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    Certificate of Foreign Status of Beneficial Owner For United States Tax Withholding and Reporting (Individuals)

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    Yordani Fabiani
    The document is a Form W-8BEN certificate of foreign status for an individual from Venezuela. It provides identification information for the individual, certifies that they are a resident of Venezuela for tax treaty purposes, and claims a reduced 10% tax rate for copyright royalties according to the US-Venezuela tax treaty.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Certificate of Foreign Status of Beneficial Owner For United States Tax Withholding and Reporting (Individuals)

    Uploaded by

    Yordani Fabiani
    49 views1 page
    The document is a Form W-8BEN certificate of foreign status for an individual from Venezuela. It provides identification information for the individual, certifies that they are a resident of Venezuela for tax treaty purposes, and claims a reduced 10% tax rate for copyright royalties according to the US-Venezuela tax treaty.

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    Tax-interview

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    The document is a Form W-8BEN certificate of foreign status for an individual from Venezuela. It provides identification information for the individual, certifies that they are a resident of Venezuela for tax treaty purposes, and claims a reduced 10% tax rate for copyright royalties according to the US-Venezuela tax treaty.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    49 views1 page

    Certificate of Foreign Status of Beneficial Owner For United States Tax Withholding and Reporting (Individuals)

    Uploaded by

    Yordani Fabiani
    The document is a Form W-8BEN certificate of foreign status for an individual from Venezuela. It provides identification information for the individual, certifies that they are a resident of Venezuela for tax treaty purposes, and claims a reduced 10% tax rate for copyright royalties according to the US-Venezuela tax treaty.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Reference Id: A08195872FZQ6ZSAF2M5P

    Certificate of Foreign Status of Beneficial


    Owner for United
    SUBSTITUTE
    States Tax Withholding and Reporting
    Form W-8BEN (July 2017)
    (Individuals)
    Do NOT use this form if: Instead, use Form:
    . You are NOT an individual W-8BEN-E
    . You are a U.S. citizen or other U.S. person, including a resident alien individual W-9
    . You are a beneficial owner claiming that income is effectively connected with the conduct of trade or business W-8ECI
    within the U.S. (other than personal services)
    . You are a beneficial owner who is receiving compensation for personal services performed in the United States 8233 or W-4
    . A person acting as an intermediary W-8IMY

    Part I Identification of Beneficial Owner


    1 Name of individual who is the beneficial owner 2 Country of citizenship

    viviana andreina arias alamo Venezuela

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

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

    distrito capital caracas 1010

    Country

    Venezuela

    4 Mailing address (if different from above)

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

    Country

    5 U.S. taxpayer identification number (SSN or ITIN), if required (see instructions) 6 Foreign tax identifying number (see instructions)

    XXXX3072

    Part II Claim of Tax Treaty Benefits

    9 I certify that the beneficial owner is a resident of Venezuela within the meaning of the income tax
    treaty between the United States and that country.

    10 Special rates and conditions (if applicable--see instructions):


    The beneficial owner is claiming the provisions of Article and paragraph 12(2) of the treaty identified on line 9 above to claim a
    10.0 % rate of withholding on (specify type of income): Copyright Royalties .
    Explain the additional conditions in the Article and paragraph the beneficial owner meets to be eligible for the rate of withholding:

    Part III Certification


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

    1. I am the individual that is the beneficial owner (or am authorized to sign for the individual that is the beneficial owner) of all the income to
    which this form relates or am using this form to document myself for chapter 4 purposes,
    2. The person named on line 1 of this form is not a U.S. person,
    3. The income to which this form relates is:
    (a) not effectively connected with the conduct of a trade or business in the United States,
    (b) effectively connected but is not subject to tax under an applicable income tax treaty, or
    (c) the partner's share of a partnership's effectively connected income,
    4. The person named on line 1 of this form is a resident of the treaty country listed on line 9 of the form (if any) within the meaning of the income
    tax treaty between the United States and that country, and
    5. For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.

    Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the
    beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. I agree that I will
    submit a new form within 30 days if any certification made on this form becomes incorrect.

    The Internal Revenue Service does not require your consent to any provisions of this document other than the certifications required to
    establish your status as a non-U.S. individual and, if applicable, obtain a reduced rate of withholding.

    Sign viviana andreina arias alamo 06-15-2021


    Here Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY) Capacity in which acting

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