Tax forms to use – U.S.A. – CBL
08.01.2025
The attached forms are for use in relation to U.S. tax procedures via Clearstream Banking S.A.
NQI clients wishing to apply for an omnibus structure and holding securities on behalf of multiple underlying recipients: please contact your Relationship Officer.
- IRS Forms and Instructions (PDF)
External Links
Attachments
- One-Time Certificate – U.S. Financial Institution ( 133 kb, pdf )
- One-Time Certificate – FATCA compliant FFI / Exempted beneficial owner own account ( 226 kb, pdf )
- One-Time Certificate – FFI – QIA: Qualified Intermediary assuming primary Non-Resident Alien (NRA) withholding responsibility and 1099 reporting and backup withholding responsibility ( 95 kb, pdf )
- One-Time Certificate – FFI – QIC Segregated Account for FATCA non-compliant recipients or Segregated account for exclusively FATCA compliant recipients being non-U.S. beneficial owners, U.S. exempt recipients, or U.S specified persons in a U.S. payee pool ( 107 kb, pdf )
- One-Time Certificate – FFI – QIB: Omnibus account for both FATCA non-compliant and compliant recipients being non-U.S. beneficial owners, U.S. exempt recipients and U.S. specified persons in a U.S. payee pool ( 97 kb, pdf )
- One-Time Certificate – FFI – QIB: Segregated account for FATCA compliant recipients being U.S. specified persons for which payee specific 1099 reporting is requested ( 144 kb, pdf )
- One-Time Certificate – FFI – QIC: Segregated account for FATCA compliant recipients being U.S. specified persons for which payee specific 1099 reporting is requested ( 101 kb, pdf )
- One-Time Certificate – FFI – NQI: Segregated Account for FATCA non-compliant recipients or FATCA compliant recipients being non-U.S. beneficial owners, U.S. exempt recipients or U.S. specified persons in a U.S. Payee Pool ( 221 kb, pdf )
- One-Time Certificate – FFI – NQI: Segregated account for FATCA compliant recipients being U.S. specified persons for which payee specific 1099 reporting is requested ( 181 kb, pdf )
- One-Time Certificate – FFI – QIC – NQI: Omnibus Account for exclusively FATCA non-compliant recipients and/or FATCA compliant recipients being non-U.S. beneficial owners, U.S. exempt recipients and U.S. specified persons in a U.S. payee pool ( 270 kb, pdf )
- Customer Waiver Clause Letter ( 62 kb, pdf )
- U.S. Taxable Securities - January 2025 ( 21,612 kb, zip )
- Withholding Statement for events subject to IRC Section 302 ( 192 kb, pdf )