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1. Home
2. Instructions
3. Instructions for Form 1042-S (2024)

* Instructions for Form 1042-S - Introductory Material
* Future Developments
* What’s New
* Reporting of distributions of publicly traded partnerships (PTPs).
* Reporting of a GIIN.
* Reminders
* Electronic filing.
* Income code 56.
* Reliance on proposed regulations reducing burden under FATCA and chapter
3.
* Withholding rates.
* Qualified derivatives dealers (QDDs).
* Foreign Account Tax Compliance Act (FATCA).
* Filing Information Returns Electronically (FIRE) System.
* Unique form identifier.
* List of foreign country codes.
* General Instructions
* Purpose of Form
* Who Must File
* Where, When, and How To File
* Electronic filing requirement.
* Extension of time to file.
* Recipient copies.
* Electronic Reporting
* Hardship waiver.
* Truncation of TIN Rules
* Need assistance?
* Additional Information
* Record Retention
* Substitute Forms
* Penalty for filing incorrect substitute form.
* Account-by-Account Reporting by Certain Financial Institutions
* Combined Reporting Procedures
* Deposit Requirements
* Definitions
* Withholding agent.
* Account holder.
* Amount realized.
* Amount subject to chapter 3 withholding.
* Authorized agent.
* Beneficial owner.
* Broker.
* Chapter 3.
* Disregarded entity.
* Disclosing QI.
* Dividend equivalent.
* Exempt beneficial owner.
* Exempt recipient.
* Expatriate.
* Fiscally transparent entity.
* Flow-through entity.
* Financial institution.
* Foreign financial institution (FFI).
* Deemed-compliant FFI.
* Nonparticipating FFI.
* Participating FFI.
* Foreign person.
* Global intermediary identification number (GIIN).
* Intermediary.
* Qualified intermediary (QI).
* Nonqualified intermediary (NQI).
* Private arrangement intermediary (PAI).
* Nonfinancial foreign entity (NFFE).
* Excepted NFFE.
* Nominee.
* Nonexempt recipient.
* Nonresident alien individual.
* Payee.
* Presumption rules.
* Publicly traded partnership (PTP).
* PTP distribution.
* PTP interest.
* Qualified derivatives dealer (QDD).
* Qualified securities lender (QSL).
* Recalcitrant account holder.
* Recipient.
* Specified notional principal contract (SNPC).
* Specified U.S. person.
* Substantial U.S. owner.
* Territory FI.
* U.S. branch treated as a U.S. person.
* Withholdable payment.
* Withholding certificate.
* Withholding foreign partnership (WP) or withholding foreign trust (WT).
* Nonwithholding foreign partnership (NWP) or nonwithholding foreign trust
(NWT).
* Amounts Subject to Reporting on Form 1042-S
* Amounts That Are Not Subject to Reporting on Form 1042-S
* Interest and OID from short-term obligations.
* Registered obligations targeted to foreign markets.
* Bearer obligations targeted to foreign markets.
* Notional principal contract payments that are not ECI or dividend
equivalents.
* Accrued interest and OID.
* Certain withholdable payments.
* Certain amounts realized.
* Distributions Attributable to Dispositions of U.S. Real Property Interests
by Publicly Traded Trusts and Qualified Investment Entities
* Publicly traded trusts.
* Qualified investment entities (QIEs).
* Look‐through rule for QIEs.
* Publicly Traded Partnerships (Sections 1446(a) and (f) Withholding Tax)
* Requirement To Withhold
* Chapter 3 withholding.
* Chapter 4 withholding.
* Before Completing Form 1042-S
* Step 1.
* Step 2.
* Step 3.
* Payments by U.S. Withholding Agents
* In general.
* Payments to Recipients
* Payments directly to beneficial owners or partners.
* Payments to a QI (including a QDD), WP, or WT under chapter 3 or 4.
* Example 2.
* Payments allocated by QIs, or presumed made, to U.S. nonexempt
recipients.
* Example 3.
* Example 4.
* Payment to QI of PTP distributions or amounts realized.
* Substitute dividends paid to qualified securities lenders (QSLs).
* Amounts paid to certain U.S. branches or territory FIs.
* Amounts paid to a foreign estate.
* Dual claims.
* Special instructions for U.S. trusts and estates.
* Payments Made to Persons Who Are Not Recipients
* Disregarded entities and hybrid entities.
* Amounts paid to an NQI or flow-through entity of withholdable payments.
* Pro-rata reporting to NQI.
* Payments allocated, or presumed made, to U.S. nonexempt recipients.
* Amounts paid to an NQI or flow-through entity of amounts realized and
PTP distributions.
* Amounts Paid by QIs
* In general.
* Amounts Paid to PAIs
* Amounts Paid by QIs to Certain Partnerships and Trusts
* Recipient-by-Recipient Reporting by QIs
* Payments made by QIs to another QI, QDD, QSL, WP, or WT.
* Payments made to an NQI (including an NQI that is an account holder of
a PAI).
* Payments made by QIs to a flow-through entity.
* Amounts Paid by Withholding Foreign Partnerships and Trusts
* In general.
* Amounts Paid by Nonqualified Intermediaries and Flow-Through Entities
* Specified Federal Procurement Payments Made to Foreign Persons
* Multiple Withholding Agent Rule
* Penalties
* Late filing of correct Form 1042-S.
* Failure to furnish correct Form 1042-S to recipient.
* Failure to file electronically.
* Avoid Common Errors
* Specific Instructions for Withholding Agents
* Rounding Off to Whole Dollars
* Unique Form Identifier
* Amended Checkbox
* Amendment Number
* Box 1, Income Code
* Box 2, Gross Income
* Box 3
* Chapter indicator.
* Boxes 3a and 4a, Chapter 3 and Chapter 4 Exemption Codes
* Chapter 3 Exemption Codes
* Chapter 4 Exemption Codes
* Special instructions for use of chapter 3 exemption codes.
* Boxes 3b and 4b, Chapter 3 and Chapter 4 Tax Rates
* Exception for central withholding agreements.
* Box 5, Withholding Allowance
* Box 6, Net Income
* Boxes 7a Through 11, Federal Tax Withheld
* Box 7a.
* Box 7b.
* Box 7c.
* Box 8.
* Box 9, Overwithheld tax repaid to recipient pursuant to adjustment
procedures.
* Box 10.
* Box 11, Tax paid by withholding agent (amounts not withheld).
* Box 12a, Withholding Agent's Employer Identification Number (EIN)
* Boxes 12b and 12c, Withholding Agent's Chapter 3 and Chapter 4 Status Code
* Boxes 12d Through 12i, Withholding Agent's Name, GIIN, Country Code,
Foreign TIN (if any), and Address
* Box 12e, Withholding agent's GIIN.
* Box 12f, Country code.
* Boxes 13a Through 13d, Recipient's Name, Country Code, and Address
* Box 13a, Recipient's name.
* Box 13b, Recipient's country code.
* Boxes 13c and 13d, Recipient's address.
* Boxes 13e and 13h, Recipient's U.S. TIN and GIIN
* Boxes 13f and 13g, Recipient’s Chapter 3 and Chapter 4 Status Codes
* Box 13i, Recipient's Foreign Tax Identification Number
* Box 13j, LOB Code
* Box 13k, Recipient’s Account Number
* Box 13l, Recipient’s Date of Birth
* Boxes 14a and 14b, Primary Withholding Agent's Name and EIN
* Box 15, Pro-Rata Basis Reporting Checkbox
* Boxes 15a Through 15i, Intermediary/Flow-Through Entity's Name, Status
Code, Country Code, Address, EIN, GIIN, and Foreign Tax Identification
Number
* Box 15f, Country code.
* Box 15g, Intermediary or flow-through entity's foreign tax identification
number.
* Boxes 16a Through 16e, Payer's Name, TIN, GIIN, and Status Code
* Boxes 17a Through 17c, State Income Tax Withheld and Related Information
* Amended Forms
* Step 1.
* Amended checkbox.
* Step 2.
* Instructions for Form 1042-S - Notices
* Privacy Act and Paperwork Reduction Act Notice.
* Instructions for Form 1042-S - Additional Material

INSTRUCTIONS FOR FORM 1042-S (2024)

FOREIGN PERSON'S U.S. SOURCE INCOME SUBJECT TO WITHHOLDING

Section references are to the Internal Revenue Code unless otherwise noted.

