Instructions for Form W-8IMY

(Rev. October 2021)

Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. 

Branches for United States Tax Withholding and Reporting

Department of the Treasury

Internal Revenue Service

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 

IRS.gov/Formw8imy.

What’s New

Guidance under section 1446(f). The Tax Cuts and Jobs 

Act (TCJA), added section 1446(f), which generally requires 

that if any portion of a gain on any disposition of an interest in 

a partnership would be treated under section 864(c)(8) as 

effectively connected gain, the transferee purchasing an 

interest in such a partnership from a non-U.S. transferor must 

withhold a tax equal to 10% of the amount realized on the 

disposition unless an exception to withholding applies. T.D. 

9926 (84 FR 76910), published on November 30, 2020, 

contains final regulations (section 1446(f) regulations) 

relating to the withholding and reporting required under 

section 1446(f), which include withholding requirements that 

apply to brokers effecting transfers of interests in publicly 

traded partnerships (PTPs). The section 1446(f) regulations 

also revise certain requirements under section 1446(a) 

relating to withholding and reporting on distributions made by 

PTPs, including by expanding the entities permitted to act as 

nominees for PTP distributions to include certain qualified 

intermediaries and U.S. branches of foreign persons that 

agree to act as U.S. persons. Withholding on transfers of 

interests in PTPs and the revisions included in the section 

1446(f) regulations relating to withholding on PTP 

distributions under section 1446(a) apply to transfers and 

distributions that occur on or after January 1, 2023. See 

Notice 2021-51, 2021-36 I.R.B. 361, for more information. 

The provisions of the section 1446(f) regulations relating to 

withholding and reporting on transfers of interests in 

partnerships that are not PTPs generally apply to transfers 

occurring after January 29, 2021. See Pub. 515 for an 

additional discussion of section 1446(f) withholding. The 

Form W-8IMY and these instructions have been updated to 

incorporate the use of this form by brokers and certain 

transferors of partnership interests for purposes of certain of 

the requirements of the section 1446(f) regulations for 

withholding on dispositions of partnership interests (in both 

PTPs and other partnerships) and for withholding on PTP 

distributions.

Section 871(m) regulations and qualified securities 

lenders (QSLs). Notice 2020-2, 2020-3 I.R.B. 327, further 

extended the transition relief provided in Notice 2018-72, 

2018-40 I.R.B. 522, for certain provisions of the section 

871(m) regulations, generally for 2021 and 2022. Notice 

2020-2 also further extended the period that a withholding 

agent may apply the transition rules to act as a QSL 

described in obsoleted Notice 2010-46, 2010-24 I.R.B. 757, 

Part III, for substitute dividend payments made in 2021 and 

2022. As a result, this Form W-8IMY includes chapter 3 

status certifications for entities acting as QSLs (applicable to 

either a qualified intermediary (QI) or other entity acting as a 

QSL) and clarifies (as provided in the QI agreement) when a 

QI may continue to claim status as a QSL in a case in which it 

is also a qualified derivatives dealer (QDD).

New lines 9a and 9b. Line 9b, foreign taxpayer 

identification number, if required, has been added for a QDD 

to indicate its foreign taxpayer identification number (FTIN) 

on this form (with line 9, GIIN (if applicable), redesignated as 

line 9a). See QDD withholding statement, later, for when a 

QDD is required to provide its FTIN on line 9b.

Nonqualified intermediary (NQI) that provides an alternative withholding statement. The Form W-8IMY and 

these instructions have been updated to allow an NQI that is 

to provide alternative withholding statements and beneficial 

owner withholding certificates for payments associated with 

this form to represent on the form that the information on the 

withholding certificates will be verified for consistency with 

any other account information the NQI has for the beneficial 

owners for determining the rate of withholding with respect to 

each payee (applying the standards of knowledge under 

section 1441 or 1471 regulations, as applicable). See T.D. 

9890 and Regulations section 1.1441-1(e)(3)(iv)(C)(3). When 

applicable, an NQI may make this representation on new 

line 17e instead of on its withholding statement. The Form 

W-8IMY and these instructions have also been updated to 

allow nonwithholding foreign partnerships and 

nonwithholding foreign trusts to make this representation 

when providing an alternative withholding statement. For 

further information, see the instructions for line 21f.

Electronic signature. These instructions have been 

updated to include additional guidance included in final 

regulations issued under chapter 3 (T.D. 9890) concerning 

the use of electronic signatures on withholding certificates. 

See Part XXIX Certification, later, and Regulations section 

1.1441-1(e)(4)(i)(B).

Section 6050Y reporting. These instructions have been 

updated to reference the use of this form by a foreign 

partnership, foreign simple trust, or foreign grantor trust that 

is the seller of a life insurance contract (or interest therein) or 

a recipient of a reportable death benefit for purposes of 

reporting under section 6050Y.

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 

Nov 02, 2021 Cat. No. 25904R
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 foreign financial 

institutions (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(a) on the foreign person’s distributive share of 

the partnership’s effectively connected taxable income or, in 

the case of a PTP, on the amount of a distribution attributable 

to effectively connected taxable income of the PTP as 

provided in Regulations section 1.1446-4 (excluding when a 

nominee rather than the PTP is required to withhold). For 

purposes of section 1446(a), the partnership may generally 

accept any beneficial owner withholding certificate submitted 

for purposes of section 1441 or 1442, with few exceptions, to 

establish the foreign status of the partner, including a 

withholding certificate that is associated with a Form W-8IMY 

submitted by an upper-tier foreign partnership, a foreign 

grantor trust, or a foreign intermediary. See Regulations 

sections 1.1446-1 through 1.1446-6 to determine whether a 

withholding certificate submitted for purposes of section 

1441 or 1442 will be accepted for purposes of section 

1446(a).

Withholding may also be required under the section 

1446(f) regulations by a transferee paying the amount 

realized from a transfer of a partnership interest to a 

transferor of the interest or, for a transfer of an interest in a 

PTP, by a broker effecting the transfer. This withholding is 

generally required when any portion of the gain from the 

transfer would be treated as effectively connected gain under 

section 864(c)(8). The withholding required of a broker on an 

amount realized on the transfer of a PTP interest is subject to 

certain exceptions such as when an amount realized is paid 

to a qualified intermediary assuming withholding 

responsibility under section 1446(f) or to a U.S. branch acting 

as a U.S. person for the amount realized. See Regulations 

section 1.1446(f)-4. For certain withholding exceptions, an 

applicable withholding certificate is required for a transfer of a 

PTP interest, such as for an entity to represent its status as 

an entity described in the preceding sentence (made on this 

Form W-8IMY) or for a transferor to claim an exemption from 

withholding based on an income tax treaty. A withholding 

certificate may also be required to establish the status of a 

broker or partner withheld upon under section 1446(f). 

Separate withholding exceptions apply to transfers of 

interests in partnerships other than PTPs, certain of which 

require the collection of a withholding certificate or other 

applicable certification. See Regulations section 1.1446(f)-2.

Additional information. For additional information and 

instructions for the withholding agent, see the Instructions for 

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 or when acting as a QDD or QSL. 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. In some 

cases you should provide Form W-8IMY for an amount 

realized or a PTP distribution. 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 and/or primary Form 1099 reporting and 

backup withholding responsibility.

• A foreign person, a foreign branch of a foreign person, or a 

foreign branch of a U.S. person, to establish that it is a QI 

acting as a QDD, as permitted by the person’s QI agreement. 

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 QDD may also use its Form W-8IMY to 

claim an exemption from withholding that may apply based 

on the QDD’s status as a foreign beneficial owner of a 

payment.

