding for whom you have not
provided Forms W-9 prior to the withholding agent making
any payments.
If you elect the alternative procedure, you must provide
the allocation information required by your QI withholding
agreement to the withholding agent no later than January 15
of the year following the year in which the payments are paid.
Failure to provide this information may result in penalties
under sections 6721 and 6722 and termination of your
withholding agreement with the IRS.

!

CAUTION

Part IV — Nonqualified Intermediary

If you are providing Form W-8IMY as a nonqualified
intermediary (NQI), you must check box 17a. By checking
this box, you are certifying to all of the statements on
line 17a.

If you are required to provide a chapter 4 status on

TIP line 5 and are acting as an intermediary for a

withholdable payment, you must provide your
chapter 4 status on line 5 or as otherwise permitted in these
instructions to avoid withholding at the chapter 4 rate of 30%
being applied to any withholdable payment you receive from
the withholding agent regardless of whether you check
box 17b (except for documentation provided with respect to
exempt beneficial owners).

The amount allocable to these two pools under the
alternative procedure excludes amounts allocated to
the chapter 4 withholding rate pool of U.S. payees.

Check box 17b if you are using this form to transmit
withholding certificates or other documentation along with a
withholding statement that satisfies the requirements of
chapters 3 and 4 (including if you are providing pooled
information for purposes of chapter 61 under the alternative
procedure for U.S. non-exempt recipients, or chapter 4
withholding rate pools (as applicable) for a withholdable
payment).

Updating the statement. Your withholding statement must
be updated as often as is necessary to allow the withholding
agent to withhold at the appropriate rate on each payment
and to correctly report the income to the IRS. The updated
information becomes an integral part of Form W-8IMY.

Check box 17c to certify that you are permitted under
Regulations section 1.6049-4(c)(4) to provide a chapter 4
withholding rate pool of U.S. payees to which a payment is
allocated on a withholding statement associated with the
Form W-8IMY.

QDD withholding statement. In addition to the information
required on a withholding statement (if any) you provide in
your QI capacity, a QDD withholding statement should (as
applicable) for each QDD:
Designate the accounts for which the QDD is receiving
dividend equivalent or dividend payments with respect to
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Instructions for Form W-8IMY (Rev. 6-2017)

withholding statement must also identify each intermediary or
flow-through entity that is receiving a payment (excluding any
intermediary or flow-through entity that is an account holder
or interest holder in a QI, WP, or WT), each such entity’s
chapter 4 status and GIIN (if applicable), and the chapter 4
withholding rate pools associated with each such entity
receiving the payment.

Check box 17d to certify that you are acting as a QSL with
respect to the accounts identified on this line or in a
withholding statement associated with this form with respect
to a payment that is a U.S. source substitute dividend.
If you are acting on behalf of another NQI or on behalf of a
foreign partnership or foreign trust that is not a withholding
foreign partnership or a withholding foreign trust, you must
attach to your Form W-8IMY the Form W-8IMY of the other
NQI, foreign partnership, or foreign trust together with the
withholding certificates and other documentation attached to
that Form W-8IMY that are required for both chapter 3 and
chapter 4 purposes.

A payment that is subject to chapter 3 withholding or
that should be subject to chapter 4 withholding
CAUTION should not be included in a U.S. payee pool that is
described in Regulations section 1.6049-4(c)(4)(ii). For
payments made on or after April 1, 2017, an allocation of a
payment of an amount subject to chapter 3 withholding to a
withholding rate pool of U.S. payees must identify the payees
as described in Regulations section 1.1471-3(c)(3)(iii)(B)(2).

!