2024

--------------------------------------------------------------------------------

INSTRUCTIONS FOR FORM 1042-S - INTRODUCTORY MATERIAL

--------------------------------------------------------------------------------

FUTURE DEVELOPMENTS

For the latest information about developments related to Form 1042-S and its
instructions, such as legislation enacted after they were published, go to
IRS.gov/Form1042S.

WHAT’S NEW

Reporting of distributions of publicly traded partnerships (PTPs).

The instructions for boxes 16a through 16e state that a withholding agent for a
PTP distribution is required to provide the applicable information for the PTP
in the payer's box (including code 38) when reporting the payment of a PTP
distribution using income code 27, 57, or 58. These instructions have been
updated to clarify that the requirement to report the PTP's information with
respect to its distribution does not apply to a withholding agent paying a PTP
distribution to a Qualified Intermediary (QI) when reporting to the QI in
reporting pools on Forms 1042-S with respect to the distribution. Under these
instructions, this exception also applies to a QI reporting a PTP distribution
using reporting pools. See Boxes 16a Through 16e, Payer's Name, TIN, GIIN, and
Status Code, later. For this change and other clarifications for the reporting
of PTP distributions, see Publicly Traded Partnerships (Sections 1446(a) and (f)
Withholding Tax), later.

Reporting of a GIIN.

The 2023 Form 1042-S instructions contained a note, which stated that if a
payment was properly classified with a chapter 3 indicator in box 3, the
withholding agent was not required to enter a GIIN in boxes 12e, 13h, 15e, and
16c. This exception to the reporting of a GIIN has been removed from these
instructions. See the instructions for the above boxes for when a GIIN is
required. See the instructions for boxes 16a through 16e for when a GIIN is
required for a PTP reported in box 16a.

REMINDERS

Electronic filing.

A withholding agent that is not a financial institution is required to file
Forms 1042-S electronically if it is either required to file at least 10
information returns during the year or is a partnership with more than 100
partners. See Regulations section 301.6011-2.

Income code 56.

Income code 56 was added to the 2022 Form 1042-S to address section 871(m)
transactions resulting from combining transactions under Regulations section
1.871-15(n) (including as modified by transition relief under Notice 2022-37,
2022-37 I.R.B. 234, available at IRS.gov/irb/2022-37_IRB#NOT-2022-37, when
applicable). Income code 56 should be used for any dividend equivalent pursuant
to a transaction that is a section 871(m) transaction as a result of combining
transactions, even if another income code could apply to the dividend
equivalent. See Box 1, Income Code , later, for additional information.

Reliance on proposed regulations reducing burden under FATCA and chapter 3.

On December 18, 2018, the IRS and the Department of the Treasury issued proposed
regulations (REG-132881-17) to reduce taxpayer burden with respect to certain
requirements under chapters 3 and 4. The proposed regulations provide that,
under section 7805(b)(1)(C), taxpayers may generally rely on the proposed
regulations until final regulations are issued. Specifically, for purposes of
these instructions, a withholding agent may rely on the following provisions in
connection with completing Form 1042-S.

* Withholding and reporting in a subsequent year. A partnership or trust that
is permitted to withhold in a subsequent year with respect to a foreign
partner's or beneficiary's share of income for the prior year may designate
the deposit of the withholding as attributable to the preceding year and in
some cases a partnership is provided an extended due date for filing and
furnishing Form 1042-S. See the instructions for box 7c, later.

* Adjustments to overwithholding under the reimbursement and set-off
procedures. A withholding agent may make adjustments to overwithholding using
either the reimbursement or set-off procedures until the extended due date
for filing Form 1042-S (unless the Form 1042-S has already been filed or
furnished). Additionally, a withholding agent may use the extended due date
for filing a Form 1042 to claim a credit for any adjustments made to
overwithholding. See the instructions for box 9, later.

Withholding rates.

The rate of withholding under section 1446(a) by a PTP on a distribution of
income effectively connected to a U.S. trade or business is 21% for corporate
partners and 37% for all other partners.

The rate of withholding by a qualified investment entity (QIE) on a distribution
to a nonresident alien or foreign corporation that is treated as gain from the
sale or exchange of a U.S. real property interest by the shareholder is 21%.

Qualified derivatives dealers (QDDs).

These instructions provide guidance on how to report payments on Form 1042-S
that are made to and by QDDs. See Payments by U.S. Withholding Agents and
Amounts Paid by QIs , later. For more information on the withholding and
reporting requirements associated with payments made to and by QDDs, see Rev.
Proc. 2022-43, 2022-52 I.R.B. 570, available at
IRS.gov/irb/2022-52_IRB#RP-2022-43. See also Notice 2022-37, 2022-37 I.R.B. 234
available at IRS.gov/irb/2022-37_IRB#NOT-2022-37, which extends the phase-in
period provided in Notice 2020-2, 2020-3 I.R.B. 327, available at
IRS.gov/irb/2020-03_IRB#NOT-2020-2, for certain provisions of the section 871(m)
regulations for 2 years (including 2024), including for certain requirements of
a QDD.

Foreign Account Tax Compliance Act (FATCA).

Form 1042-S reports payments and amounts withheld under the provisions commonly
known as FATCA or chapter 4 of the Internal Revenue Code (chapter 4) in addition
to those amounts required to be reported under chapter 3 of the Internal Revenue
Code (chapter 3). Form 1042-S requires the reporting of an applicable exemption
to the extent withholding under chapter 4 did not apply to a payment of U.S.
source fixed or determinable annual or periodical (FDAP) income (including
deposit interest) that is reportable on Form 1042-S. For payments to
intermediaries, flow-through entities, and recipients, Form 1042-S requires that
the chapter 3 status (or classification) and, when the payment reported is a
withholdable payment, the chapter 4 status, be reported on the form according to
the codes provided in these instructions. For the requirement of a withholding
agent to file a Form 1042-S for chapter 4 purposes, see Regulations section
1.1474-1(d).

Filing Information Returns Electronically (FIRE) System.

For files submitted on the FIRE System, it is the responsibility of the filer to
check the status within 5 business days to verify the results of the
transmission. The IRS will not mail error reports for files that are bad. See
Pub. 1187, Specifications for Electronic Filing of Form 1042-S, Foreign Person’s
U.S. Source Income Subject to Withholding.

Unique form identifier.