• A foreign person, or a foreign branch of a U.S. person, to 

establish that it is a QI assuming primary withholding 

responsibility with respect to payments of substitute interest, 

as permitted by the QI agreement.

• For purposes of withholding under section 1446(f), a 

foreign person, or foreign branch of a U.S. person, to 

establish that it is a QI that is not acting for its own account 

and to represent that it has assumed primary withholding 

responsibility for a payment of an amount realized from the 

sale of an interest in a PTP or has provided, or will provide, a 

withholding statement, as required, for the amounts realized.

• A foreign person, or a foreign branch of a U.S. person, to 

establish that it is a QI not acting for its own account, to 

represent that it has assumed primary withholding 

responsibility for distributions from PTPs for which the QI acts 

as a nominee or has provided, or will provide, a withholding 

statement, as required, for the distributions.

• A foreign person to establish that it is an NQI that is not 

acting for its own account for chapter 3 purposes (including 

for amounts subject to withholding under section 1446(a) or 

(f)), 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 (when permitted) and has provided, or will provide, 

a withholding statement, when required (including for 

payments subject to withholding under section 1446(a) and, 

in certain cases, for section 1446(f)).

• 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 

-2- Instructions for Form W-8IMY (Rev. 10-2021)
evidence it is treated as a U.S. person under Regulations 

section 1.1441-1(b)(2)(iv)(A) with respect to reportable 

amounts associated with the Form W-8IMY, or (2) to transmit 

the documentation of the persons for whom it receives a 

payment of such an amount 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.

• For purposes of section 1446(f), a U.S. branch that is 

acting as an intermediary, to certify that it agrees to act as a 

U.S. person with respect to amounts realized on sales of 

interests in PTPs.

• A U.S. branch, to represent that it is treated as a U.S. 

person and is acting as a nominee for distributions from 

PTPs under Regulations section 1.1446-4(b)(3) (or has 

otherwise provided (or will provide) a withholding statement 

for a distribution).

• 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 payments of income that 

are not effectively connected with the conduct of a trade or 

business in the United States associated with the Form 

W-8IMY, or (2) to certify that it is transmitting documentation 

of the persons for whom it receives such payment and has 

provided, or will provide, a withholding statement, as 

required.

• For withholding under section 1446(f), a financial 

institution incorporated or organized under the laws of a U.S. 

territory that is acting as an intermediary or that is a 

flow-through entity, to certify that it is acting as a U.S. person 

for amounts realized on sales of interests in PTPs.

• A financial institution incorporated or organized under the 

laws of a U.S. territory that is acting as an intermediary or that 

is a flow-through entity, to certify that it agrees to act as a 

U.S. person and as a nominee for distributions from PTPs 

under Regulations section 1.1446-4(b)(3) (or has otherwise 

provided (or will provide) a withholding statement for a 

distribution).

• A foreign partnership or a foreign simple or grantor trust to 

establish that it is a withholding foreign partnership or 

withholding foreign trust for purposes of chapters 3 and 4.

• 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 for reportable 

amounts and withholdable payments, 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(a) and, except for a 

partnership that is a PTP, 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 foreign partnership to establish that it is the transferor of 

an amount realized from the transfer of a partnership interest 

for purposes of section 1446(f) and, when applicable, to 

represent that it has provided, or will provide, a withholding 

statement with respect to a modified amount realized for 

purposes of withholding under section 1446(f) on the 

transfer.

• A foreign grantor trust transferring a partnership interest 

providing, on behalf of each grantor or other owner of the 

trust under Regulations section 1.1446(f)-1(c)(2)(vii), a 

withholding statement to allocate an amount realized to each 

grantor or owner for withholding under section 1446(f) on the 

transfer.

• 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 with respect to its receipt of a 

withholdable payment.

• A QSL that is either a QI (to the extent not acting as a 

QDD) or other entity certifying to a withholding agent that it is 

acting as a QSL in Part IV of Form W-8IMY with respect to 

U.S. source substitute dividends received from the 

withholding agent prior to January 1, 2023, pursuant to a 

securities lending transaction within the meaning of Notice 

2010-46. See also Notice 2020-2.

• 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.

• A foreign partnership, foreign simple trust, or foreign 

grantor trust that is the seller of a life insurance contract (or 

interest therein) or a recipient of a reportable death benefit to 

establish its foreign status and to associate this form with any 

other applicable documentation for purposes of section 

6050Y or chapter 3. See Regulations sections 1.6050Y-3 

and 1.6050Y-4.

This form may serve to establish foreign status for 

purposes of sections 1441, 1442, and 1446(a) or (f). 

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(a) or (f), 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 or a QSL acting as a principal for substitute 

dividend payments) 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.

Instructions for Form W-8IMY (Rev. 10-2021) -3-
• 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.

• You are a foreign reverse hybrid entity (unless you are a 

QDD acting in your QDD capacity or a QSL acting as a 

principal for substitute dividend payments) 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 

as a QI.

• You are a QI receiving payments of U.S. source income 

that you beneficially own other than payments received as a 

QDD in respect of potential section 871(m) transactions or 

underlying securities or received as a QSL acting as a 

principal in a security lending or sale-repurchase transaction 

(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.

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.

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

multiple branches receiving payments from the same 

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.

TIP

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.

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. For the validity period of a Form W-8IMY used by 

a QDD to claim an exemption from withholding that applies 

based on a QDD’s status as a foreign beneficial owner of the 

payment, see Regulations section 1.1441-1(e)(4)(ii)(A)(1).

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 

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.

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.

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). 

CAUTION

!

-4- Instructions for Form W-8IMY (Rev. 10-2021)
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.

Amount realized. For purposes of section 1446(f), an 

amount realized on the transfer of an interest in a partnership 

other than a PTP is determined under section 1001 (including 

Regulations sections 1.1001-1 through 1.1001-5) and section 

752 (including Regulations sections 1.752-1 through 

1.752-7). See Regulations section 1.1446(f)-2(c)(2). An 

amount realized on the transfer of a PTP interest is the 

amount of gross proceeds (as defined in Regulations section 

1.6045-1(d)(5)) paid or credited to a partner or broker (as 

applicable) that is a transferor of the interest. The amount 

realized on a PTP distribution is the amount of the distribution 

reduced by the portion of the distribution that is attributable to 

the cumulative net income of the partnership (as determined 

under Regulations section 1.1446(f)-4(c)(2)(iii)).

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 (including such an amount on a 

PTP distribution unless indicated otherwise). FDAP income is 

all income included in gross income, including interest (as 

well as OID), dividends (including dividend equivalents), 

rents, royalties, and compensation. Amounts subject to 

chapter 3 withholding do not include amounts that 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(a), the amount subject to 

withholding is the foreign partner’s share of the partnership’s 

effectively connected taxable income. For purposes of 

section 1446(f), the amount subject to withholding is the 

amount realized on the transfer of a partnership interest.

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.

Generally, these beneficial owner rules apply for purposes 

of sections 1441, 1442, and 1446(a) and (f), except that 

sections 1446(a) and (f) require a foreign simple trust to 

provide a Form W-8 on its own behalf rather than on behalf of 

the beneficiary of such trust.

The beneficial owner of income paid to a foreign estate is 

the estate itself.

A payment to a U.S. partnership, U.S. trust, or U.S. estate 

is treated as a payment to a U.S. payee. A U.S. partnership, 

trust, or estate should provide the withholding agent with a 

Form W-9. However, for purposes of section 1446(a), a U.S. 

grantor trust or disregarded entity shall not provide the 

withholding agent a Form W-9 pertaining to itself. Instead, 

the entity must provide a Form W-8 or Form W-9 pertaining 

to each grantor or owner, as appropriate, and in the case of a 

trust, a statement identifying the portion of the trust treated as 

owned by each such person. For purposes of section 

1446(f), the grantor or owner must provide a Form W-8 or 

Form W-9 to certify its status and the amount realized 

allocable to the grantor or owner, which, alternatively, can be 

provided by the U.S. grantor trust on behalf of a grantor or 

owner.

