Form W-8ECI

(Rev. October 2021)

Certificate of Foreign Person's Claim That Income Is Effectively 

Connected With the Conduct of a Trade or Business in the United States

Department of the Treasury 

Internal Revenue Service 

▶ Section references are to the Internal Revenue Code. 

▶ Go to www.irs.gov/FormW8ECI for instructions and the latest information. 

▶ Give this form to the withholding agent or payer. Do not send to the IRS. 

OMB No. 1545-1621

Note: Persons submitting this form must file an annual U.S. income tax return to report income claimed to be effectively connected with a U.S. trade or business. See instructions. 

Do not use this form for: Instead, use Form: 

• A beneficial owner solely claiming foreign status or treaty benefits . . . . . . . . . . . . . . . . . W-8BEN or W-8BEN-E 

• 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(s) 115(2), 501(c), 892, 895, or 1443(b) . . . . W-8EXP 

Note: These entities should use Form W-8ECI if they received effectively connected income and are not eligible to claim an exemption for chapter 3 

or 4 purposes on Form W-8EXP. 

• A foreign partnership or a foreign trust (unless claiming an exemption from U.S. withholding on income effectively connected with the 

conduct of a trade or business in the United States) . . . . . . . . . . . . . . . . . . . . . W-8BEN-E or W-8IMY 

• A person acting as an intermediary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8IMY 

Note: See instructions for additional exceptions. 

Part I Identification of Beneficial Owner (see instructions) 

1 Name of individual or organization that is the beneficial owner 2 Country of incorporation or organization 

3 Name of disregarded entity receiving the payments (if applicable)

4 Type of entity (check the appropriate box):

Partnership 

Foreign Government - Controlled Entity

Foreign Government - Integral Part

Private foundation 

Simple trust 

Grantor trust 

International organization 

Individual 

Complex trust 

Central bank of issue 

Corporation 

Estate 

Tax-exempt organization 

5 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address. 

City or town, state or province. Include postal code where appropriate. Country 

6 Business address in the United States (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address. 

City or town, state, and ZIP code 

7 U.S. taxpayer identification number (required—see instructions) SSN or ITIN EIN 

8a Foreign tax identifying number (FTIN) 8b Check if FTIN not legally required . . . . . . . . . . .

9 Reference number(s) (see instructions) 10 Date of birth (MM-DD-YYYY) 

11 Specify each item of income that is, or is expected to be, received from the payer that is effectively connected with the conduct of a trade or 

business in the United States (attach statement if necessary). 

12 Check here to certify that: you are a dealer in securities (as defined in section 475(c)(1)); you are a transferor of an interest in a publicly traded partnership 

(PTP) claiming an exception from withholding under Regulations section 1.1446(f)-4(b)(6); and any gain from the transfer of the PTP interest associated 

with this form is effectively connected with the conduct of a trade or business within the United States without regard to section 864(c)(8). . . .

Part II Certification

Sign 

Here 

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and 

complete. I further certify under penalties of perjury that: 

• I am the beneficial owner (or I am authorized to sign for the beneficial owner) of all the payments to which this form relates, 

• The amounts for which this certification is provided are effectively connected with the conduct of a trade or business in the United States,

• The income for which this form was provided is includible in my gross income (or the beneficial owner’s gross income) for the taxable year, and 

• The beneficial owner is not a U.S. person. 

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the payments of which I am the 

beneficial owner or any withholding agent that can disburse or make payments of the amounts of which I am the beneficial owner. 

I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.

I certify that I have the capacity to sign for the person identified on line 1 of this form. 

Signature of beneficial owner (or individual authorized to sign for the beneficial owner) Print name Date (MM-DD-YYYY)

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25045D Form W-8ECI (Rev. 10-2021)