Withholding agents must assign a unique identifying number to each Form 1042-S
they file. This identifying number is used, for example, to identify which
information return is being corrected or amended when multiple information
returns are filed by a withholding agent with respect to the same recipient. The
unique identifying number cannot be the recipient's U.S. or foreign TIN. The
unique identifying number must be numeric. The length of a given identifying
number must be exactly 10 digits. The identifying number must be unique to each
original Form 1042‐S filed for the current year. The identifying number can be
used on a new original form in a subsequent year.

List of foreign country codes.

Form 1042-S filers must use the same list of country codes used on other IRS
forms (for example, Forms 926, 1118, 3520, and 8805). This list of foreign
country codes may be found at IRS.gov/CountryCodes.

NOTE.

Although the list of country codes is maintained by Modernized e-File, Form
1042-S filers who file electronically will continue to use the FIRE System. See
the instructions for Electronic Reporting, later. Also, if applicable, the
option to file Form 1042-S by paper is still available.

GENERAL INSTRUCTIONS

PURPOSE OF FORM

Use Form 1042-S to report income described under Amounts Subject to Reporting on
Form 1042-S , later, and to report amounts withheld under chapter 3 or chapter
4.

Use Form 1042-S to report specified federal procurement payments paid to foreign
persons that are subject to withholding under section 5000C.

Use Form 1042-S to report payments of eligible deferred compensation items or
distributions from nongrantor trusts to covered expatriates that are subject to
withholding under section 877A. See Box 1, Income Code , later.

Use Form 1042-S to report certain distributions that are made by publicly traded
trusts and QIEs (as defined under section 897(h)(4)(A)). See Distributions
Attributable to Dispositions of U.S. Real Property Interests by Publicly Traded
Trusts and Qualified Investment Entities , later.

Use Form 1042-S to report distributions of effectively connected income (ECI) by
a PTP or nominee and amounts realized paid on certain transfers of PTP
interests. See Publicly Traded Partnerships (Section 1446(a) and (f) Withholding
Tax) , later.

Every person required to deduct and withhold any tax under chapter 3 or chapter
4 is liable for such tax.

Do not use Form 1042-S to report an item required to be reported on any of the
following forms.

* Form W-2 (wages and other compensation made to employees (other than
compensation for dependent personal services for which the beneficial owner
is claiming treaty benefits), including wages in the form of group-term life
insurance).

* Form 1099 (except if indicated otherwise in these instructions).

* Form 8288-A, Statement of Withholding on Certain Dispositions by Foreign
Persons, or Form 8805, Foreign Partner's Information Statement of Section
1446 Withholding Tax. Withholding agents otherwise required to report a
distribution partly on a Form 8288-A or Form 8805 and partly on a Form 1042-S
may instead report the entire amount on Form 8288-A or Form 8805.

* Form 8966, FATCA Report. Foreign financial institutions (FFIs), sponsoring
entities of certain FFIs and other foreign entities, and withholding agents
are required to report on Form 8966 certain account holders and payees. An
FFI or withholding agent may also be required to file Form 1042-S to report
payments of U.S. source FDAP income made to such persons and to report tax
deducted and withheld, if any.

WHO MUST FILE

Every withholding agent (defined in Definitions , later) must file an
information return on Form 1042-S to report amounts paid during the preceding
calendar year that are described under Amounts Subject to Reporting on Form
1042-S , later. However, withholding agents who are individuals are not required
to report a payment on Form 1042-S if they are not making the payment as part of
their trade or business and no withholding is required to be made on the
payment. For example, an individual making a payment of interest that qualifies
for the portfolio interest exception from withholding is not required to report
the payment if the portfolio interest is paid on a loan that is not connected to
the individual's trade or business. However, an individual who is a withholding
agent paying an amount that actually has been subject to withholding is required
to report the payment. Also, an individual paying an amount on which withholding
is required must report the payment, whether or not the individual actually
withholds. See Multiple Withholding Agent Rule, later, for exceptions to
reporting when another person has reported the same payment to the recipient.
Note that there may be a payment for tax purposes, even if there is no net
payment. For example, see Regulations section 1.871-15(i) for when there is a
dividend equivalent.

You must file a Form 1042-S even if you did not withhold tax under chapter 3
because the income was exempt from tax under a U.S. tax treaty or the Internal
Revenue Code, including the exemption for income that is effectively connected
with the conduct of a trade or business in the United States, or you released
the tax withheld to the recipient. For exceptions, see Amounts That Are Not
Subject to Reporting on Form 1042-S , later.

Amounts paid to an individual that is a bona fide resident of a U.S. territory
are not subject to reporting on Form 1042-S if the beneficial owner of the
income is a U.S. citizen, national, or resident alien (such amounts may be
subject to Form 1099 reporting).

If you file Form 1042-S, you must also file Form 1042, Annual Withholding Tax
Return for U.S. Source Income of Foreign Persons. See Form 1042 and its
instructions for more information.

WHERE, WHEN, AND HOW TO FILE

Forms 1042-S, whether filed on paper or electronically, must be filed with the
IRS and be furnished to the recipient of the income by March 15, 2025. If the
15th falls on a Saturday, Sunday, or legal holiday in the District of Columbia
or where the return is to be filed, the due date is the next business day.

Copy A is filed with the IRS. Send all paper Forms 1042-S with Form 1042-T,
Annual Summary and Transmittal of Forms 1042-S, to the address in the Form
1042-T instructions. You must use Form 1042-T to transmit paper Forms 1042-S.
Use a separate Form 1042-T to transmit each type of Form 1042-S. See Payments by
U.S. Withholding Agents, later, and the Form 1042-T instructions for more
information.

Electronic filing requirement.

See Electronic Reporting , later, for information on who is required to file
Form 1042-S electronically.

Attach only Copy A to Form 1042-T. Provide Copies B, C, and D to the recipient
of the income. All copies must match the copy filed with the IRS. Any
differences between the copy of the form issued to recipients and the copy filed
with the IRS will lead to delays in processing the recipient's tax return. The
IRS may disallow claims for refund or credit for amounts withheld reported on
Form 1042-S if the form attached to such claims differs from the copy that was
filed with the IRS.

With respect to a withholdable payment, the recipient copy should be provided to
the intermediary or flow-through entity named as a recipient with respect to a
chapter 4 reporting pool, if applicable.

Extension of time to file.

To request an extension of time to file Forms 1042-S, file Form 8809,
Application for Extension of Time To File Information Returns. See the
instructions for Form 8809 at IRS.gov/Form8809 for where to file that form. You
should request an extension as soon as you are aware that an extension is
necessary, but no later than the due date for filing Form 1042-S. By filing Form
8809, you will get an automatic 30-day extension to file Form 1042-S. If you
need more time, you may submit a second Form 8809 before the end of the initial
extended due date. See Form 8809 for more information.

RECIPIENT COPIES.

You may request an extension of time to provide the statements to recipients by
faxing a letter to:

Internal Revenue Service
Technical Services Operation
Attn: Extension of Time Coordinator
Fax: 877-477-0572
(International 304-579-4105) The letter must include:

1. Your name,

2. Your TIN,

3. Your address,

4. Type of return (Form 1042-S),

5. A statement that your extension request is for providing statements to
recipients,

6. Reason for delay, and

7. The signature of the payer or authorized agent.

Your request must be received no later than the date the Forms 1042-S are due to
the recipients. If your request for an extension is approved, generally you will
be granted a maximum of 30 extra days to furnish the recipient statements. See
Extension to provide statements to recipients in Pub. 515, Withholding of Tax on
Nonresident Aliens and Foreign Entities.