Broker. A person described in Regulations section 

1.1446(f)-1(b)(1) when referenced in connection with a 

transfer of a PTP interest.

Chapter 3. Chapter 3 of the Internal Revenue Code 

(Withholding of Tax on Nonresident Aliens and Foreign 

Corporations), excluding sections 1445 and 1446.

Chapter 3 withholding rate pool. 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 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 of the Internal Revenue Code (Taxes 

to Enforce Reporting on Certain Foreign Accounts). 

Chapter 4 contains sections 1471 through 1474.

Chapter 4 status. 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 Non-Financial Foreign Entity (NFFE) or 

passive NFFE.

Chapter 4 withholding rate pool. 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 

Instructions for Form W-8IMY (Rev. 10-2021) -5-
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.

Disclosing QI. For purposes of section 1446(a) or (f), a QI 

that provides with its withholding statement the specific 

payee documentation referenced in Regulations section 

1.1446(f)-4(a)(7)(iii) (for an amount realized) or Regulations 

section 1.1446-4(e)(4) (for withholding on a PTP distribution 

under section 1446(a)) instead of the chapter 3 withholding 

rate pool information otherwise permitted to be included on 

the withholding statement. A QI that acts as a disclosing QI 

for a payment must act as a disclosing QI for the entire 

payment.

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.

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.

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.

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.

Flow-through entity. 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 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). The 

identification number assigned to an entity that has 

registered with the IRS for chapter 4 purposes.

Hybrid entity. 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, earlier, under Who Must 

Provide Form W-8IMY, and Regulations section 1.1471-3(d) 

for the documentation requirements with respect to entities 

receiving withholdable payments.

Intergovernmental Agreement (IGA). 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/FATCAArchive.aspx.

-6- Instructions for Form W-8IMY (Rev. 10-2021)
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.

Intermediary. 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 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);

• 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.

Qualified derivatives dealer (QDD). A QI that is an 

eligible entity that agrees to meet the requirements of 

Regulations section 1.1441-1(e)(6)(i) and the QI agreement 

and has been approved by the IRS to so act. An eligible 

entity is defined in Regulations section 1.1441-1(e)(6)(ii).

The home office or branch, as applicable, that is a QDD 

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 necessary). Each home office 

or branch that obtains QDD status is treated as a separate 

QDD.

Qualified securities lender (QSL). Notice 2010-46, 

provided rules for QSLs acting with respect to payments of 

substitute dividends. A QSL that is a QI should certify to its 

QSL status in Part III of this form, regardless of whether it is 

acting as a principal or an agent with respect to its QSL 

transactions. A QSL that is not a QI, including a QSL acting 

as a principal with respect to QSL transactions, should certify 

its QSL status in Part IV of this form. Notwithstanding the 

foregoing, a QDD may not act as a QSL for potential section 

871(m) transactions, except with respect to a payment on a 

securities lending or sale-repurchase transaction for which 

the QI has determined that it is acting as an intermediary for 

the payment. While Notice 2010-46 was obsoleted, Notice 

2020-2 permits withholding agents to apply the transition 

rules described in Notice 2010-46 for payments made in 

2021 and 2022.

Nonqualified intermediary. Any intermediary that is not 

a U.S. person and that is not a qualified intermediary.

Modified amount realized. In the case of an amount 

realized under section 1446(f) received by a transferor that is 

a foreign partnership, the amount determined under 

Regulations section 1.1446(f)-4(c)(2)(ii) (for a transfer of a 

PTP interest) or under Regulations section 1.1446(f)-2(c)(2)

(iv) (for a transfer of an interest in a partnership other than a 

PTP).

Nominee. When referenced in connection with a PTP 

distribution, a person that holds an interest in a PTP on 

behalf of a foreign person and that is either a U.S. person, a 

QI that assumes primary withholding responsibility for a PTP 

distribution, or a U.S. branch of a foreign person (or territory 

financial institution) that agrees to be treated as a U.S. 

person with respect to the distribution. See Regulations 

section 1.1446-4(b)(3).

Nonreporting IGA FFI. 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.

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.

Participating FFI. 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.

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).

Publicly traded partnership (PTP). A PTP is an entity that 

has the same meaning as in section 7704 and Regulations 

sections 1.7704-1 through 1.7704-4 but does not include a 

PTP treated as a corporation under that section.

Instructions for Form W-8IMY (Rev. 10-2021) -7-
PTP distribution. A PTP distribution is a distribution made 

by a PTP.

PTP interest. A PTP interest is an interest in a PTP if the 

interest is publicly traded on an established securities market 

or is readily tradable on a secondary market (or the 

substantial equivalent thereof).

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 

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).

Reverse hybrid entity. 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. 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), for 

purposes of withholding on a PTP distribution as a nominee 

under Regulations section 1.1446-4(b)(3), or for an amount 

realized under section 1446(f).

Transfer. A sale, exchange, or other disposition of an 

interest in a partnership, and includes a distribution from a 

partnership to a partner, as well as a transfer treated as a 

sale or exchange under section 707(a)(2)(B).

Transferee. Any person, foreign or domestic, that acquires 

a partnership interest through a transfer, and includes a 

partnership that makes a distribution.

Transferor. A transferor is any person, foreign or domestic, 

that transfers an interest in a partnership. In the case of a 

trust, to the extent 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, the term transferor means the 

grantor or other person.

Underlying security. The term underlying security is 

defined in Regulations section 1.871-15(a)(15).

Withholdable payment. The term withholdable payment is 

defined in Regulations section 1.1473-1(a).

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(a), in general, the 

withholding agent is the partnership conducting the trade or 

business in the United States. For purposes of section 

1446(a), the withholding agent for a PTP may be the 

partnership or a nominee for a distribution holding an interest 

on behalf of a foreign person. See Regulations section 

1.1446-4.

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 sections 1441 through 1443 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.

Withholding statement. A withholding statement for a 

reportable amount 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 section 1441 

and chapter 4 regulations) of each payment an intermediary 

or flow-through entity receives. For purposes of section 

1446(a), a withholding statement provided by an upper-tier 

foreign partnership (or foreign grantor trust to a lower-tier 

partnership or intermediary receiving the amount on behalf of 

the foreign partnership or grantor trust) provides an allocation 

of the effectively connected income to each partner or owner 

in the upper-tier partnership or the trust. For purposes of 

section 1446(f), a withholding statement provided by an 

intermediary for an amount realized on the transfer of a PTP 

interest provides an allocation of the amount realized to each 

transferor of the PTP interest or to a chapter 3 or 4 

withholding rate pool when permitted under Regulations 

section 1.1446(f)-4(a)(7). The withholding statement 

provided by an intermediary for a PTP distribution provides 

allocation information with respect to each partner receiving 

a distribution of an amount subject to withholding under 

section 1446(a) or (f), with respect to each beneficial owner 

or payee receiving an amount subject to withholding under 

chapter 3 or 4 on the distribution (such as a beneficiary of a 

partner in the PTP that is a simple trust receiving a payment 

subject to chapter 3 withholding), or with respect to a 

chapter 3 or 4 withholding rate pool as permitted (including a 

QI not assuming withholding responsibility for the distribution, 

but excluding an allocation to a U.S. partner or when the QI 

acts as a disclosing QI). For the limitation on when a 

nonqualified intermediary may provide a withholding 

statement for an amount realized, however, see Withholding 

statement for amount realized or PTP distribution in Part IV, 

later. Also, see Regulations section 1.1446-4(d)(1) for when 

the amounts subject to withholding on a PTP distribution 

cannot be determined from a qualified notice issued by the 

PTP. For a withholding statement provided by a foreign 

partnership to claim a modified amount realized for purposes 

of section 1446(f), see the instructions for Line 21d, later.