Withholding statement of an NQI. If you are an NQI, you
must provide a withholding statement and appropriate
documentation to obtain reduced rates of withholding for your
customers under chapter 3 and chapter 61 and to avoid
certain reporting responsibilities. However, see the
paragraph later describing an NQI’s withholding statement
for chapter 4 purposes for when an NQI may provide a
chapter 4 withholding rate pool of U.S. payees without such
documentation. The withholding statement must be provided
prior to a payment and becomes an integral part of the Form
W-8IMY and, therefore, the certification statement that you
sign in Part XXIX of the form applies to the withholding
statement as well as to the form.
For chapter 4 purposes. If you are an NQI that is a
participating FFI or registered deemed-compliant FFI and
you receive a withholdable payment, you must provide a
withholding statement which satisfies the requirements of an
FFI withholding statement or chapter 4 withholding
statement.
An FFI withholding statement may allocate the payment to
chapter 4 reporting rate pools (as appropriate), including a
chapter 4 withholding rate pool for nonparticipating FFIs,
recalcitrant account holders (in each class of account holders
described in Regulations section 1.1471-4(d)(6)(i)), or other
pool of payees permitted on an FFI withholding statement
under the chapter 3 or 4 regulations (see Regulations
sections 1.1471-3(c)(3)(iii)(B) and 1.1441-1(e)(3)(iv)(C)),
and, for a participating FFI (including a reporting Model 2 FFI)
or a registered deemed-compliant FFI (including a reporting
Model 1 FFI), U.S. payees. However, if you are an NQI, you
may allocate a portion of a reportable amount (regardless of
whether the payment is a withholdable payment) to a
chapter 4 withholding rate pool of U.S. payees when you
satisfy the requirements to provide such a pool (including the
requirement to certify to your status as a participating FFI
(including a reporting Model 2 FFI) or registered
deemed-compliant FFI (including a reporting Model 1 FFI)).
The withholding statement must also identify each
intermediary or flow-through entity that is receiving a
payment (excluding any intermediary or flow-through entity
that is an account holder or interest holder in a QI, WP, or
WT), each such entity’s chapter 4 status and GIIN (if
applicable), and the chapter 4 withholding rate pools
associated with each such entity receiving the payment.
A chapter 4 withholding statement must contain the name,
address, TIN (if any), entity type, chapter 4 status of each
payee, the amount allocated to each payee, and a valid
withholding certificate or other documentation sufficient to
establish each payee’s chapter 4 status. However, a
chapter 4 withholding statement may instead include pooled
information for payees that are nonparticipating FFIs or
another pool of payees as permitted under the chapter 4
regulations for a chapter 4 withholding statement. The
Instructions for Form W-8IMY (Rev. 6-2017)

For chapter 3 and chapter 61 purposes. For chapter 3
and chapter 61 purposes, in the case of a reportable amount
that is also a withholdable payment, the withholding
statement should allocate only the portion of the payment
that was not allocated to a chapter 4 withholding rate pool or
a pool described in Regulations section 1.1441-1(e)(3)(iv)(C)
or to a payee identified on the withholding statement to whom
withholding was applied under chapter 4. The withholding
statement generally must include the following information.
Include the name, address, U.S. TIN (if any), chapter 4
status (for a foreign person receiving a withholdable
payment), and the type of documentation (documentary
evidence, Form W-9, or type of Form W-8) for every person
for whom documentation has been received and state
whether that person is a U.S. exempt recipient, a U.S.
non-exempt recipient, or a foreign person. The statement
must indicate whether a foreign person is a beneficial owner
or an intermediary, flow-through entity, U.S. branch, or
territory financial institution and the type of recipient, based
on the recipient codes shown on Form 1042-S.
Allocate each payment by income type to every payee for
whom documentation has been provided. The type of income
is based on the income codes reported on Form 1042-S (or,
if applicable, the income categories for Form 1099). If a
payee receives income through another NQI, flow-through
entity, or U.S. branch acting as an intermediary, the
withholding certificate must also state the name, address,
U.S. TIN (if known), and, for a withholdable payment, the
chapter 4 status (if required) and GIIN (if applicable) of the
other NQI or U.S. branch from which the payee directly
receives the payment or the flow-through entity in which the
payee has a direct ownership interest. If another NQI,
flow-through entity, or U.S. branch fails to allocate a
payment, you must provide, for that payment, the name of
the NQI, flow-through entity, or U.S. branch that failed to
allocate the payment.
If a payee is identified as a foreign person, specify the rate
of withholding under chapter 3 to which the payee is subject,
the payee’s country of residence and, if a reduced rate of
withholding is claimed, the basis for that reduced rate (for
example, treaty benefit, portfolio interest, or exemption under
section 501(c)(3), 892, or 895). The statement must also
include the U.S. or foreign TIN (if required) and, if the
beneficial owner is not an individual and is claiming treaty
benefits, state whether the limitation on benefits and section
894 statements have been provided by the beneficial owner.
You must inform the withholding agent as to which payments
those statements relate.
Include any other information the withholding agent
requests in order to fulfill its withholding and reporting
-13-

