Fill in the following fields:
1. Name of Individual or prganization that is the beneficial owner — Your full name. NOME COMPLETO
2. Country of incorporation or organization — Your Country. PAÍS RESIDENTE
3. Type of beneficial owner — tick “Individual”. Assinalar INDIVIDUAL
4. Permanent residence address… — Your mailing address, with city/town, state, postal code, and country. MORADA
Part II: Claim of Tax Treaty Benefits
On line no.9 “I certify that (check all that apply):”, tick “a The beneficial owner is a resident of …” and fill in your country in the blank field.
Assinalar o 9 a), e completar com o PAÍS RESIDENTE
Part III: Notional Principal Contracts
Tick line no.11, “I have provided or will provide a statement that ….”.
Part IV: Certification
Sign your signature at “Sign Here” and fill in the Date. Note that it is in the MMM-DD-YY format, month comes first before date. Example: 06-29-06.
Part III: Notional Principal Contracts
Tick line no.11, “I have provided or will provide a statement that ….”.
Part IV: Certification
Sign your signature at “Sign Here” and fill in the Date. Note that it is in the MMM-DD-YY format, month comes first before date. Example: 06-29-06.
ASSINAR NO FIM, e completar com a data MÊS-DIA-ANO
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