Form descriptions - Standard refund - French equities (held in CBF)

22.04.2022

Information is provided here about the forms and their use in relation to the procedure for standard refund of withholding tax on income from French equities, as follows:

  • Form 5000 Certificate of Residence;
  • Form 5000 Attestation of Percentage;
  • Form 5001 Calculation and Repayment of Withholding Tax on Dividends;
  • Certificate of residence;
  • Form RPPM Revenus et profits du patrimoine mobilier;
  • UCIT attestation;
  • Power of Attorney;
  • Letter of Request to Clearstream Banking for Reclaim of French Withholding Tax;
  • Letter of Indemnity - French Forms 5000, 5001, and RPPM Power of Attorney - CBF (LOI);
  • Tax Attestation.

Additional special documentation is required for various types of mutual funds, pension funds and particular foreign entities.

Form 5000 Certificate of Residence

The Form 5000 Certificate of Residence contains the beneficial owner's information and must be signed by both the beneficial owner (or its representative under cover of a Power of Attorney) and the beneficial owner's local tax authorities.

As a general rule:

  • Box I: "Dividends" and "Normal procedure" must be ticked.
  • Box II must contain the appropriate beneficial owner type to specify the "Occupation".
    This must match the "BO type" used in the uploaded per-payment Detailed List of Beneficial Owners.
    The legal form of the company (GmbH, SA, SPA, LLP etc.) should be entered in the “Surname and first name, or company name” field and must be in line with the beneficial owner type.
    Note: it is recommended to avoid using the "Legal Entity" and "Investment Fund" BO types. Beneficial owners of these statuses are required to provide a tax attestation.
  • Box III must be fully completed.
  • Box IV must be completed, signed and stamped by the BO’s local tax authorities.
  • Box V must be left blank.
  • Box VII must be left blank.

Notes on French Tax Forms

Forms 5000

Each form is available in French, German, English, Spanish, Italian, Dutch and Chinese and is to be completed in triplicate: two versions in the foreign language most appropriate to the DTT country and one version in French.

The information in all three copies is identical and they must all three be completed and sent to the local tax authorities of the beneficial owner’s country of residence for certification purposes. These forms must be printed on both sides.

The copies are processed as follows:

  • The first local language copy is kept by the tax authorities of the beneficial owner’s country of residence;
  • The second local language copy is returned and kept by the beneficial owner;
  • The third copy, in French, is returned and submitted to the French Tax Authorities.

Notes for U.S. beneficial owners

For U.S.A. resident beneficial owners that are not individuals (physical persons):

  • It is mandatory to submit an original Form 6166 issued by the Internal Revenue Service (IRS). IRS Form 6166 is valid for the year issued, as long as the beneficiary name, the tax ID number and the status of the beneficial owner have not changed during that tax year. If an original IRS Form 6166 was submitted with a reclaim within the same year, a copy of that submitted form will be accepted.
  • The legal status of the U.S. beneficiary and the Internal Revenue Code section to which it refers (for example, charitable foundations or charities 501(c)-3) must be clearly stated.
  • U.S. pension funds must include, in their IRS certification, mention of the relevant IRS section (401 (a), 401(b), 403 or 457) or that they are organised as a collective trust.
  • Because an original IRS Form 6166 is submitted together with the Form 5000, Box IV of Form 5000 does not have to be certified by the IRS.

For U.S.A. resident beneficial owners who are individuals (physical persons):

  • If an original IRS Form 6166 is submitted together with the Form 5000, Box IV of Form 5000 does not have to be certified by the IRS.
  • If no IRS Form 6166 is submitted with the Form 5000, Box IV or Box VI of Form 5000 must be filled, stamped, dated and signed.

N.B.: For customers that are residents of a Double Taxation Treaty (DTT) country to renew their certificate at the beginning of the year (YYYY), an extension of validity of the previous year's Form 5000 (YYYY-1) is granted until the 31 March YYYY on condition that the new Form 5000, correctly completed and signed in year YYYY, is received by Clearstream Banking before the 31 March YYYY.

Note for investment schemes:

If the beneficial owner is an investment scheme, one (1) or more Forms 5000 Attestation of Percentage must be completed.

Who completes it?