See Pub. 1187 for more information about filing extension requests
electronically instead of on a paper Form 8809.

ELECTRONIC REPORTING

Forms 1042-S must be filed electronically if:

* You are a person (including a corporation, partnership, individual, trust, or
estate) that is required to file 10 or more information returns during the
year or is a partnership with more than 100 partners, or

* You are a financial institution (whether U.S. or foreign) regardless of the
number of returns required to be filed.

Electronic submissions are filed using the FIRE System. The FIRE System operates
24 hours a day, 7 days a week, at fire.irs.gov. For more information, see Pub.
1187.

The electronic filing requirement also applies to amended returns for a
withholding agent required to file its original Form 1042-S returns
electronically under the above requirements.

If you file electronically, do not file the same returns on paper. Duplicate
filing may cause penalty notices to be generated.

NOTE.

Regardless of the above requirements, the IRS encourages filers to transmit
forms electronically.

Hardship waiver.

To receive a hardship waiver from filing Forms 1042-S electronically, submit
Form 8508, Request for Waiver From Filing Information Returns Electronically.
Waiver requests should be filed at least 45 days before the due date of the
returns. See Form 8508 for more information.

TRUNCATION OF TIN RULES

Withholding agents may truncate the recipient's TIN (social security number
(SSN), individual taxpayer identification number (ITIN), or employer
identification number (EIN)) on the recipient's copy of Form 1042‐S (that is,
Copies B, C, and D), including a substitute form. To truncate the recipient's
TIN, only the last four digits of a TIN must be displayed and the remaining
digits must be replaced with either asterisks (*) or Xs. For example, an SSN or
ITIN must be truncated on the recipient's copy as XXX‐XX‐nnnn. An EIN must be
truncated as XX‐XXXnnnn.

Withholding agents may also truncate a recipient’s foreign tax identification
number (FTIN) on the recipient’s copy of Form 1042‐S (Copies B, C, and D),
including a substitute form. The same rules for truncating a recipient’s U.S.
TIN stated above must be followed if truncating a recipient’s FTIN.

NOTE.

The recipient's TIN and FTIN must not be truncated on Copy A filed with the IRS.
The withholding agent's EIN cannot be truncated on any copy.

Need assistance?

For additional information and instructions on filing Forms 1042-S
electronically, extensions of time to file (Form 8809), and hardship waivers
(Form 8508), see Pub. 1187. You also can call the Information Reporting Program
at 866-455-7438 (toll free) or 304-263-8700 (not a toll-free number). Do not
call the Information Reporting Program for tax law questions. The Information
Reporting Program can also be reached by fax at 877-477-0572 (toll free) and
international fax at 304-579-4105 (not a toll-free number).

If you have tax law questions pertaining to Form 1042-S, call 267-941-1000 (not
a toll-free number).

ADDITIONAL INFORMATION

For more information on the withholding of tax, see Pub. 515. To order this
publication and other publications and forms, call 800-TAX-FORM (800-829-3676).
You can download or print some of the forms and publications you may need on
IRS.gov/Forms. Otherwise, you can go to IRS.gov/OrderForms to place an order and
have forms mailed to you. You should receive your order within 10 business days.

RECORD RETENTION

Withholding agents should retain a copy of the information returns filed with
the IRS, or have the ability to reconstruct the data, for at least 3 years after
the reporting due date.

SUBSTITUTE FORMS

The official Form 1042-S is the standard for substitute forms. All substitute
forms must comply with the rules set forth in Pub. 1179, General Rules and
Specifications for Substitute Forms 1096, 1098, 1099, 5498, and Certain Other
Information Returns. A substitute of Form 1042-S that is furnished to the
recipient (Copy B, C, or D) must conform in format and size to the official IRS
form and must contain the exact same information as the copy filed with the IRS.
However, the size of the form may be adjusted if the substitute form is
presented on a landscape-oriented page instead of portrait. Only one Form 1042-S
may be submitted per page, regardless of orientation. You may be subject to a
penalty for failure to furnish a correct information return. See Penalties ,
later.

NOTE.

A withholding agent is required to provide a recipient with a separate
substitute Form 1042-S for each type of payment of income (as determined by the
income code in box 1).

All of the fields on the substitute form must match the copy filed with the IRS
and must comply with IRS standards (see Pub. 1179). Any differences between the
substitute form issued to recipients and the copy filed with the IRS will lead
to delays in processing the recipient's tax return. The IRS may disallow claims
for refund or credit for amounts withheld reported on Form 1042-S if the
substitute form attached to such claims differs from the copy that was filed
with the IRS.

PENALTY FOR FILING INCORRECT SUBSTITUTE FORM.

Privately printed substitute Forms 1042-S must be exact copies of both the
format and content of the official Form 1042-S. If you file a substitute for
Form 1042-S, Copy A, with the IRS that is not an exact copy of the official Form
1042-S, Copy A, you may be subject to a penalty for failure to file a correct
information return. See Penalties , later.

ACCOUNT-BY-ACCOUNT REPORTING BY CERTAIN FINANCIAL INSTITUTIONS

A U.S. financial institution or U.S. branch of an FFI maintaining an account
within the United States is required to report payments of the same type of
income (as determined by the income code in box 1) made to multiple financial
accounts held by the same recipient on a separate Form 1042-S for each account.
For this purpose, a financial account is an account described in Regulations
section 1.1471-5(b)(1). See the instructions for Box 13k, Recipient’s Account
Number, later, for information on designating each account with a separate
account number.

COMBINED REPORTING PROCEDURES

Rev. Proc. 99-50 provides special procedures for successor entities to use
combined information reporting under chapter 3 in certain situations following a
merger or acquisition. A withholding agent may also use these procedures for
purposes of reporting under chapter 4.

DEPOSIT REQUIREMENTS

For information and rules concerning federal tax deposits, see Depositing
Withheld Taxes in Pub. 515 or Deposit Requirements in the Instructions for Form
1042.

DEFINITIONS

Withholding agent.

A withholding agent is any person, U.S. or foreign, that has control, receipt,
or custody of an amount subject to withholding under chapter 3 who can disburse
or make payments of an amount subject to withholding, or who makes a
withholdable payment under chapter 4. The withholding agent may be an
individual, corporation, partnership, trust, association, or any other entity.
The term “withholding agent” also includes, but is not limited to, a qualified
intermediary (QI), a nonqualified intermediary (NQI), a withholding foreign
partnership (WP), a withholding foreign trust (WT), a flow-through entity, a
U.S. branch that is treated as a U.S. person under Regulations section
1.1441-1(b)(2)(iv)(A), a territory FI, a nominee under section 1446, and an
authorized agent. A person may be a withholding agent even if there is no
requirement to withhold from a payment or if another person has already withheld
the required amount from a payment.

In most cases, the U.S. person who pays (or causes to be paid) the item of U.S.
source income to a foreign person (or to its agent) must withhold. However,
other persons may be required to withhold. For example, if a payment is made by
a QI (whether or not it assumes primary withholding responsibility) and the QI
knows that withholding was not done by the person from which it received the
payment, then that QI is required to do the appropriate withholding. In
addition, withholding must be done by any QI that assumes primary withholding
responsibility under chapters 3 and 4, a WP, a WT, a U.S. branch that agrees to
be treated as a U.S. person under Regulations section 1.1441-1(b)(2)(iv)(A), or
an authorized agent. Finally, if a payment is made by an NQI or a flow-through
entity that knows, or has reason to know, that withholding was not done, that
NQI or flow-through entity is required to withhold since it also falls within
the definition of a withholding agent.

