Tax forms to use - U.S.A. - CFCL
23.09.2025
The attached forms are for use in relation to U.S. tax procedures via Clearstream Fund Centre 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
- Affidavit - U.S.A. ( 99 kb, pdf )
- One-Time Certificate – U.S. Financial Institution ( 124 kb, pdf )
- One-Time Certificate – FFI – QIA: Qualified Intermediary assuming primary Non-Resident Alien (NRA) withholding responsibility and 1099 reporting and backup withholding responsibility ( 142 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 ( 156 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 ( 154 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 ( 272 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 ( 354 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 ( 342 kb, pdf )
- One-Time Certificate – FFI – QIC: Account for exclusively FATCA compliant recipients being non-U.S. beneficial owners, U.S. exempt recipients and U.S. specified persons in a U.S. payee pool ( 238 kb, pdf )
- One-Time Certificate – FFI – QIC 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 (QIC for non-U.S. BO and U.S. exempt) ( 110 kb, pdf )
- One-Time Certificate – FATCA compliant FFI / Exempted Beneficial Owner Own account ( 178 kb, pdf )
- U.S. Tax Guide Decision Table ( 70 kb, pdf )