Beneficial owner or its legal representative or a notarya (for deceased persons) and the beneficial owner’s tax authority.

How often is it provided?

Per standard refund application.

When is it provided?

At the latest, two (2) months before the statutory deadline.

Copy or original?

Original required.

a. For deceased BOs the notary (or equivalent according to the countries) must indicate in the 5000 the name of the BO at the moment of the dividend payment and provide an attestation indicating the names of the heirs and their percentage of inheritance.

Form 5000 Attestation of Percentage

Form 5000 Attestation of Percentage, dated and signed by the beneficial owner (or by the customer representing the beneficial owner under cover of a Power of Attorney) in order to attest to the percentage of resident shareholders during the accounting period in which the income was realised.

As the collective entitlement of such funds and companies to treaty benefits is limited to the portion of their unit holders and shareholders who are residents of their home country, the percentage must be 100% in order to participate in the simplified procedure. If the percentage is lower, the company/fund can apply for the standard refund procedure.

An eligible beneficial owner that is a collective investment scheme must, in most cases (see Note: below), fill in Box VII of Form 5000 to certify the percentage of shareholders eligible under the claimed Double Taxation Treaty (DTT) during the relevant accounting period. As the accounting period may not correspond to a calendar year, customers might be required to provide Clearstream Banking with multiple Forms 5000. In this case, on condition that a Form 5000 signed by the local tax authorities is already in place for the calendar year, the newly submitted Form 5000 may be provided, signed and dated by the beneficial owner/representative only (that is, not by the local tax authorities).

As a general rule:

  • Box I: "Dividends" and "Normal procedure" must be ticked;
  • Box II must contain the appropriate beneficial owner type to specify the "Occupation";
    This must match the "BO type" used in the uploaded per-payment Detailed List of Beneficial Owners.
    The legal form of the company (GmbH, SA, SPA, LLP etc.) should be entered in the “Surname and first name, or company name” field and must be in line with the beneficial owner type.
    Note: it is recommended to avoid using the "Legal Entity" and "Investment Fund" BO types. Beneficial owners of these statuses are required to provide a tax attestation;
  • Box III must be fully completed;
  • Box IV must be left blank;
  • Box V must be left blank;
  • Box VII must contain the beginning and end dates of the current accounting period and the percentage of shareholders eligible under the respective Double Taxation Treaty (DTT) and for the relevant accounting period.

For a newly issued collective investment scheme whose first accounting period has not yet been closed, information must be supplied on Form 5000 as follows:

  • Box II must clearly mention “NEWLY ISSUED COLLECTIVE INVESTMENT SCHEME”; and
  • Box VII must contain the beginning and end dates of the first/current accounting period.

Note: For investment companies and funds from Spain, the U.S.A. and Trinidad and Tobago, treaty benefits apply, as indicated in the notes accompanying Form 5000, to all income received from French sources and, consequently, in these cases, Box VII of Form 5000 should not be filled in.

How many are provided?

One (1) (or more, if applicable) per beneficial owner.

Who completes it?

The beneficial owner or the customer representing the beneficial owner under Power of Attorney. It must be signed, stamped and dated before the first dividend payment date to which it applies or per reclaim application.

How often is it provided?

Once (or more, if applicable) per relevant applicable accounting period.

When is it provided?

Together with the set of reclaim documentation.

Copy or original?

Original required. Must be in French for the French Tax Authorities.

Form 5001 Calculation and repayment of withholding tax on dividends

Form 5001 provides all the details necessary for the entitlement and calculation of the standard refund for entities claiming the benefit of the DTT, including EU parent companies and for foreign CIVs.

For reclaim applications, DTT residents and foreign CIVs must fill in page two only while EU parent companies must fill in page one and two as follows:

  • Box I should only be filled in and signed if the beneficial owner is entitled to benefit from the application of the Parent-Subsidiary regime;
  • Box II must be completed by the beneficial owner or its representative;
  • Box III must be left blank for completion by the paying institution.

For reclaim applications, multiple dividend payments can be filed in a single reclaim as long as the payments are all from the same calendar year.

Notes on French Tax Forms

Form 5001

Each form is available in French, German, English, Spanish, Italian, Dutch and Chinese and is to be completed in triplicate: two versions in the foreign language most appropriate to the DTT country and one version in French.