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 

-8- Instructions for Form W-8IMY (Rev. 10-2021)
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 

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. See QDD withholding statement, later.

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).

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.

If you are a disregarded entity that is a QDD, identify the 

QDD by the name used by the QDD for the QI application. 

For instructions for identifying the names of multiple QDDs, 

see QDD withholding statement, later.

If you are not required to provide the legal name of 

the disregarded entity, however, you may want to 

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 

CAUTION

!

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.

Form W-8IMY may be provided to satisfy 

documentation requirements for purposes of 

withholding on certain partnership allocations to 

foreign partners under section 1446(a). Section 1446(a) 

generally requires withholding when a partnership is 

conducting a trade or business in the United States and 

allocates taxable income effectively connected with that 

trade or business (ECTI) to foreign persons that are partners 

in the partnership. Section 1446(a) can also apply when 

certain income is treated as effectively connected income of 

the partnership and is so allocated.

An upper-tier foreign partnership that is allocated ECTI as a 

partner in a lower-tier partnership (LTP) may request, if 

certain requirements are met, the lower-tier partnership 

perform withholding under section 1446(a) on that ECTI 

taking into account the status of the partners in the upper-tier 

partnership. Upper-tier PTPs are not permitted to use these 

look-through rules. 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 ECTI of the upper-tier 

partnership will be allocated to the partners. Domestic 

non-PTPs that meet similar requirements may be able to 

elect to apply look-through rules, if the LTP agrees, by using 

Form W-9, instead of a W-8IMY. For further information, see 

Regulations section 1.1446-5. A foreign grantor trust that is 

allocated ECTI 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 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.

TIP

Instructions for Form W-8IMY (Rev. 10-2021) -9-
For most of the chapter 4 classifications, you are 

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 

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 on 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 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.

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.

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 are a territory financial 

institution that certifies that it has agreed to be treated as a 

U.S. person for any payments associated with this Form 

W-8IMY.

If you are acting as a QI (including a QDD), withholding 

foreign partnership, or withholding foreign trust, check the 

TIP

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, an upper-tier partnership or trust that is allocated 

ECTI (or receives a PTP distribution attributable to ECTI) as a 

partner in a lower-tier partnership is required to provide a 

U.S. TIN. The requirement to include a U.S. TIN in this line 8 

also applies to a foreign partnership or a foreign trust 

receiving an amount realized from a transfer of an interest in 

a partnership conducting a trade or business in the United 

States. Additionally, a QSL providing this form with respect to 

a U.S. source substitute dividend must provide an EIN (a 

QI-EIN if the QSL is a QI).

Line 9a. Complete line 9a 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 country of residence) on 

line 9a. 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 9a 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 9a 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 9a.

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

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 line 9a by writing “applied 

for.” However, the person requesting this form from you must 

receive and verify your GIIN within 90 days.

If you are a disregarded entity that completed Part I, line 3, 

do not enter your GIIN on line 9a. Instead, enter it on line 13.

Line 9b. Complete line 9b if you are a QDD that must 

provide a foreign taxpayer identification number (FTIN). For 

information on this requirement (and when an FTIN is not 

required), see QDD withholding statement, later.

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.

TIP

-10- Instructions for Form W-8IMY (Rev. 10-2021)
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 on 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 9a, 

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.

If the disregarded entity receiving a withholdable 

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 

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.

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.

Line 12. Enter the address of the branch or disregarded 

entity.

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 9a. If you 

are a U.S. branch, do not enter a GIIN on line 13.

TIP

If you are in the process of registering your branch 

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 QI for one account, but an 

NQI for another account, you should provide one Form 

W-8IMY in your capacity as a QI and a separate Form 

W-8IMY in your capacity as an NQI.

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.

Part III — Qualified Intermediary

Line 14. Check the box on line 14 if you are a 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.

Line 15. 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. If you are acting in both QI 

capacities, you should complete both lines 15 and 16 to the 

extent applicable.

Line 15a. Check the box on line 15a if you have assumed 

primary withholding responsibility under both chapter 3 and 

chapter 4 with respect to the account(s) identified on a 

withholding statement attached to this form (or, if no 

withholding statement is attached to this form, for all 

accounts). The representation made in this box on line 15a 

may be made regardless of whether you assume primary 

withholding responsibility for a PTP distribution (by checking 

the box on line 15c) as the representation made on this 

line 15a does not apply to an amount subject to chapter 3 

withholding on a PTP distribution.

Furthermore, the box on line 15a may be checked 

regardless of which boxes you check on lines 15b through 

15i for any accounts identified on a withholding statement.

Line 15b. Check the box on line 15b if you have assumed 

primary withholding and reporting responsibilities under 

section 1446(f) for each payment of an amount realized on a 

sale of a PTP interest associated with each account identified 

on a withholding statement attached to this form for receiving 

such amounts (or, if no withholding statement is attached to 

this form, for all accounts).

Line 15c. Check the box on line 15c if you have assumed 

primary withholding responsibility as a nominee for each 

distribution by a PTP that is associated with each account 

identified on a withholding statement attached to this form for 

receiving such distributions (or, if no withholding statement is 

attached to this form, for all accounts).

TIP

Instructions for Form W-8IMY (Rev. 10-2021) -11-
Line 15d. Check the box on line 15d if you are a QI that is 

acting as a QSL with respect to payments associated with 

each account identified on a withholding statement attached 

to this form (or, if no withholding statement is attached to this 

form, for all accounts) that are U.S. source substitute 

dividends made in 2021 or 2022 by a party to a securities 

lending transaction (as described in Notice 2010-46) for 

which you are not acting as a QDD. See Notice 2020-2 and 

Qualified securities lender (QSL), earlier, for the limitation on 

when a QI is permitted to act as a QSL.

Line 15e. Check the box on line 15e 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 and regardless of whether you act 

as a QDD or QSL.

Line 15f. Check the box on line 15f 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 on line 15f, you should not check 

the boxes on lines 15g through 15i.

If you checked boxes 15a and 15f with respect to any 

accounts, or box 15b or 15c (as applicable) and the 

box on line 15f when this form is associated with an 

amount realized or PTP distribution, you do not have to 

provide a withholding statement for any payments made to 

those accounts.

Line 15g. Check the box on line 15g if you have not 

assumed primary Form 1099 reporting and backup 

withholding responsibility with respect to the account(s) 

identified on a withholding statement attached to this form 

(or, if no withholding statement is attached to this form, for all 

accounts). This box applies to an amount realized only if you 

have not checked the box on line 15b and does not apply to a 

payment made by a QSL that is described on line 15d. If you 

check the box on line 15g, check the applicable 

certification(s) on line 15h or 15i.

Lines 15h and 15i. 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 the boxes on lines 

15h and/or 15i (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 

TIP

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.

A payment that is subject to chapter 3 withholding or 

that should be subject to chapter 4 withholding may 

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 unless 

you are acting as a disclosing QI with respect to an amount 

realized or PTP distribution. Also, 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 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.

Line 16a. Check the box on line 16a to certify that each 

QDD identified on the form or on the QDD 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 and has been 

approved by the IRS to act as a QDD.