required to include information that is already on the
withholding certificates (including name, address, TIN,
chapter 4 status, and GIIN), and you are not required to
provide the rate of withholding applicable to each beneficial
owner, so long as the withholding agent can determine the
appropriate rate based on the withholding certificates. Just
as for a nonqualified intermediary withholding statement, the
alternative withholding statement must provide information
for allocating the payment to each payee and must include
any other information the withholding agent needs to fulfill its
withholding and reporting obligations. You must also provide
a representation on the alternative withholding statement that
the information on the withholding certificates is not
inconsistent with any other account information you have for
the beneficial owner applicable to determining the
appropriate rate of withholding. See Regulations section
1.1441-1T(e)(3)(iv)(C)(3).

obligations under chapters 3 and 4 of the Code and/or Form
1099 reporting and backup withholding responsibility.
Alternative procedure for NQIs. To use the alternative
procedure you must inform the withholding agent on your
withholding statement that you are using the procedure, and
the withholding agent must agree to the procedure.
Under this procedure, you must provide a withholding
agent with all the information required on the withholding
statement and all payee documentation, except the specific
allocation information for each payee, prior to the payment of
a reportable amount. In addition, you must provide the
withholding agent with withholding rate pool information. The
withholding statement must assign each payee that is not
subject to withholding under chapter 4 to a chapter 3
withholding rate pool prior to the payment of a reportable
amount. The withholding rate pool may be established by any
reasonable method agreed upon by you and the withholding
agent. For example, you may agree to establish a separate
account for a single withholding rate pool, or you may agree
to divide a payment made to a single account into portions
allocable to each withholding rate pool. You must determine
withholding rate pools based on valid documentation or, to
the extent a payment cannot be reliably associated with valid
documentation, the applicable presumption rules.
You must provide the withholding agent with sufficient
information to allocate the income in each withholding rate
pool to each payee (including U.S. exempt recipients) within
the pool no later than January 31 of the year following the
year of payment. If you fail to provide allocation information, if
required, by January 31 for any withholding rate pool, you
may not use this procedure for any payment made after that
date for all withholding rate pools. You may remedy your
failure to provide allocation information by providing the
information to the withholding agent no later than February
14.
In the case of a reportable amount that is also a
withholdable payment, you may include amounts allocable to
a chapter 4 withholding rate pool (other than a chapter 4
withholding rate pool of U.S. payees) and payees subject to
chapter 4 withholding for whom you will provide payee
specific information in a 30-percent rate pool together with
payees subject to chapter 3 withholding at the 30-percent
rate and may not otherwise apply these provisions for
payments made to U.S. non-exempt recipients (regardless of
whether the payment is a withholdable payment). For the
amount of the payment allocable to a chapter 4 withholding
rate pool of U.S. payees, you may include such an amount in
the withholding rate pool that is exempt from withholding (you
can include such payees in an exempt pool regardless of
whether the payment is a withholdable payment). You must
identify prior to the payment each chapter 4 withholding rate
pool to be allocated a portion of the payment and must also
allocate by January 31 the portion of the payment to each
such pool in addition to allocating the payment to each other
payee as described in the preceding paragraph. See
Regulations section 1.1441-1(e)(3)(iv)(D) for further
information on alternative procedures for an NQI.
Alternative withholding statement. If a withholding
agent agrees, instead of providing a withholding statement
that contains all of the information described previously, you
may provide an alternative withholding statement. You may
only use an alternative withholding statement if you are
providing the withholding agent with withholding certificates
(and not documentary evidence) from the beneficial owners
of the payment. The alternative withholding statement is not

