w-8ben -e · 7 of cty 8 lis if n note. please complete remainder of the form including signing act...

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如您為【臺灣成立之公司/團體或註冊地非美國之公司/團體】，以設立地在臺灣之公司為填寫範例供參：請填寫公司英文名稱請勾選公司所屬之 FATCA 身分，並請依指示填寫後方對應欄位請勾選稅籍分類，如無適合得免勾選請填寫公司登記地址，如通訊地址與登記地址相同得免填寫。如為金融機構且有取得 GIIN，此欄位須填寫公司設立地 W-8BEN-E 適用註冊地非美國之公司/ 團體填寫以下填寫內容可用英文或中文填寫請填寫公司統一編號，如為境外公司可免填

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Page 1: W-8BEN -E · 7 Of Cty 8 LIS if N Note. Please complete remainder of the form including signing Act Notiœ. wpuate details a GA FFI FFI a FFI 2 GA) g—lt of a US. of C.nplete Pan

如您為【臺灣成立之公司/團體或註冊地非美國之公司/團體】，以設立地在臺灣之公司為填寫範例供參：

請填寫公司英文名稱

請勾選公司所屬之FATCA身分，並請依指示填寫後方對應欄位

請勾選稅籍分類，如無適合得免勾選

請填寫公司登記地址，如通訊地址與登記地址相同得免填寫。

如為金融機構且有取得GIIN，此欄位須填寫

公司設立地

W-8BEN-E 適用註冊地非美國之公司/

團體填寫

以下填寫內容可用英文或中文填寫

請填寫公司統一編號，如為境外公司可免填

Page 2: W-8BEN -E · 7 Of Cty 8 LIS if N Note. Please complete remainder of the form including signing Act Notiœ. wpuate details a GA FFI FFI a FFI 2 GA) g—lt of a US. of C.nplete Pan

填寫完公司基本資料，請依欄位 5所勾選之 FATCA身分填寫後方(PartIV至 PartXXVIII)對應欄位。

例如：身分為 Active NFFE，請勾選 PartXXV，其他欄位免填。

勾選該 FATCA身分所須聲明事項

Page 3: W-8BEN -E · 7 Of Cty 8 LIS if N Note. Please complete remainder of the form including signing Act Notiœ. wpuate details a GA FFI FFI a FFI 2 GA) g—lt of a US. of C.nplete Pan

00001111.12.2015.12.2015.12.2015.12.2015 KevinKevinKevinKevin ChengChengChengCheng Kevin Cheng

公司有權代表人簽名(可簽中文或英文)

請以正楷書寫左方簽名

有權代表公司簽署文件之聲明

簽署日期

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