A QDD must act as a QDD for all payments it 

receives as a principal with respect to potential 

section 871(m) transactions and underlying 

securities, excluding any payments that are treated as 

effectively connected with the conduct of a trade or business 

within the United States within the meaning of section 864. A 

QDD may not act as a QDD for any other payments it 

receives. To certify your foreign status for any other payment 

of U.S. source income you beneficially own, see Who Must 

Provide Form W-8IMY and Do Not Use Form W-8IMY If You 

are Described Below, 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. If the Form W-8IMY is being used for 

more than one QDD and different boxes must be checked for 

different QDDs, check all relevant boxes and include the 

applicable information on the withholding statement for each 

QDD. See QDD withholding statement, later.

Claim of treaty benefits or beneficial ownership. 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 

CAUTION

!

CAUTION

!

-12- Instructions for Form W-8IMY (Rev. 10-2021)
2023). See Notice 2020-2. 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 for Part II. 

Alternatively, a Form W-8BEN-E may be used for this 

purpose. An entity acting as a QDD (other than a 

flow-through entity or disregarded entity) for a payment of 

U.S. source FDAP income may also use Form W-8IMY to 

claim status as the foreign beneficial owner of the payment 

when the entity provides its foreign TIN (when required) on 

line 9b to this form).

If you are acting as a QDD and fiscally transparent in 

your jurisdiction of organization, do not claim treaty 

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.

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.

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 for one or more accounts (as indicated 

otherwise on line 15a), or 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. You must also 

provide a withholding statement for an amount realized or a 

PTP distribution for which you have not assumed primary 

withholding responsibility. 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. If you are a QDD, see also QDD withholding statement, 

later.

A QI withholding statement must also:

• 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;

• If you receive an amount realized or a PTP distribution, 

designate those accounts for which you are assuming 

primary withholding and reporting responsibility for either 

such amount;

• 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

• For any account for which you are not assuming primary 

withholding and reporting responsibility, 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) 

(with respect to a chapter 4 withholding rate pool). You must, 

however, provide information to allocate the payment to the 

CAUTION

!

specific partners receiving the payment (rather than including 

any part of the payment in any chapter 3 withholding rate 

pool) when you act as a disclosing QI for a payment of an 

amount realized or PTP distribution.

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 

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).

Additionally, a chapter 4 withholding rate pool of U.S. 

payees may be provided in the above-described cases for a 

payment of an amount realized for which a withholding 

statement is provided for purposes of section 1446(f) that 

allocates some amount of the payment to a U.S. person. 

See, For a payment of an amount realized, later, and 

Example 5 and Example 6, later.

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 

Instructions for Form W-8IMY (Rev. 10-2021) -13-
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.

For a payment of an amount realized. In the case of a 

payment of an amount realized, you must provide chapter 3 

withholding rate pool information with respect to the foreign 

transferors receiving the payment for your broker to meet its 

withholding and reporting obligations (except when you act 

as a disclosing QI). See Regulations section 1.1446(f)-4(a)

(7)(iii). The chapter 3 withholding rate pool information you 

provide on a withholding statement may be properly adjusted 

to take into account the withholding required on a transferor 

that is a foreign partnership for which you permit a modified 

amount realized. With respect to U.S. transferors receiving 

an amount realized, and regardless of whether you act as a 

disclosing QI, you must allocate the payment to each such 

transferor to the extent of the amount that may not be 

allocated to a chapter 4 withholding rate pool of U.S. payees 

(to the extent permitted for chapter 4 purposes).

For a PTP distribution. In the case of a PTP distribution, 

you must provide to the PTP or nominee from which you 

receive the distribution chapter 3 withholding rate pool 

information and chapter 4 withholding rate pool information 

(when permitted for chapter 4 purposes) for your foreign 

partners with respect to the amounts subject to withholding 

on the distribution (except when you act as a disclosing QI). 

For determining the amounts to include in each withholding 

rate pool, the QI must rely on the allocation of each amount 

subject to withholding on the distribution as determined by 

the PTP or nominee that pays the distribution to the QI. When 

acting as a disclosing QI for a PTP distribution, you must 

provide with respect to each partner an allocation of the 

income attributable to the distribution that is subject to 

withholding under section 1446(a) or (f) (and, for an amount 

subject to chapter 3 or 4 withholding, an allocation of such 

amount to each beneficial owner or payee). See Withholding 

statement, earlier, for the requirements of a withholding 

statement provided by an intermediary for a PTP distribution. 

Regardless of whether you act as a disclosing QI, you must 

allocate the amounts subject to withholding on the 

distribution to each U.S. partner.

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 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:

• $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 the boxes on lines 14, 15a, and 15f.

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 

for 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. 

-14- Instructions for Form W-8IMY (Rev. 10-2021)
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 the boxes on lines 14, 15a, 

and 15g and 15h.

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 the boxes on lines 14 and 15a.

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 the boxes on lines 14, 15g, and 

15h.

Example 5. A QI that is foreign corporation and a 

Participating FFI does not assume primary withholding and 

reporting responsibility for a payment of $100 from a U.S. 

broker that is an amount realized from the sale of a PTP 

interest. The QI also does not assume primary Form 1099 

reporting and backup withholding responsibility for any of its 

accounts. The QI holds the PTP interest in an account with a 

U.S. broker and does not act as a disclosing QI for the 

payment of the amount realized. The QI determines that the 

amount realized from the sale is allocable to the following 

transferors of the interest in the PTP on whose behalf the QI 

held the interest:

• $20 each on behalf of A and B, two nonresident alien 

individuals who are account holders of the QI;

• $10 each on behalf of C and D, two 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;

• $20 on behalf of F, a foreign partnership and account 

holder of the QI that has provided the certification and other 

information specified in Regulations section 1.1446(f)-4(c)(2)

(ii)(C) for QI to determine a modified amount realized of $10 

(one-half of the $20 is allocable to partners of F who are 

nonresident alien individuals and one-half allocable to a U.S. 

partner of F (USP)), and QI does not report F’s account as a 

U.S. account for purposes of chapter 4 reporting;

• $10 on behalf of foreign grantor trust H, an account holder 

of QI that has provided to QI the documentation from which 

QI can associate the amount realized with G, a nonresident 

alien that is the sole grantor of the trust;

• $10, on behalf of N, an account holder of the QI that is a 

nonqualified intermediary.

As QI is not acting as a disclosing QI for this payment, QI 

may provide to its U.S. broker a withholding statement that 

allocates the amount realized to chapter 3 withholding rate 

pools, excluding amounts allocable to a U.S. partner or to a 

chapter 4 reporting pool of U.S. payees. QI must report on 

the withholding statement the payment allocated as follows:

• To a chapter 3 withholding rate pool at a 10% rate - $70 

(for the $40 allocable to A and B, $10 allocable to F’s 

nonresident alien partners; $10 allocable to G, and $10 

allocable to N);

• To a chapter 4 withholding rate pool of U.S. payees - $20 

(for the total amount allocable to C and D); and

• To USP, for the $10 of the $20 of amount realized by F that 

is allocable to USP.

The QI will complete Form W-8IMY and check the box on 

line 14. As QI does not assume primary withholding 

responsibility under section 1446(f) for the amount realized, 

QI must not check the box on line 15b but should check the 

boxes on lines 15g and 15h because it has not assumed 

Form 1099 reporting and backup withholding responsibility. 

QI does not account for any of the account holders of N on its 

withholding statement as withholding applies to N at the 10% 

rate on the payment regardless of the statuses of N’s 

account holders receiving the payment. See Regulations 

section 1.1446(f)-4(a)(2) for this withholding requirement. 

See Withholding statement for amount realized or PTP 

distribution in Part IV, later, however, for when N (as an NQI) 

would be permitted to provide to QI allocation information 

and beneficial owner withholding certificates for the account 

holders of N receiving the amount realized from the sale. 