Part V — Territory Financial
Institution
Line 18

Check box 18a to certify that you are a financial institution
(other than an investment entity that is not also a depository
institution, custodial institution, or specified insurance
company) incorporated or organized under the laws of a
possession of the United States.
You must also check either box 18b or 18c. Check
box 18b to certify that you have agreed to be treated as a
U.S. person for purposes of both chapter 3 and chapter 4
with respect to payments associated with this Form W-8IMY.
In this case, you will be responsible for chapter 3 withholding
and reporting, backup withholding under section 3406, and
chapter 4 withholding and reporting for any payments you
make to persons for whom you are receiving a reportable
amount or withholdable payment. If you check this box 18b,
you must provide an EIN on line 8.
Check box 18c to certify that you are a territory financial
institution that has not agreed to be treated as a U.S. person.
You must certify that you are transmitting withholding
certificates or other documentation for persons for whom you
are receiving a payment (as required for chapter 3,
chapter 61, and section 3406 purposes, and, in the case of a
withholdable payment, for chapter 4 withholding and
reporting purposes). You must also certify that you have
provided or will provide a withholding statement (as required)
with the information required on an NQI withholding
statement.
A territory entity that is a flow-through entity but is not
a territory FI may not complete this Part V and agree
CAUTION to be treated as a U.S. person. Instead, complete
Part IV or Part VIII, as appropriate.

!

Part VI — Certain U.S. Branches
Line 19

Check box 19a to certify that you are a U.S. branch
described in Regulations section 1.1441-1(b)(2)(iv) receiving
income that is not effectively connected with the conduct of a
trade or business in the United States.
You must also check either box 19b or 19c. Check
box 19b to certify that you are a U.S. branch of a foreign bank
or insurance company described in this certification that has

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Instructions for Form W-8IMY (Rev. 6-2017)

Note. If you are receiving income that is effectively
connected with the conduct of a trade or business in the
United States, provide Form W-8ECI (instead of Form
W-8IMY). If you are not receiving the income on behalf of
your partners, beneficiaries, or owners, do not complete Part
VIII. If you are a hybrid entity claiming treaty benefits, provide
Form W-8BEN-E. However, if you are receiving a
withholdable payment you may also be required to provide
this Form W-8IMY and provide your chapter 4 status and the
chapter 4 status of each of your owners. See the instructions
for Form W-8BEN-E for more information about hybrid
entities claiming treaty benefits.
If you are receiving a withholdable payment, you must
provide a chapter 4 status in line 5 and provide your GIIN (if
applicable) and the information required for the withholding
agent to report under section 1472.

agreed with the withholding agent to be treated as a U.S.
person with respect to payments associated with this Form
W-8IMY. In such case, you will be responsible for chapter 3
withholding and reporting, backup withholding under section
3406, chapter 4 withholding and reporting for any payments
you make to persons for whom you are receiving a
withholdable payment (including any of your branches
treated as NPFFIs), and will be treated as a U.S. payor for
chapter 61 purposes. You must provide your EIN on line 8.
You do not need to provide a chapter 4 status on line 5 or a
GIIN on line 9.
Check box 19c to certify that you are a U.S. branch that
does not have an agreement with the withholding agent to be
treated as a U.S. person. You must certify that you are
transmitting withholding certificates or other documentation
for persons for whom you are receiving the payment. You
must also certify that you have provided or will provide a
withholding statement (as required) with the information
required on an NQI withholding statement. For payments
made on or after July 1, 2017, also check box 19c to certify
that, when you are receiving a withholdable payment
associated with this form, you are applying the rules
described in Regulations section 1.1471-4(d)(2)(iii)(C). You
must also provide your EIN on line 8 but do not need to
include a chapter 4 status in Part I, line 5 or a GIIN on line 9.
If you are unable to make this certification, you cannot fill out
this part but instead must check the box on line 5 indicating
you are a nonparticipating FFI.

Withholding statement of nonwithholding foreign partnership or nonwithholding foreign trust. You must
provide the withholding agent with a withholding statement to
obtain reduced rates of withholding and relief from certain
reporting obligations. The withholding statement must
provide the same information as required for an NQI
withholding statement, including the information required with
respect to an NQI, foreign partnership, or foreign trust (other
than a WP or WT) for which you receive a payment. The
withholding statement becomes an integral part of the Form
W-8IMY. If you are an FFI and allocate any portion of the
payment to a chapter 4 withholding rate pool of U.S. payees
with respect to accounts that you maintain, you must meet
the requirements of Regulations section 1.6049-4(c)(4)(iii)
and certify to your status in Part I, line 5 as a participating
FFI, registered deemed-compliant FFI, reporting Model 1 FFI,
or reporting Model 2 FFI. By providing a withholding
statement making such an allocation with this form, you
certify that you meet the requirements outlined for an NQI
withholding statement described earlier.