Account holder.

Generally, the account holder is the person that holds the account. See
Regulations section 1.1471-5(a).

Amount realized.

An amount realized on the transfer of a PTP interest is the amount of gross
proceeds (as defined in Regulations section 1.6045-1(d)(5)) paid or credited to
a partner or broker (as applicable) that is a transferor of the interest. The
amount realized on a PTP distribution is the amount of the distribution reduced
by the portion of the distribution that is attributable to the cumulative net
income of the partnership (as determined under Regulations section
1.1446(f)-4(c)(2)(iii)).

Amount subject to chapter 3 withholding.

Generally, an amount subject to chapter 3 withholding is an amount from sources
within the United States that is FDAP income. FDAP income is all income included
in gross income, including interest (as well as original issue discount (OID)),
dividends, rents, royalties, and compensation. Amounts subject to chapter 3
withholding do not include amounts that are not FDAP, such as most gains from
the sale of property (including market discount and option premiums), as well as
other specific items of income (such as interest on bank deposits and short-term
OID). See Regulations section 1.1441-2.

Authorized agent.

An agent is an authorized agent for purposes of filing Form 1042 or making tax
deposits and payments on behalf of its principal (payer) only if all five of the
following conditions apply.

1. There is a written agreement between the payer and the person acting as
agent.

2. A Form 8655, Reporting Agent Authorization, is filed with the IRS if the
agent is filing Form 1042 (in its own name) on behalf of the payer.

3. The books and records and relevant personnel of the agent are available to
the payer.

4. The payer remains fully liable for the acts of its agent and does not assert
any of the defenses that may otherwise be available.

5. If the agent is filing Form 1042 (in its own name) on behalf of the payer,
the agent is reported as the withholding agent in boxes 12a through 12i and
information about the payer is reported in boxes 16a through 16e of the Form
1042-S.

A sponsoring entity is a reporting agent with respect to withholdable payments
and must fulfill the above conditions to be an authorized agent.

For more information on these conditions, see Regulations sections 1.1441-7(c)
and 1.1474-1(a)(3)(ii).

Beneficial owner.

For payments other than those for which a reduced rate of withholding is claimed
under an income tax treaty, the beneficial owner of income in most cases is the
person who is required under U.S. tax principles to include the income in gross
income on a tax return. A person is not a beneficial owner of income, however,
to the extent that person is receiving the income as a nominee, agent, or
custodian, or to the extent the person is a conduit whose participation in a
transaction is disregarded. In the case of amounts paid that do not constitute
income, beneficial ownership is determined as if the payment were income.

Foreign partnerships, foreign simple trusts, and foreign grantor trusts are not
the beneficial owners of income paid to the partnership or trust for chapter 3
purposes. The beneficial owners of income paid to a foreign partnership in most
cases are the partners in the partnership, provided that the partner is not
itself a partnership, foreign simple or grantor trust, nominee, or other agent.
The beneficial owner of income paid to a foreign simple trust (a foreign trust
that is described in section 651(a)) in most cases is the beneficiary of the
trust, if the beneficiary is not a foreign partnership, foreign simple or
grantor trust, nominee, or other agent. The beneficial owner of a foreign
grantor trust (a foreign trust to the extent that all or a part of the income of
the trust is treated as owned by the grantor or another person under sections
671 through 679) is the person treated as the owner of the trust. The beneficial
owner of income paid to a foreign complex trust (a foreign trust that is not a
foreign simple trust or foreign grantor trust) is the trust itself.

The beneficial owner of income paid to a foreign estate is the estate itself.

A payment to a U.S. partnership, U.S. trust, or U.S. estate is not subject to
withholding under chapter 3 or 4. A U.S. partnership, trust, or estate should
provide the withholding agent with a Form W-9, Request for Taxpayer
Identification Number and Certification. In most cases, these beneficial owner
rules apply for purposes of section 1446; however, there are exceptions.

1. Chapter 3 withholding rate pool. A payment of a single type of income,
determined in accordance with the income codes used to file Form 1042-S,
that is subject to a single rate of withholding and a single chapter 4
exemption code.

2. Chapter 4 withholding rate pool. A pool of account holders or payees
provided on an FFI withholding statement (or a chapter 4 withholding
statement) that is described in Regulations section 1.1471-1(b)(20).

Broker.

A broker is a person described in Regulations section 1.1446(f)-1(b)(1) when
referenced in connection with a transfer of a PTP interest.

Chapter 3.

Chapter 3 (Withholding of Tax on Nonresident Aliens and Foreign Corporations),
excluding sections 1445 and 1446.

Disregarded entity.

A business entity that has a single owner and is not a corporation under
Regulations section 301.7701-2(b) is disregarded as an entity separate from its
owner.

Disclosing QI.

For purposes of section 1446(a) or (f), a QI that provides with its withholding
statement the specific payee documentation referenced in Regulations section
1.1446(f)-4(a)(7)(iii) (for an amount realized) or Regulations section
1.1446-4(e)(4) (for withholding on a PTP distribution under section 1446(a))
instead of the chapter 3 withholding rate pool information otherwise permitted
to be included on the withholding statement. A QI that acts as a disclosing QI
for a payment must act as a disclosing QI for the entire payment. See the 2023
QI agreement in Rev. Proc. 2022-43 for further information.

Dividend equivalent.

To the extent specified in section 871(m) and the regulations thereunder, a
dividend equivalent is a payment (within the meaning of Regulations section
1.871-15(i)) that, directly or indirectly, is contingent on, or determined by
reference to, the payment of a dividend from U.S. sources, including pursuant to
a securities lending, sale-repurchase transaction, a specified notional
principal contract, or a specified equity-linked instrument.

Certain other payments made by the withholding agent to satisfy a tax liability
with respect to a dividend equivalent by the party receiving the dividend
equivalent are dividend equivalents. See Regulations section 1.871-15(c) for
additional information, including the definitions of specified notional
principal contract and specified equity-linked instrument.

Any section 871(m) amount of a QDD is treated as a dividend equivalent. See Rev.
Proc. 2022-43 for additional information, including the definition of a section
871(m) amount.

Exempt beneficial owner.

An exempt beneficial owner means a person that is described in Regulations
section 1.1471-6 and includes a foreign government, a political subdivision of a
foreign government, a wholly owned instrumentality or agency of a foreign
government or governments, an international organization, a wholly owned agency
or instrumentality of an international organization, a foreign central bank of
issue, a government of a U.S. territory, certain retirement funds, and certain
entities wholly owned by one or more exempt beneficial owners. In addition, an
exempt beneficial owner includes any person treated as an exempt beneficial
owner under an applicable Model 1 IGA or Model 2 IGA.

Exempt recipient.

An exempt recipient is any payee that is exempt from the Form 1099 reporting
requirements.

Exempt recipients are not exempt from withholding under chapter 3 unless they
are U.S. persons or foreign persons entitled to an exemption from withholding
under chapter 3.

Expatriate.

A person is considered an expatriate if he or she relinquishes U.S. citizenship
or, in the case of a long-term resident of the United States, ceases to be a
lawful permanent resident as defined in section 7701(b)(6).

Fiscally transparent entity.

