Download:
pdf |
pdfForm
8966
FATCA Report
Department of the Treasury
Internal Revenue Service
▶
OMB No. 1545-2246
2020
Go to www.irs.gov/Form8966 for instructions and the latest information.
If you are filing paper Forms 8966, enter the three-digit identifier number used to identify this Form 8966 filing
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶
Check if report is being corrected, amended, voided, or there are no accounts to report:
Corrected report
Amended report
Voided report
Check if no accounts to report (see instructions)
Part I
Identification of Filer
1b Enter the filer category (see instructions) ▶
1a Name of filer
2
Number, street, and room or suite no. (if P.O. box, see instructions)
3a City or town
3b
3c Country, including postal code
State, province, or region
4 Global intermediary identification number (GIIN)
5 TIN
.
.
6 Name of sponsored entity or intermediary, if applicable
.
7 Number, street, and room or suite no. (if P.O. box, see instructions)
8a City or town
8b State, province, or region
9 GIIN
Part II
8c Country, including postal code
10 TIN
.
.
.
Account Holder or Payee Information
1b Indicate whether account holder or payee is an individual or entity
1a Name of account holder or payee
Individual
Entity
2 Number, street, and room or suite no. (if P.O. box, see instructions)
3a City or town
3b State, province, or region
3c Country, including postal code
4 TIN
5 If account holder or payee is an entity, check applicable box to specify the entity type:
Owner-Documented FFI with specified U.S. Owner(s)
Passive NFFE with substantial U.S. Owner(s)
Non-Participating FFI
Specified U.S. Person
Part III
Owner Information (File a separate report for each U.S. Owner that is a specified U.S. Person.)
1 Name of owner
2 Number, street, and room or suite no. (if P.O. box, see instructions)
3a City or town
3b State, province, or region
3c Country, including postal code
4 TIN of owner
Part IV
Financial Information
1 Account number
2 Currency code (see instructions)
3a Account balance
3b Check if account closed during the year (see instructions)
4a Interest
4c Gross proceeds/Redemptions
4b Dividends
4d Other
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 55748F
Form 8966 (2020)
Page 2
Form 8966 (2020)
Part V
Pooled Reporting Type
1 Check applicable pooled reporting type (check only one):
Recalcitrant account holders with U.S. Indicia
Recalcitrant account holders without U.S. Indicia
Dormant accounts
Non-Participating FFI
Recalcitrant account holders that are U.S. Persons
Recalcitrant account holders that are passive NFFEs
2 Number of accounts
3 Aggregate payment amount
4 Aggregate account balance
5 Currency code
Form 8966 (2020)
File Type | application/pdf |
File Title | 2020 Form 8966 |
Subject | Fillable |
Author | SE:W:CAR:MP |
File Modified | 2020-11-18 |
File Created | 2020-11-18 |