Part VII — Withholding Foreign
Partnership (WP) or Withholding
Foreign Trust (WT)

Check box 20 if you are a WP or a WT and you are receiving
the payment on behalf of your partners, beneficiaries, or
owners.

Foreign partnerships and trusts providing Form W-8IMY
for purposes of section 1446. In general, a partnership is
required to withhold under section 1446 on effectively
connected taxable income (ECTI) allocable to a foreign
partner. A foreign upper-tier partnership (UTP) that is a
partner in a lower-tier partnership (LTP) should provide the
LTP with a Form W-8IMY and documentation sufficient for
the LTP to determine the status of the indirect partner to
whom the ECTI is allocable (looking through additional
foreign UTPs, if applicable) and to determine such partner’s
share of the lower-tier partnership’s ECTI.
A foreign grantor trust that is a partner in a partnership
should provide Form W-8IMY to the partnership along with
documentation and information concerning the grantor or
other owner sufficient for the partnership to reliably associate
the portion of the trust’s allocable share of ECTI with the
grantor or other owner.
Check line 21b to certify that you are a foreign partnership
or grantor trust providing this Form W-8IMY to a lower-tier
partnership for purposes of section 1446.

If you are acting as a WP or WT, you must assume
primary withholding and reporting responsibility under
chapter 3 and chapter 4 for all payments that are made to
you for your partners, beneficiaries, or owners. Therefore,
you are not required to provide information to the withholding
agent regarding each partner’s, beneficiary’s, or owner’s
distributive share of the payment and the information for the
withholding agent to report under section 1472 (if otherwise
required). If you are also receiving payments from the same
withholding agent for persons other than your partners,
beneficiaries, or owners, you must provide a separate Form
W-8IMY for those payments. If you are receiving a
withholdable payment, you must provide your chapter 4
status in line 5 and provide your GIIN (if applicable).

Part VIII — Nonwithholding Foreign
Partnership, Simple Trust, or Grantor
Trust

Check box 21a if you are a foreign partnership or a foreign
simple or grantor trust that is not a WP or WT. Check box 21b
if you are a foreign partnership or foreign grantor trust
providing this form for purposes of section 1446. If you are a
foreign partnership or grantor trust receiving payments of
reportable amounts and providing this form for purposes of
section 1446, you may check both boxes. By checking either
box, you are certifying to the applicable statements on the
form.

Instructions for Form W-8IMY (Rev. 6-2017)

If you are providing this Form W-8IMY solely for

TIP purposes of section 1446, you generally are not

required to provide a chapter 4 status because items
of effectively connected income are not withholdable
payments. However, if you do not provide a chapter 4 status
and subsequently receive a withholdable payment, you will
also be required to provide a Form W-8IMY to provide your
chapter 4 status or the lower-tier partnership may have to
-15-

participating FFI, or a reporting Model 1 FFI that has agreed
to act as a designated withholding agent with respect to you
(see Regulations section 1.1471-5(f)(3)).

withhold on the payment. You may provide your chapter 4
status on this form even if you are not required to do so.

Certification of Chapter 4 Status:
Parts IX Through XXVIII

You must also check either box 24b or 24c. Check
box 24b to certify that you have provided or will provide the
documentation set forth in the certifications, including the
owner reporting statement described in this line 24b. Check
box 24c to certify that you have provided or will provide an
auditor’s letter (in lieu of the information required by
line 24(b)) that satisfies the requirements described in this
line.

You should complete only one part certifying to your
chapter 4 status (if required). Identify which part (if any) you
should complete by reference to the box you checked on
line 5.

Part IX — Nonparticipating FFI With
Exempt Beneficial Owners

Part XII — Certified
Deemed-Compliant Nonregistering
Local Bank

You are not required to complete this part unless you

TIP are a nonparticipating FFI providing documentation
on behalf of an exempt beneficial owner.

You must check box 25 to certify that you satisfy all of the
requirements for certified deemed-compliant nonregistering
local bank status.