The information in all three copies is identical and they must all three be completed and sent to the local tax authorities of the beneficial owner’s country of residence for certification purposes. These forms must be printed on both sides.

The copies are processed as follows:

  • The first local language copy is kept by the tax authorities of the beneficial owner’s country of residence;
  • The second local language copy is returned and kept by the beneficial owner;
  • The third copy, in French, is returned and submitted to the French Tax Authorities.

Who completes it?

Beneficial owner or a customer representing or a notarya (for deceased persons) the beneficial owner under Power of Attorney.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two (2) months before the statutory deadline.

Copy or original?

Original required.

a. For deceased BOs the notary (or equivalent according to the countries) must also provide an attestation indicating the names of the heirs and their percentage of inheritance

Certificate of residence (COR)

A certificate of residence may be provided either: 

  • by residents of Canada, Belgium, UAE, Spain, USA(6166), Hong-Kong, Portugal as these countries do not certify the form 5000. The COR must be sent together with the non-certified form 5000. For other countries, the certified form 5000 must be provided
  • by the foreign individuals instead of a form 5000 Certificate of residence. 

It must be signed by the tax authorities of the country of residence of the foreign individual.

Who completes it?

the local Tax Authorities of the beneficial owner.

How often is it provided?

Per standard refund application.

When is it provided?

At the latest, two (2) months before the statutory deadline.

Copy or original?

Original- in French or English.

Form RPPM – Revenus et profits du patrimoine mobilier

For reclaim application, Form RPPM is used as an attestation of comparability of the foreign CIV with a French CIV. It must be provided by eligible AIFs. 

As a general rule,

  • Boxes I and II must be fully completed by the CIV or its managing company;
  • Box III must contain date, place, signature and stamp;
  • The table must be updated with the requested details according to the status of the CIV. Crossing a category in column 3 implies to fill in the related details in column 4.

Who completes it?

Beneficial owner (AIF or its managing company).

How many are provided?

One (1) per sub-fund.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two (2) months before the statutory deadline.

Copy or original?

Original required, in French.

UCIT Attestation

For reclaim application, the UCIT Attestation is used as an attestation of comparability of the foreign CIV with a French CIV. It must be provided by eligible UCITS.

Who completes it?

The competent authority (BAFIN, CSSF, AMF…)

How many are provided ?

One (1) per sub-fund.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two (2) months before the statutory deadline.

Copy or original?

Original required, in French or English.

Power of Attorney

If the customer or a third party is completing the Forms 5000, 5001 and RPPM on behalf of the beneficial owner, a Power of Attorney must be provided to Clearstream Banking.

The original is required however, as of 12 December 2019 copies are accepted upon receipt of an accompanying Letter of Indemnity.

Customers are required to provide copies of the POA with each renewed document, stating on the copy of the POA the reference of the first one registered in Clearstream Banking.

Note: Any POA signed by the BO in favour of a third party before he died automatically expires with the death of the BO.

Who completes it?

Beneficial owner.

How often is it provided?

Per reclaim application.

When is it provided?

Together with the related reclaim documentation.

Copy or original?

Original required, in French or English.

Letter of Indemnity - French Forms 5000, 5001 and RPPM Power of Attorney - CBF (LOI)


The LOI must be provided with every first copy of POA. This letter of indemnity is a self-declaration to be signed by the customer of Clearstream Banking and by which the customer commits to provide originals of the POAs upon request of the FTA. If this LOI is not provided, any copy of POAs will be rejected, and the full tax will apply to the dividend payment due to the related beneficial owner.

The letter of indemnity must be provided once along with the first copy of POA and is valid until revoked.

The LOI is not required from customers who provide original POAs.

Who completes it?

Beneficial owner.

How often is it provided?

Once with the first copy of POA.

When is it provided?

Together with the related copy of POA.

Copy or original?

Original required.

Letter of Request for Reclaim to Clearstream Banking for Reclaim of French Withholding Tax

This authorises Clearstream Banking to reclaim withholding tax from the French Tax Authorities on the customer's behalf.

Who completes it?

Customer.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest two (2) months before the statutory deadline.

Copy or original?

Original required.