An entity is treated as fiscally transparent with respect to an item of income
for which treaty benefits are claimed to the extent that the interest holders in
the entity must, on a current basis, take into account separately their shares
of an item of income paid to the entity, whether or not distributed, and must
determine the character of the items of income as if they were realized directly
from the sources from which realized by the entity. For example, partnerships,
common trust funds, and simple trusts or grantor trusts in most cases are
considered to be fiscally transparent with respect to items of income received
by them.

Flow-through entity.

For chapter 3 purposes, a flow-through entity is a foreign partnership (other
than a WP), a foreign simple or grantor trust (other than a WT), or, for any
payments for which a reduced rate of withholding under an income tax treaty is
claimed, any entity to the extent the entity is considered to be fiscally
transparent under section 894 with respect to the payment by an interest
holder's jurisdiction.

Financial institution.

A financial institution generally means an entity that is a depository
institution, custodial institution, investment entity, or an insurance company
(or holding company of an insurance company) that issues cash value insurance or
annuity contracts. See Regulations section 1.1471-5(e).

Foreign financial institution (FFI).

An FFI is an entity described in Regulations section 1.1471-5(d) or an entity
treated as a financial institution under an Intergovernmental Agreement (IGA).

DEEMED-COMPLIANT FFI.

Under section 1471(b)(2), certain FFIs are deemed to comply with the regulations
under chapter 4 without the need to enter into an FFI agreement with the IRS.
However, certain deemed-compliant FFIs are required to register with the IRS and
obtain a GIIN. These FFIs are referred to as “registered deemed-compliant FFIs.”
See Regulations section 1.1471-5(f)(1). Registered deemed-compliant FFIs also
include certain FFIs that satisfy the requirements of an applicable IGA.

NONPARTICIPATING FFI.

A nonparticipating FFI is an FFI that is not a participating FFI,
deemed-compliant FFI, or exempt beneficial owner.

PARTICIPATING FFI.

A participating FFI is an FFI that has agreed to comply with the terms of an FFI
agreement with respect to all branches of the FFI, other than a branch that is a
reporting Model 1 FFI or a U.S. branch. The term “participating FFI” also
includes a reporting Model 2 FFI and a QI branch of a U.S. financial
institution, unless such branch is a reporting Model 1 FFI.

Foreign person.

A foreign person includes a nonresident alien individual, a foreign corporation,
a foreign partnership, a foreign trust, a foreign estate, and any other person
that is not a U.S. person. The term also includes a foreign branch or office of
a U.S. financial institution or U.S. clearing organization if the foreign branch
is a QI. A payment to a U.S. branch of a foreign person is treated as a payment
to a foreign person for purposes of Form 1042-S.

Global intermediary identification number (GIIN).

The GIIN is the identification number that is assigned to a participating FFI
(including a reporting Model 2 FFI), registered deemed-compliant FFI (including
a reporting Model 1 FFI), or other entity for chapter 4 reporting purposes.

Intermediary.

An intermediary is a person that acts as a custodian, broker, or nominee, or
otherwise as an agent for another person, regardless of whether that other
person is the beneficial owner of the amount paid, a flow-through entity, or
another intermediary.

QUALIFIED INTERMEDIARY (QI).

A QI is an intermediary or eligible entity that is a party to a withholding
agreement with the IRS. A QI that is a financial institution must have a chapter
4 status described in Regulations section 1.1441-1(e)(5)(ii). An entity must
indicate its status as a QI on a Form W-8IMY submitted to a withholding agent.

A branch of a financial institution may not act as a QI in a country that does
not have approved know-your-customer (KYC) rules. Countries having approved KYC
rules are listed at
IRS.gov/businesses/international-businesses/list-of-approved-kyc-rules. Branches
that operate in non-KYC approved jurisdictions as intermediaries are required to
act as NQIs. See the Instructions for Form W-8IMY for more information.

NONQUALIFIED INTERMEDIARY (NQI).

An NQI is any intermediary that is not a U.S. person and that is not a QI.

PRIVATE ARRANGEMENT INTERMEDIARY (PAI).

A QI that is an FFI may enter into a contractual agreement with another
intermediary under which the other intermediary generally agrees to perform all
of the obligations of the QI with respect to the accounts maintained directly by
the other intermediary. See the QI agreement for the requirements of a PAI and a
QI's agreement with a PAI.

Nonfinancial foreign entity (NFFE).

An NFFE is a foreign entity or an entity incorporated or organized under the
laws of any U.S. territory that is not a financial institution.

EXCEPTED NFFE.

The term “excepted NFFE” means an NFFE that is described in Regulations section
1.1472-1(c)(1) and generally includes a publicly traded corporation, certain
affiliated entities related to a publicly traded corporation, certain territory
entities, active NFFEs, and entities excluded from the definition of FFI
(excluded FFIs) described in Regulations section 1.1471-5(e)(5).

Nominee.

See Regulations section 1.1446-4(b)(3) and Publicly Traded Partnerships
(Sections 1446(a) and (f) Withholding Tax), later, for persons that may act as a
nominee for a PTP distribution.

Nonexempt recipient.

A nonexempt recipient is any person who is not an exempt recipient under chapter
61.

Nonresident alien individual.

Any individual who is not a citizen or resident of the United States is a
nonresident alien individual. An alien individual meeting either the green card
test or the substantial presence test for the calendar year is a resident alien.
Any person not meeting either test is a nonresident alien individual.
Additionally, an alien individual who is treated as a nonresident alien pursuant
to Regulations section 301.7701(b)-(7) for purposes of figuring out the
individual’s U.S. tax liability, or an alien individual who is a bona fide
resident of Puerto Rico, Guam, the Commonwealth of the Northern Mariana Islands,
the U.S. Virgin Islands, or American Samoa is a nonresident alien individual. An
individual will not be treated as a U.S. person for a tax year or any portion of
a tax year that the individual is a dual-resident taxpayer who is treated as a
nonresident alien for purposes of figuring his or her U.S. tax liability. See
Pub. 519, U.S. Tax Guide for Aliens, for more information on resident and
nonresident alien status.

Even though a nonresident alien individual married to a U.S. citizen or resident
alien may choose to be treated as a resident alien for certain purposes (for
example, filing a joint income tax return), such individual is still treated as
a nonresident alien for withholding tax purposes.

Payee.

Except as otherwise provided, the payee is the person to whom a payment is made,
regardless of whether such person is the beneficial owner of the amount or
treated as the recipient of the payment for purposes of reporting on Form
1042-S. See Regulations section 1.1471-3(a).

Presumption rules.

For withholdable payments and for amounts subject to withholding under chapter
3, the presumption rules are those rules that a withholding agent must follow to
determine the status of a beneficial owner or payee (for example, as a U.S.
person or a foreign person) when it cannot reliably associate a payment with
valid documentation. See, for example, Regulations sections 1.1441-1(b)(3),
1.1441-4(a), 1.1441-5(d) and (e), 1.1441-9(b)(3), 1.1446-1(c)(3), and
1.6049-5(d). Also see Pub. 515. See Regulations section 1.1446(f)-4(a)(2) and
(b)(2) for a broker's requirement to treat a transferor of a PTP interest (or
broker acting for the transferor) as a foreign person for section 1446(f)
purposes absent the broker's receipt of a certification of non-foreign status.
For a withholdable payment (defined in Regulations section 1.1473-1(a)), the
withholding agent must also follow the presumption rules under Regulations
sections 1.1471-3(f) and, for an FFI, 1.1471-4(c)(4)(i) to determine the chapter
4 status of the payee when it cannot reliably associate a payment with valid
documentation.