Check box 22 to certify that you are transmitting
withholding certificates or other documentation for exempt
beneficial owners for chapter 4 purposes on whose behalf
you are receiving a payment that is a withholdable payment.
See Regulations section 1.1471-6. You must also certify that
you have provided or will provide a withholding statement (as
required) allocating a portion of the payment to the exempt
beneficial owners as required under Regulations section
1.1471-3(d)(8)(ii). The withholding statement must include
the name, address, TIN (if any), entity type, and chapter 4
status of each exempt beneficial owner on behalf of which
you are receiving the payment, the amount of the payment
allocable to each exempt beneficial owner, a valid
withholding certificate or other documentation sufficient to
establish the chapter 4 status of each exempt beneficial
owner under the requirements of chapter 4, and any other
information the withholding agent reasonably requests in
order to fulfill its obligations under chapter 4. Additionally, the
withholding statement must provide all information required
for purposes of chapter 3 with respect to each exempt
beneficial owner if the payment is an amount subject to
chapter 3 withholding. The withholding statement must
allocate the remainder of the payment that is not allocated to
an exempt beneficial owner to you.

Part XIII — Certified
Deemed-Compliant FFI with Only
Low-Value Accounts

You must check box 26 to certify that you satisfy all of the
requirements for certified deemed-compliant FFI with only
low-value account status.

Part XIV — Certified
Deemed-Compliant Sponsored,
Closely Held Investment Vehicle

On line 27a, enter the name of the sponsoring entity that has
agreed to fulfill your chapter 4 due diligence, reporting, and
withholding obligations on your behalf. You must also enter
the GIIN of your sponsoring entity on line 9.
You must check box 27b to certify that you satisfy the
requirements for certified deemed-compliant classification as
a sponsored closely held investment vehicle.

Part XV — Certified
Deemed-Compliant Limited Life Debt
Investment Entity

Part X — Sponsored FFI

If you are a sponsored FFI described in Regulations section
1.1471-5(f)(1)(i)(F), on line 23a, enter the name of the
sponsoring entity that has agreed to fulfill your chapter 4 due
diligence, reporting, and withholding obligations on your
behalf. You must provide your GIIN on line 9.

You must check box 28 to certify that you satisfy the
requirements for certified deemed-compliant limited life debt
investment entity status.

Part XVI — Certain Investment
Entities that Do Not Maintain
Financial Accounts

You must check the applicable box in line 23b or 23c to
certify that you are either an investment entity or controlled
foreign corporation (within the meaning of section 957(a))
and satisfy the other relevant requirements for this
classification.

You must check box 29 to certify that you meet all of the
requirements for certified deemed-compliant status as an
investment entity that does not maintain financial accounts.

Part XI — Owner-Documented FFI
An owner-documented FFI should only complete
Form W-8IMY if it is a flow-through entity receiving
CAUTION income allocable to its partners, owners, or
beneficiaries. An owner-documented FFI is not permitted to
act as an intermediary with respect to a withholdable
payment.

Part XVII — Restricted Distributor

!

You must check box 30a to certify that you satisfy the
requirements of restricted distributor status.

You must also check either box 30b or 30c, as
appropriate, to certify that your distribution agreement meets
the requirements of this classification.

You must check box 24a to certify that you satisfy the
requirements for owner-documented FFI status and are
providing this form to a U.S. financial institution, a
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Instructions for Form W-8IMY (Rev. 6-2017)

Part XVIII — Foreign Central Bank of
Issue

Part XXII — Excepted Nonfinancial
Start-Up Company

You must check box 31 to certify that you are a foreign
central bank of issue acting as an intermediary and are an
entity defined in Regulations section 1.1471-6 that is treated
as the beneficial owner of the payment for chapter 4
purposes (applying the rule in Regulations section
1.1471-6(d)(4)). You cannot be treated as an intermediary for
purposes of this Part XVIII if you are receiving the payment in
connection with a commercial activity described in
Regulations section 1.1471-6(h)(1) or are not receiving
payments subject to chapter 3 withholding.

You must check box 35 to certify that you satisfy the
requirements of excepted nonfinancial start-up company
status. You must also provide the date you were formed or
your board passed a resolution (or equivalent measure)
approving a new line of business (which cannot be that of a
financial institution or passive NFFE).

Part XXIII — Excepted Nonfinancial
Entity in Liquidation or Bankruptcy

You must check box 36 to certify that you satisfy the
requirements of excepted nonfinancial entity in liquidation or
bankruptcy status. You must also provide the date that you
filed a plan of liquidation, plan of reorganization, or
bankruptcy petition.