With respect to grantor trust H, the withholding is determined 

with respect to grantor G, rather than H, as G is the transferor 

of the PTP interest. With respect to foreign partnership F, the 

withholding statement includes the $10 allocable to F’s 

foreign partners in a chapter 3 withholding rate pool at the 

10% rate as these partners did not claim any exception to 

withholding based on an income tax treaty. With respect to 

USP, QI discloses the identity of USP on the withholding 

statement because it does not assume primary Form 1099 

reporting and backup withholding responsibility and does not 

report the account of USP for purposes of QI’s chapter 4 

requirements as a participating FFI. QI must also provide the 

documentation permitted for section 1446(f) purposes to 

support USP’s non-foreign status. With respect to C and D, 

however, as QI reports their accounts under QI’s 

requirements as a participating FFI, QI may report the 

amount realized allocable to C and D in a chapter 4 

withholding rate pool of U.S. payees.

Example 6. The facts are the same as Example 5, except 

the QI acts as a disclosing QI for the payment of the amount 

realized. Unlike Example 5, because the QI is a disclosing 

QI, it may not allocate any portion of the payment to a 

chapter 3 withholding rate pool on the withholding statement 

Instructions for Form W-8IMY (Rev. 10-2021) -15-
provided to the U.S. broker. QI must instead allocate the 

payment of the amount realized to each account holder that 

is a transferor of the PTP interest, excluding any transferors 

that are includible in a chapter 4 withholding rate pool of U.S. 

payees. See Regulations section 1.1446(f)-4(a)(7)(iii). Thus, 

with respect to QI’s account holders that are foreign 

transferors, QI must allocate $20 of the amount realized each 

to A and B and must associate a valid Form W-8BEN for 

each of them with the withholding statement. With respect to 

foreign partnership F, QI must identify F as the transferor of 

the interest (with a valid Form W-8IMY from F completed in 

accordance with Part VIII , later), must indicate on its 

withholding statement that QI has determined a modified 

amount realized of $10 from the $20 of the amount realized 

allocable to F, and must allocate the amount realized 

between each of the partners of F based on the certification 

and withholding statement provided by F for this payment in 

accordance with Regulations section 1.1446(f)-4(c)(2)(ii)(C). 

QI must include on the withholding statement the amount 

allocable to USP for the reasons noted in Example 5, earlier, 

(with the documentation permitted to support USP’s 

non-foreign status) that F should have provided to QI with its 

withholding statement. With respect to foreign grantor trust 

H, QI must allocate the $10 received on behalf of H to G (as 

G is the transferor), and must associate with the withholding 

statement a valid Form W-8IMY from H (completed in 

accordance with Part VIII, later), a valid Form W-8BEN from 

G, and information provided by H regarding the amount 

realized allocable to G. With respect to nonqualified 

intermediary N, QI must allocate the $10 received on behalf 

of N to N and associate this amount with the withholding 

statement and a valid Form W-8IMY from N. See Withholding 

statement for amount realized or PTP distribution in Part IV, 

later, however, for when N would also be permitted to provide 

to QI allocation information and beneficial owner withholding 

certificates for the account holders of N receiving the amount 

realized from the sale. As indicated in Example 5, earlier, QI 

may include C and D in a chapter 4 withholding rate pool of 

U.S. payees with respect to the amount allocable to them (an 

allowance that applies even when a QI acts as a disclosing 

QI for an amount realized).

Alternative procedure for reportable amounts paid to 

U.S. non-exempt recipients (and for chapter 4). 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.

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.

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.

QDD withholding statement. Similar to a QI withholding 

statement, a QDD withholding statement becomes an 

integral part of a QDD's Form W-8IMY. In addition to the 

information required on a withholding statement (if any) you 

provide in your QI capacity, generally a QDD withholding 

statement should (as applicable) for each QDD (identifying 

the QDD by name used for the QI application):

• Designate the accounts for which the QDD is receiving 

payments with respect to potential section 871(m) 

transactions or underlying securities as a QDD;

• Designate the accounts for which the QDD is receiving 

payments 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 as a QDD for 

which withholding is required; 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 line 9b, your foreign 

taxpayer identification number (FTIN) issued by the 

jurisdiction in which you are tax resident identified on line 6, 

unless you were not issued an FTIN (including if the 

jurisdiction does not issue FTINs). If you do not provide your 

FTIN, you must provide on your QDD withholding statement 

a reasonable explanation of why you have not been issued 

an FTIN. For this purpose, such an explanation includes a 

statement that you are not legally required to obtain an FTIN 

in your jurisdiction of tax residence. Do not write “not 

applicable.” If you are acting as a QDD, you are required to 

provide your FTIN or an explanation of why you have not 

been issued an FTIN 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).

If you are a QDD using its Form W-8IMY to make a claim 

for treaty benefits, see Claim of treaty benefits or beneficial 

ownership, earlier, for the information required for the claim 

(including for a hybrid entity that is a disregarded entity).

Part IV — Nonqualified Intermediary

Line 17a. If you are providing Form W-8IMY as a 

nonqualified intermediary (NQI), you must check the box on 

line 17a. By checking this box, you are certifying to all of the 

statements on line 17a.

Line 17b. Check the box on line 17b if you are using this 

form to transmit withholding certificates or other 

CAUTION

!

-16- Instructions for Form W-8IMY (Rev. 10-2021)
documentation along with a withholding statement that 

satisfies the requirements of chapters 3 and 4 (including for 

purposes of section 1446(a) and 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).

If you are required to provide a chapter 4 status on 

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 the 

box on line 17b (except for documentation provided with 

respect to exempt beneficial owners).

Line 17c. Check the box on line 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. This checkbox does not 

apply to a PTP distribution. You may check this box with 

respect to U.S. source substitute dividends you receive as a 

QSL regardless of whether you act as an intermediary or 

principal for those amounts. See the instructions to line 8 for 

a QSL's requirement to provide a U.S. TIN.

Line 17d. Check the box on line 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. You may check this box with respect to 

U.S. source substitute dividends you receive as a QSL 

regardless of whether you act as an intermediary or principal 

for those amounts. See the instructions for line 8 for a QSL's 

requirement to provide a U.S. TIN.

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.

If you are an NQI receiving an amount realized from 

the transfer of a PTP interest, however, the 

preceding paragraph and the representation made 

on line 17b applies only to the extent indicated in Withholding 

statement for amount realized or PTP distribution, later.

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 under 

chapter 3 and section 3406 for your customers receiving 

reportable amounts 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 instead of documentation for those payees. 

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.

TIP

CAUTION

!

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 

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 payment that is subject to chapter 3 withholding or 

that should be subject to chapter 4 withholding 

should not be included in a U.S. payee pool that is 

described in Regulations section 1.6049-4(c)(4)(ii). Instead, 

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).

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 must generally include the following information.

CAUTION

!

Instructions for Form W-8IMY (Rev. 10-2021) -17-
• 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 

obligations under chapters 3 and 4 of the Code and/or Form 

1099 reporting and backup withholding responsibility.

Withholding statement for amount realized or PTP 

distribution. In the case of a PTP distribution, an NQI may 

provide a withholding statement and appropriate 

documentation for each of its account holders receiving the 

distribution to allocate to its account holders the amounts 

subject to withholding on the distribution under chapters 3 

and 4 (or under section 1446(a)). See Withholding statement, 

earlier, for additional requirements of a withholding statement 

provided by an intermediary for a PTP distribution.