Publicly traded partnership (PTP).

A PTP is an entity that has the same meaning as in section7704 and Regulations
sections 1.7704-1 through 1.7704-4 but does not include a PTP treated as a
corporation under that section.

PTP distribution.

A PTP distribution is a distribution made by a PTP.

PTP interest.

A PTP interest is an interest in a PTP if the interest is publicly traded on an
established securities market or is readily tradable on a secondary market (or
the substantial equivalent thereof).

Qualified derivatives dealer (QDD).

A QDD is a QI that is an eligible entity that agrees to meet the requirements of
Regulations section 1.1441-1(e)(6)(i) and the QI agreement. An eligible entity
is defined in Regulations section 1.1441-1(e)(6)(ii).

To act as a QDD, the home office or branch, as applicable, must qualify and be
approved for QDD status and must represent itself as a QDD on its Form W-8IMY
and separately identify the home office or branch as the recipient on a
withholding statement (if required). Each home office or branch that obtains QDD
status is treated as a separate QDD. See Regulations section 1.1441-1(e)(6) and
Rev. Proc. 2022-43 for more information.

Qualified securities lender (QSL).

A QSL is an FFI that satisfies all of the following.

* It is a bank, custodian, broker-dealer, or clearing organization that is
regulated by the government in its home jurisdiction and that regularly
borrows and lends the securities of U.S. corporations to unrelated customers.

* It is subject to audit by the IRS under section 7602 or by an external
auditor if it is a QI.

* It provides to the withholding agent an annual certification of its QSL
status.

* It meets the requirements to qualify as a QSL provided in Notice 2010-46 for
the transition period. See Notice 2010-46 at
IRS.gov/irb/2010-24_IRB#NOT-2010-46. While Notice 2010-46 was obsoleted,
Notice 2022-37 permits withholding agents to apply the transition rules
described in Notice 2010-46 for payments made in 2023 and 2024.

Recalcitrant account holder.

Generally, a recalcitrant account holder is an account holder of a participating
or registered deemed-compliant FFI that failed to provide the documentation
required under chapter 4 to determine the account holder's status or to report
the account as a U.S. account. See Regulations section 1.1471-5(g).

Recipient.

For chapter 3 purposes (including sections 1445 and 1446), a recipient includes
any of the following.

* A beneficial owner of income.

* A QI other than a disclosing QI.

* A WP or WT.

* A U.S. branch that is treated as a U.S. person under Regulations section
1.1441-1(b)(2)(iv)(A) or for section 1446 purposes.

* A foreign partnership or a foreign trust (other than a WP or WT), but only to
the extent the income is effectively connected with its conduct of a trade or
business in the United States (except as indicated below for a grantor
trust).

* A payee who is not known to be the beneficial owner, but who is presumed to
be a foreign person under the presumption rules.

* A PAI.

* A partner receiving a distribution of ECI from a PTP or nominee.

* A QSL.

For chapter 3 purposes (including section 1445 and 1446), a recipient does not
include any of the following.

* An NQI or disclosing QI.

* A nonwithholding foreign partnership (NWP), if the income is not effectively
connected with its conduct of a trade or business in the United States.

* A disregarded entity other than a hybrid entity claiming treaty benefits.

* A foreign trust that is described in section 651(a) (a foreign simple trust)
if the income is not effectively connected with the conduct of a trade or
business in the United States.

* A foreign trust to the extent that all or a part of the trust is treated as
owned by the grantor or other person under sections 671 through 679 (a
foreign grantor trust).

* A U.S. branch that is not treated as a U.S. person unless the income is, or
is treated as, effectively connected with the conduct of a trade or business
in the United States.

For chapter 4 purposes, a recipient also includes any of the following.

* A recalcitrant account holder not included in a chapter 4 reporting pool.

* A QI (other than a disclosing QI).

* A WP or WT.

* A PAI.

* A participating FFI or a registered deemed-compliant FFI that is an NQI, NWP,
or NWT and provides chapter 4 withholding rate pool information to the extent
permissible.

* A participating FFI or deemed-compliant FFI that is the beneficial owner,
including a nonreporting FFI under a Model 1 or Model 2 IGA.

* A U.S. branch or territory FI treated as a U.S. person under Regulations
section 1.1441-1(b)(2)(iv)(A).

* An NFFE that is not a flow-through entity or acting as an intermediary.

* A foreign partnership or a foreign trust (other than a WP or WT), but only to
the extent the income is effectively connected with its conduct of a trade or
business in the United States.

* A partner or beneficiary of a flow-through entity that is an NFFE (other than
a WP or WT).

* A nonparticipating FFI that is a beneficial owner.

* An exempt beneficial owner that is not a flow-through entity or acting as an
intermediary.

In the case of a PTP distribution subject to withholding under section 1446(a),
if another partnership or a trust (other than a grantor trust) receives the
distribution, the partnership or trust is the recipient for chapter 3 purposes.

For chapter 4 purposes, a recipient is generally the same person that is a
recipient for chapter 3 purposes.

Specified notional principal contract (SNPC).

An SNPC is any specified notional principal contract within the meaning of
Regulations section 1.871-15(d).

Specified U.S. person.

A specified U.S. person is any U.S. person other than a person identified in
Regulations section 1.1473-1(c).

Substantial U.S. owner.

A substantial U.S. owner is a specified U.S. person described in Regulations
section 1.1473-1(b). For purposes of filing this form, a reporting Model 2 FFI
reporting an account held by a passive NFFE should substitute the term
“controlling person that is a specified U.S. person” for “substantial U.S.
owner” and refer to the applicable Model 2 IGA for the definition of controlling
person. A territory NFFE that is not an excepted NFFE determines its substantial
U.S. owners by applying the 10% threshold in Regulations section 1.1473-1(b)(1).

Territory FI.

A territory FI is a financial institution that is incorporated or organized
under the laws of any U.S. territory and is not an investment entity. See
Regulations section 1.1471-5(e)(1)(iii) for the definition of investment entity.

U.S. branch treated as a U.S. person.

A U.S. branch may agree to be treated as a U.S. person if it meets the
requirements described in the regulations under chapter 3. See Regulations
section 1.1441-1(b)(2)(iv)(A). A U.S. branch may also agree to be treated as a
U.S. person for purposes of a sale subject to section 1446(f) or for a PTP
distribution. Additionally, a territory FI may agree to be treated as a U.S.
person for any of these purposes.

The U.S. branch or territory FI must provide a Form W-8IMY evidencing that it is
agreeing to be treated as a U.S. person.

A U.S. branch that is treated as a U.S. person is treated as such solely for
purposes of determining whether a payment is subject to withholding by the
branch. The branch is, for purposes of information reporting, a foreign person,
and payments to such a branch must be reported on Form 1042-S.

Withholdable payment.

A withholdable payment is generally any payment of U.S. source FDAP income,
subject to certain exceptions. For exceptions and additional information, see
Pub. 515 and Regulations section 1.1473-1(a).

Withholding certificate.

The term “withholding certificate” refers to Form W-8 or Form W-9 in most cases.

NOTE.

Throughout these instructions, a reference to or mention of “Form W-8” is a
reference to Forms W-8BEN, W-8BEN-E, W-8ECI, W-8EXP, and/or W-8IMY.

Withholding foreign partnership (WP) or withholding foreign trust (WT).

