Tax residence and entity self-certification form

Legislation on exchange of financial account information in tax matters (FATCA (Foreign Account Tax Compliant Act) and CRS/DAC2 (Common Reporting Standard)) requires banks to request information on customers’ tax residence and tax identification number (part 1). In addition, a company (hereinafter Entity) must also be classified (part 2) according to definitions in these regulations.

Completing this form is mandatory for new customers. Pre-existing customers who are asked to complete the form but fail to do so, may be considered as reportable.

Please consult your tax advisor if you are in doubt how to complete the form.

Account holder information

Part 1 – Tax residency

The entity's country of tax residence and tax identification number (TIN).

Part 2 – Entity classification

The entity must be classified.Only one option can apply, please tick the applicable box in one of the three sections 2a-2c. Explanations of the terms used can be found below at the question marks, and in the received cover letter.

Please check above checkbox
Please check above checkbox
Please check above checkbox

Part 3 – Controlling Persons

Please only complete if the Entity is i) a Passive Non-Financial Entity or ii) An Investment Entity in a non CRS-participating jurisdiction managed by another Financial Institution.

US citizenship/tax residency

The Controlling Person is (either) a US citizen or otherwise tax resident in the USA.

Controlling Person in the capacity of:

Mandatory to check

Part 4 – Confirmation

Please check above checkbox
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