In the case of an amount realized (including on a PTP 

distribution), however, an NQI may provide a withholding 

statement and appropriate documentation on the transferors 

of the PTP interest only when:

• The broker paying the amount realized to the NQI agrees 

to report (or ensures another broker will report) under section 

1461 (and, if required, under section 6045) with respect to 

the amount realized allocated each of the account holders 

that are the transferors of the PTP interest (and provide NQI 

a copy of each Form 1042-S issued due to this reporting);

• The NQI provides to the broker the statement described in 

Regulations section 1.6031(c)-1T(a)(1) with respect to each 

NQI account holder that is a partner required to be issued a 

statement under section 6031(b) for the calendar year of the 

payment and the information for the broker to allocate the 

amount realized to each transferor; and

• The NQI receives from the broker paying the amount 

realized a written representation that the broker is acting as 

an agent of the PTP with respect to the statement described 

in Regulations section 1.6031(c)-1T(a) or otherwise 

designates the broker as its agent for providing the statement 

to the PTP (or the PTP's agent).

The allowance for an NQI to provide a withholding 

statement and transferor documentation applies 

despite that an NQI may not obtain reduced 

withholding on an amount realized it receives from the 

transfer of a PTP interest.

Alternative procedure for NQIs receiving reportable 

amounts (and for chapter 4). 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 

CAUTION

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-18- Instructions for Form W-8IMY (Rev. 10-2021)
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 for a 

payment of a reportable amount. 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 

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.

Line 17e. As part of providing any alternative withholding 

statements that are associated with your Form W-8IMY, you 

may make the representation indicated on line 17e. If you 

check the box line 17e, you are not required to represent on 

each alternative withholding statement that the information 

on the withholding certificates provided with the alternative 

withholding statement is not inconsistent with any other 

account information you have for the beneficial owners for 

determining the appropriate rate of withholding. See 

Regulations section 1.1441-1(e)(3)(iv)(C)(3) for further 

information on the representation otherwise required on each 

alternative withholding statement.

Part V — Territory Financial 

Institution

Line 18. Check the box on line 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 territory of the United States.

You must also check either the box on line 18b or 18c, the 

box on line 18d, and either the box line on 18e or 18f (each 

box as applicable based on the types of payments received). 

Check the box on line 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 of reportable 

amounts and withholdable 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 the box on line 18b, you must provide an EIN on 

line 8.

Check the box on line 18c to certify that you are a territory 

financial institution that has not agreed to be treated as a 

U.S. person for reportable amounts and withholdable 

payments associated with this form. 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.

If this form is being provided for purposes of the entity’s 

holding of an interest in a PTP, check the box on line 18d to 

certify that you have agreed to be treated as a U.S. person 

under Regulations section 1.1446(f)-4(a)(2)(i)(B) with respect 

to an amount realized from a sale of a PTP interest. You may 

provide a withholding statement when you do not act as a 

U.S. person for an amount realized under the same 

conditions that apply to an NQI receiving an amount realized. 

See Withholding statement for amount realized or PTP 

distribution in Part IV, earlier. Check the box on line 18e to 

certify that you have agreed to be treated as a U.S. person 

(as described in Regulations section 1.1441-1(b)(2)(iv)) and 

as a nominee under Regulations section 1.1446-4(b)(3) with 

respect to distributions made by PTPs. If you check either the 

box on line 18d or 18e, you must provide an EIN on line 8. If 

you receive PTP distributions for which you do not act as a 

nominee under Regulations section 1.1446-4(b)(3), check 

the box on line 18f instead of the box on line 18e. You should 

provide a withholding statement to allocate the amounts 

subject to withholding on a distribution and provide the 

appropriate account holder documentation, taking into 

account the limitation on an NQI providing this 

documentation for an amount realized (to the extent 

applicable). See Withholding statement, earlier, for the 

requirements of a withholding statement provided by an 

intermediary for a PTP distribution.

A territory entity that is a flow-through entity but is not 

a territory financial institution may not complete this 

Part V to agree 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 the box on line 19a to certify that you are a 

U.S. branch receiving payments of income that are 

reportable amounts or withholdable payments not effectively 

connected with the conduct of a trade or business in the 

United States, payments of PTP distributions, or payments of 

amounts realized.

You must also check either the box on line 19b or 19c if 

you are receiving payments of reportable amounts or 

withholdable payments associated with this form. Check the 

box on line 19b to certify that you are a U.S. branch of a 

foreign bank or insurance company described in this 

certification that has agreed with the withholding agent to be 

treated as a U.S. person under Regulations section 

1.1441-1(b)(2)(iv) with respect to such payments associated 

with this Form W-8IMY. In such case, you will be responsible 

for chapter 3 withholding and reporting and chapter 4 

withholding and reporting for any such payments you make 

to persons for whom you are receiving a withholdable 

payment (including any of your branches treated as NPFFIs). 

In addition, you will be treated as a U.S. payor for chapter 61 

purposes by checking the box on line 19b (including for 

backup withholding under section 3406). 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.

CAUTION

!

Instructions for Form W-8IMY (Rev. 10-2021) -19-
Check the box on line 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 under Regulations 

section 1.1441-1(b)(2)(iv). You must certify that you are 

transmitting withholding certificates or other documentation 

for persons for whom you are receiving the payment of a 

reportable amount or withholdable 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. Also, check the box on line 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.

If this form is being provided for purposes of the entity’s 

holding of an interest in a PTP, check the box on line 19d to 

certify that you are a U.S. branch described in Regulations 

section 1.1446(f)-4(a)(2)(i)(B) that is acting as a U.S. person 

with respect to an amount realized from the sale of a PTP 

interest. You may provide a withholding statement when you 

do not act as a U.S. person for an amount realized under the 

same conditions that apply to an NQI receiving an amount 

realized. See Withholding statement for amount realized or 

PTP distribution in Part IV, earlier. Check the box on line 19e 

to certify that you are a U.S. branch described in Regulations 

section 1.1441-1(b)(2)(iv) that is acting as a nominee with 

respect to distributions by PTPs under Regulations section 

1.1446-4(b)(3). You must provide your EIN on line 8 but do 

not need to provide a chapter 4 status on line 5 or a GIIN on 

line 9 when you check either the box on line 19d or 19e. If 

you are a U.S. branch receiving PTP distributions associated 

with the form and are not acting as a nominee for the 

distributions under Regulations section 1.1446-4(b)(3), you 

should check the box on line 19f instead of the box on 

line 19e. You should provide a withholding statement to 

allocate the amounts subject to withholding on a distribution 

and provide the appropriate account holder documentation, 

taking into account the limitation on an NQI providing this 

documentation for an amount realized (to the extent 

applicable). See Withholding statement, earlier, for the 

requirements of a withholding statement provided by an 

intermediary for a PTP distribution.

Part VII — Withholding Foreign 

Partnership (WP) or Withholding 

Foreign Trust (WT)

Line 20. Check the box on line 20 if you are a WP or a WT 

and you are receiving the payment on behalf of your 

partners, beneficiaries, or owners.

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). You are not, however, permitted to assume 

primary withholding and reporting responsibility for payments 

subject to withholding under section 1445, 1446(a), 1446(f), 

or any other amount subject to withholding on a PTP 

distribution. 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 on line 5 and provide your GIIN (if applicable).

Part VIII — Nonwithholding Foreign 

Partnership, Simple Trust, or Grantor 

Trust

Line 21a. Check the box on line 21a if you are a foreign 

partnership or a foreign simple or grantor trust that is not a 

WP or WT, and is providing this form for payments that are 

not effectively connected, or are not treated as effectively 

connected, with the conduct of a trade or business in the 

United States.

Line 21b. Check the box on line 21b if you are a foreign 

partnership or foreign grantor trust providing this form for 

purposes of section 1446(a). See Foreign partnerships and 

trusts providing Form W-8IMY for purposes of section 

1446(a), later. If you are a foreign partnership (other than a 

WP) or grantor trust receiving payments of both the amounts 

described on line 21a and for purposes of section 1446(a), 

you should check both boxes. By checking either box, you 

are certifying to the applicable statements on the form.