Part XIX — Nonreporting IGA FFI

Check box 32 to indicate that you are treated as a
nonreporting IGA FFI. You must identify the IGA by entering
the name of the jurisdiction that has the applicable IGA in
effect with the United States and indicate whether it is a
Model 1 or a Model 2 IGA. You must also provide the
withholding agent with the specific category of entity
described in Annex II of the IGA applicable to your status. In
providing the specific category of FFI described in Annex II,
you should use the language from Annex II that best and
most specifically describes your status in the IGA. For
example, indicate “investment entity wholly owned by exempt
beneficial owners” rather than “exempt beneficial owner.” If
you are a nonreporting IGA FFI claiming a deemed-compliant
status under the regulations, you must instead indicate on
this line which section of the regulations you qualify under.

Part XXIV — Publicly Traded NFFE or
NFFE Affiliate of a Publicly Traded
Corporation

If you are a publicly traded NFFE, you must check box 37a to
certify that you are not a financial institution and provide the
name of a securities exchange on which your stock is
publicly traded. If you are an NFFE that is a member of the
same expanded affiliated group (as described in Regulations
section 1.1471-5(i)) as a publicly traded U.S. or foreign
entity, you must check box 37b to certify that you are a NFFE
affiliate of a publicly traded corporation, provide the name of
the publicly traded entity, and identify the securities market
on which the stock of the publicly traded entity is traded. See
Regulations section 1.1472-1(c)(1)(i) to determine if an entity
is publicly traded.

If you are a nonreporting financial institution under an
applicable IGA because you qualify as an
owner-documented FFI under the regulations, do not check
“Nonreporting IGA FFI.” Instead you must check
“Owner-documented FFI” and complete Part XI rather than
this Part XIX.

Part XXV — Excepted Territory NFFE

You must check box 38 to certify that you satisfy the
requirements for excepted territory NFFE status. See
Regulations section 1.1472-1(c)(1)(iii) for the definition of an
excepted territory NFFE.

See instructions for line 9 for when a GIIN is required for a
nonreporting IGA FFI (including a trustee of a
trustee-documented trust that is a foreign person).

Part XX — Exempt Retirement Plans

Part XXVI — Active NFFE

You must check the appropriate box to certify that you satisfy
the requirements of exempt retirement plan status.

You must check box 39 to certify that you satisfy the
requirements of active NFFE status.

If you are not a flow-through entity or acting as an
intermediary with respect to the payment for
CAUTION chapter 3 purposes, do not complete Form W-8IMY.
If you are the beneficial owner of the payment and are
claiming an exemption under sections 115(2), 892, or 895 as
well as exempt beneficial owner status under Regulations
section 1.1471-6 you should provide Form W-8EXP. If you
are receiving payments which do not qualify for a statutory
exemption from tax but for which you are claiming benefits
under an applicable income tax treaty, provide Form
W-8BEN-E.

Part XXVII — Passive NFFE

!

If you are a passive NFFE, you must check box 40 to certify
that you are not a financial institution (other than an
investment entity organized in a possession of the United
States). You must also certify that you have provided a
withholding statement associated with Form W-8IMY to the
extent you are required to provide a withholding statement.
Note. If you would be a passive NFFE but for the fact that
you are managed by certain types of FFIs (see Regulations
section 1.1471-5(e)(4)(i)(B)), you should not complete Part
XXVII as you would be considered a financial institution and
not a passive NFFE.

Part XXI — Excepted Nonfinancial
Group Entity

Part XXVIII— Sponsored Direct
Reporting NFFE

You must check box 34 to certify that you satisfy the
requirements of excepted nonfinancial group entity status.

If you are a sponsored direct reporting NFFE, you must
check the box on line 42 to certify that you are not a financial
institution and that you satisfy all relevant requirements for

Instructions for Form W-8IMY (Rev. 6-2017)

-17-

cannot provide the certifications in Parts IX through XXVIII,
do not check a box in line 5. However, if you determine your
status under the definitions of the IGA and can certify to a
chapter 4 status included on this form, you do not need to
provide the certifications described in this paragraph unless
required by the FFI to whom you are providing this form.

this classification. Enter the name of the sponsoring entity in
line 41.