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), when you are permitted to use that form to claim an 

exemption from withholding. 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 on line 5 and provide your GIIN (if 

applicable) and the information required for the withholding 

agent to report under section 1472 (to the extent required).

Withholding statement of nonwithholding foreign partnership or nonwithholding foreign trust for purposes of 

chapters 3 and 4. 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 

-20- Instructions for Form W-8IMY (Rev. 10-2021)
requirements outlined for an NQI withholding statement 

described earlier.

Foreign partnerships and trusts providing Form W-8IMY 

for purposes of section 1446(a). In general, a partnership 

is required to withhold under section 1446(a) on effectively 

connected taxable income (ECTI) allocable to a foreign 

partner (or in the case of a PTP distribution, to the extent the 

distribution is attributable to ECTI, unless withholding is 

required by a nominee). 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, for a 

partnership other than a PTP, documentation sufficient for 

the LTP (or nominee for the amounts) 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.

Also, for purposes of section 1446(a), 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 the box on 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(a).

Lines 21c and 21d. Check the box on line 21c if you are a 

foreign partnership that is a transferor of an interest in a 

partnership receiving an amount realized from the transfer. If 

you check the box on line 21c and are providing a 

withholding statement for a modified amount realized on the 

transfer, also check the box on line 21d. The withholding 

statement for a modified amount realized must show the 

allocation of the gain from the transfer to each of the partners 

for which a lower rate of withholding is being requested, and 

you must provide withholding certificates for each of the 

partners to avoid the requirement that the transferee (or your 

broker for a transfer of a PTP interest) treat a partner as a 

presumed foreign partner.

For a modified amount realized, you may not use a 

withholding statement that you provided to your 

transferee or broker that only allocates a reportable 

amount or withholdable payment to your partners. You must 

provide a withholding statement that allocates the gain from 

the transfer of the PTP interest. Once you have provided that 

withholding statement, you may provide it for a subsequent 

amount realized provided that the gain allocations have not 

changed. You may instead provide a withholding statement 

that indicates both that it may be used for all reportable 

amounts, withholdable payments and gains on transfers 

allocable to your partners and that you will update the 

withholding statement for a change to any of these 

allocations.

Line 21e. Check the box on line 21e if you are a foreign 

grantor trust providing the form on behalf of each grantor or 

owner of the trust under Regulations section 1.1446(f)-1(c)(2)

(vii) that is transmitting withholding certificates and providing 

a withholding statement to allocate an amount realized to 

each grantor or other owner in the trust for purposes of 

section 1446(f).

CAUTION

!

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

purposes of section 1446(a) or (f), you 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 or broker 

making the payment to you may have to withhold on the 

payment. You may provide your chapter 4 status on this form 

even if you are not required to do so.

Line 21f. To the extent that the entity identified in Part 1 of 

this form is providing an alternative withholding statement 

described in Regulations section 1.1441-1(e)(3)(iv)(C)(3), 

you may check the box on this line to make the 

representation included on this line instead of making the 

representation on each alternative withholding statement. 

See Alternative withholding statement, earlier.

Certification of Chapter 4 Status: 

Parts IX Through XXVIII

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

You are not required to complete this part unless you 

are a nonparticipating FFI providing documentation 

on behalf of an exempt beneficial owner.

Line 22. Check the box on line 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 X — Sponsored FFI

Line 23a. 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 

TIP TIP

Instructions for Form W-8IMY (Rev. 10-2021) -21-
obligations on your behalf. You must provide your GIIN on 

line 9.

Lines 23b and 23c. You must check the applicable box on 

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.

Part XI — Owner-Documented FFI

An owner-documented FFI should only complete 

Form W-8IMY if it is a flow-through entity receiving 

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.

Line 24a. You must check the box on line 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 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)).

Lines 24b and 24c. You must also check either the box on 

line 24b or 24c. Check the box on line 24b to certify that you 

have provided or will provide the documentation set forth in 

the certifications, including the owner reporting statement 

described on this line 24b. Check the box on line 24c to 

certify that you have provided or will provide an auditor’s 

letter (in lieu of the information required by line 24b) that 

satisfies the requirements described on this line.

Part XII — Certified 

Deemed-Compliant Nonregistering 

Local Bank

Line 25. You must check the box on line 25 to certify that 

you satisfy all of the requirements for certified 

deemed-compliant nonregistering local bank status.

Part XIII — Certified 

Deemed-Compliant FFI with Only 

Low-Value Accounts

Line 26. You must check the box on line 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

Line 27a. 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.

Line 27b. You must check the box on line 27b to certify that 

you satisfy the requirements for certified deemed-compliant 

classification as a sponsored closely held investment vehicle.

CAUTION

!

Part XV — Certified 

Deemed-Compliant Limited Life Debt 

Investment Entity

Line 28. You must check the box on line 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

Line 29. You must check the box on line 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 XVII — Restricted Distributor

Line 30a. You must check the box on line 30a to certify that 

you satisfy the requirements of restricted distributor status.

Lines 30b and 30c. You must also check either the box on 

line 30b or 30c, as appropriate, to certify that your distribution 

agreement meets the requirements of this classification.

Part XVIII — Foreign Central Bank of 

Issue

Line 31. You must check the box on line 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.

Part XIX — Nonreporting IGA FFI

Line 32. Check the box on line 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.

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.

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).

-22- Instructions for Form W-8IMY (Rev. 10-2021)
Part XX — Exempt Retirement Plans

Line 33. You must check the appropriate box on line 33a, b, 

c, d, e, or f to certify that you satisfy the requirements of 

exempt retirement plan status.

If you are not a flow-through entity or acting as an 

intermediary with respect to the payment for 

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 XXI — Excepted Nonfinancial 

Group Entity

Line 34. You must check the box on line 34 to certify that 

you satisfy the requirements of excepted nonfinancial group 

entity status.

Part XXII — Excepted Nonfinancial 

Start-Up Company

Line 35. You must check the box on line 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

Line 36. You must check the box on line 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 XXIV — Publicly Traded NFFE or 

NFFE Affiliate of a Publicly Traded 

Corporation

Lines 37a and 37b. If you are a publicly traded NFFE, you 

must check the box on line 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 the box 

on line 37b to certify that you are an 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.

Part XXV — Excepted Territory NFFE

Line 38. You must check the box on line 38 to certify that 

you satisfy the requirements for excepted territory NFFE 

CAUTION

!

status. See Regulations section 1.1472-1(c)(1)(iii) for the 

definition of an excepted territory NFFE.

Part XXVI — Active NFFE

Line 39. You must check the box on line 39 to certify that 

you satisfy the requirements of active NFFE status.

Part XXVII — Passive NFFE

Line 40. If you are a passive NFFE, you must check the box 

on line 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 financial institutions 

(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 XXVIII— Sponsored Direct 

Reporting NFFE

Lines 41 and 42. 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 this classification. Enter the name of the 

sponsoring entity on 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).

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. A withholding agent may also rely on 

an electronically signed withholding certificate if you provide 

any additional information or documentation requested by 

the withholding agent to support that the form was signed by 

you or other person authorized to do so. See Regulations 

section 1.1441-1(e)(4)(i)(B).

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) 

Instructions for Form W-8IMY (Rev. 10-2021) -23-
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.

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 

cannot provide the certifications in Parts IX through XXVIII, 

do not check a box on 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.

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.

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,15 

hrs., 04 mins.; Learning about the law or the form, 6 hrs., 

31 mins.; Preparing the form, 8 hrs.; Sending 16 mins.

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.

-24- Instructions for Form W-8IMY (Rev. 10-2021)