Part XXIX — Certification

Form W-8IMY must be signed and dated by a person
authorized to sign a declaration under penalties of perjury on
behalf of the person whose name is on the form. By signing
Form W-8IMY the authorized representative, officer, or agent
also agrees to provide a new form within 30 days following a
change in circumstances (unless no future payments will be
made to the intermediary or flow-through entity by the
withholding agent and the requestor does not need an
updated form for chapter 4 purposes).

Any certifications provided under an applicable IGA
remain subject to the penalties of perjury statement and other
certifications made in Part XXIX.

Entities Providing Alternate or Additional
Certifications Under Regulations

If you qualify for a status that is not shown on of this form, you
may attach applicable certifications for such status from any
other Form W-8 on which the relevant certifications appear. If
the applicable certifications do not appear on any Form W-8
(if, for example, new regulations provide for an additional
status and this form has not been updated) then you may
provide an attachment certifying that you qualify for the
applicable status described in a particular Regulations
section. Include a citation to the applicable provision in the
Regulations. Any such attached certification becomes an
integral part of this Form W-8IMY and is subject to the
penalties of perjury statement and other certifications made
in Part XXIX.

A withholding agent may allow you to provide this form
with an electronic signature. The electronic signature must
indicate that the form was electronically signed by a person
authorized to do so (for example, with a time and date stamp
and a statement that the form has been electronically
signed). Simply typing your name into the signature line is not
an electronic signature.

Special Instructions
Entities Providing Certifications Under an
Applicable IGA (Do Not Complete Line 5)

An FFI in an IGA jurisdiction with which you have an account
may provide you with a chapter 4 status certification other
than as shown in Parts IX through XXVIII in order to satisfy its
due diligence requirements under the applicable IGA. In such
a case, you may attach the alternative certification to this
Form W-8IMY in lieu of completing a certification otherwise
required in Parts IX through XXVIII provided that you: (a)
determine that the certification accurately reflects your status
for chapter 4 purposes or under an applicable IGA; and (b)
the withholding agent provides a written statement to you that
it has provided the certification to meet its due diligence
requirements as a participating FFI or registered
deemed-compliant FFI under an applicable IGA. For
example, Entity A organized in Country A holds an account
with an FFI in Country B. Country B has a Model 1 IGA in
effect. The FFI in Country B may ask Entity A to provide a
chapter 4 status certification based on the terms of the
Country B IGA in order to fulfill its due diligence and
documentation requirements under the Country B IGA.

Paperwork Reduction Act Notice. We ask for the
information on this form to carry out the Internal Revenue
laws of the United States. You are required to provide the
information. We need it to ensure that you are complying with
these laws and to allow us to figure and collect the right
amount of tax.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their contents may become material in
the administration of any Internal Revenue law. Generally,
tax returns and return information are confidential, as
required by section 6103.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
burden for business taxpayers filing this form is approved
under OMB control number 1545-0123. The estimated
burden for all other taxpayers who file this form is shown
below. The estimated average time is: Recordkeeping,11
hr., 43 min.; Learning about the law or the form, 5 hr., 55
min.; Preparing the form, 7 hr., 34 min.

You may also provide with this form an applicable IGA
certification if you are determining your chapter 4 status
under the definitions provided in an applicable IGA and your
certification identifies the jurisdiction that is treated as having
an IGA in effect and describes your status as an NFFE or FFI
in accordance with the applicable IGA. However, if you
determine your status under an applicable IGA as an NFFE,
you must still determine if you are an excepted NFFE under
the regulations in order to complete this form unless you are
provided an alternative certification by an FFI described in
the preceding paragraph that covers your certification as an
NFFE (such as “active NFFE”) as defined in an applicable
IGA. Additionally, you are required to comply with the
conditions of your status under the law of the IGA jurisdiction
if you are determining your status under that IGA. If you

If you have comments concerning the accuracy of these
time estimates or suggestions for making this form simpler,
we would be happy to hear from you. You can send us
comments from IRS.gov/FormComments. You can write to
the Internal Revenue Service, Tax Forms and Publications,
1111 Constitution Ave. NW, IR-6526, Washington, DC
20224. Do not send Form W-8IMY to this office. Instead, give
it to your withholding agent.

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Instructions for Form W-8IMY (Rev. 6-2017)