A WP or WT is a foreign partnership or trust that has entered into a withholding
agreement with the IRS in which it agrees to assume primary withholding
responsibility for all payments that are made to it for its partners,
beneficiaries, or owners under chapter 3 (except for sections 1445 and 1446(a)
or (f)) and under chapter 4. For information on these withholding agreements,
see Rev. Proc. 2017-21 at IRS.gov/irb/2017-06_IRB#RP-2017-21 and Regulations
section 1.1441-5.

NONWITHHOLDING FOREIGN PARTNERSHIP (NWP) OR NONWITHHOLDING FOREIGN TRUST (NWT).

An NWP or NWT is any partnership or trust (other than a complex trust) that is
not a U.S. person and that is not a WP or WT.

AMOUNTS SUBJECT TO REPORTING ON FORM 1042-S

Amounts subject to reporting on Form 1042-S are amounts from U.S. sources paid
to foreign persons (including persons presumed to be foreign) or included in a
U.S. payee pool that are reportable under chapters 3 and 4, even if no amount is
deducted and withheld from the payment because of a treaty or Internal Revenue
Code exception to taxation or if any amount withheld was repaid to the payee.
Amounts subject to reporting are amounts from sources within the United States
that constitute (a) FDAP income (including deposit interest); (b) certain gains
from the disposal of timber, coal, or domestic iron ore with a retained economic
interest; and (c) gains relating to contingent payments received from the sale
or exchange of patents, copyrights, and similar intangible property. A payment
is also subject to reporting if withholding under chapter 4 is applied (or
required to be applied) to the payment.

Amounts subject to reporting on Form 1042-S include, but are not limited to, the
following amounts to the extent they are from U.S. sources.

* Interest on deposits paid to certain nonresident aliens. Withholding agents
must report certain interest described in section 871(i)(2)(A) aggregating
$10 or more paid with respect to a deposit maintained at an office within the
United States if such interest is paid to a nonresident alien individual who
is a resident of a country identified in Rev. Proc. 2021-32, 2021-42 I.R.B.
465, available at IRS.gov/irb/2021-42_IRB#REV-PROC-2021-32 (or any
superseding revenue procedure that is effective as of January 1, 2024). A
payer may elect to report interest described above paid to any nonresident
alien individual by reporting all such interest.

When completing Form 1042-S, use income code 29 in box 1 and exemption code
02 in box 3a for chapter 3 purposes, and the applicable chapter 4 exemption
code in box 4a (see the instructions for boxes 3a and 4a, later).

* Interest on deposits subject to chapter 4 withholding. Interest on deposits
from U.S. sources are withholdable payments and, therefore, may be subject to
withholding under chapter 4. If payers withhold tax, they must report the
interest and tax on Form 1042-S.

* Corporate distributions. The entire amount of a corporate distribution
(whether actual or deemed) must be reported, regardless of any estimate of
the part of the distribution that represents a taxable dividend. Any
distribution, however, that is treated as gain from the redemption of stock
is not an amount subject to withholding. For information on distributions
from the disposition of a U.S. real property interest paid by a publicly
traded trust or a QIE, see Distributions Attributable to Dispositions of U.S.
Real Property Interests by Publicly Traded Trusts and Qualified Investment
Entities, later.

* Interest. Interest subject to reporting includes the part of a notional
principal contract payment that is characterized as interest.

* Rents.

* Royalties.

* Compensation for independent personal services performed in the United
States.

* Compensation for dependent personal services performed in the United States
(but only if the beneficial owner is claiming treaty benefits).

* Annuities.

* Pension distributions and other deferred income.

* Most gambling winnings. Proceeds from a wager placed in blackjack, baccarat,
craps, roulette, or big-6 wheel are not amounts subject to reporting.

* Cancellation of indebtedness. Agents must report income from the cancellation
of indebtedness unless the withholding agent is unrelated to the debtor and
does not have knowledge of the facts that give rise to the payment.

* Effectively connected income (ECI). ECI includes amounts that are (or are
presumed to be) effectively connected with the conduct of a trade or business
in the United States even if no withholding certificate is required. Note
that bank deposit interest is subject to Form 1042-S reporting if it is ECI
or otherwise reportable on Form 1042-S (see Interest on deposits paid to
certain nonresident aliens in this bullet list, earlier). ECI of a PTP
distributed to a foreign partner or an amount realized subject to reporting
under Regulations section 1.1461-1(c)(2)(i)(Q) must be reported on Form
1042-S.

* Notional principal contract income. Income from notional principal contracts
that the payer knows, or must presume, is effectively connected with the
conduct of a U.S. trade or business is subject to reporting using income code
32. The amount to be reported is the amount of cash paid on the contract
during the calendar year. Any amount of interest determined under the
provisions of Regulations section 1.446-3(g)(4) (dealing with interest in the
case of a significant nonperiodic payment) is reportable as interest and not
as notional principal contract income. See, however, the separate reporting
for dividend equivalents, later.

* Insurance premiums. Insurance premiums from U.S. sources (regardless of
whether or not the premium payments are subject to the section 4371 excise
tax) are withholdable payments under chapter 4. If the payment is actually
withheld upon or should have been withheld upon (but the withholding agent
failed to withhold), such amount must be reported on Form 1042-S. Insurance
premiums from U.S. sources are amounts subject to chapter 3 withholding
(excluding amounts subject to the section 4371 excise tax that must be
reported on Form 1042-S).

* REMIC excess inclusions. Excess inclusions from REMICs (income code 02) and
withheld tax must be reported on Form 1042-S. A domestic partnership must
separately state a partner's allocable share of REMIC taxable income or net
loss and the excess inclusion amount on Schedule K-1 (Form 1065). If the
partnership allocates all or some part of its allocable share of REMIC
taxable income to a foreign partner, the partner must include the partner's
allocated amount in income as if that amount was received on the earliest to
occur of (1) the date of distribution by the partnership, (2) the date the
foreign partner disposes of its indirect interest in the REMIC residual
interest, or (3) the last day of the partnership's tax year.

The partnership must withhold tax on the part of the REMIC amount that is an
excess inclusion.

An excess inclusion allocated to the following foreign persons must be included
in that person's income at the same time as other income from the entity is
included in income.

* Shareholder of a real estate investment trust (REIT).

* Shareholder of a regulated investment company (RIC).

* Participant in a common trust fund.

* Patron of a subchapter T cooperative organization.

NOTE.

In the case of a dividend equivalent, because the dividend equivalent is
determined on a gross basis, there may be a payment for reporting purposes even
when there is no transfer of funds. See Regulations section 1.871-15(i).

* Students, teachers, and researchers. Amounts paid to foreign students,
trainees, teachers, or researchers as scholarship or fellowship income, and
compensation for personal services (whether or not exempt from tax under an
income tax treaty) must be reported. However, amounts that are exempt from
tax under section 117 are not subject to reporting.

* Amounts paid to foreign governments, foreign central banks of issue, and
international organizations. These amounts are subject to reporting even if
they are exempt from chapter 3 withholding under section 892 or 895.

* Foreign targeted registered obligations. Interest paid on registered
obligations targeted to foreign markets paid by a U.S. person to a foreign
person other than a financial institution or a member of a clearing
organization is an amount subject to reporting.

* Original issue discount (OID) from the redemption of an OID obligation. The
amount subject to reporting is the amount of OID actually includible in the
gross income of the foreign beneficial owner of the income, if known.
Otherwise, the withholding agent should report the entire amount of OID as if
the recipient held the instrument from the date of original issuance. See
Pub. 1212, Guide to Original Issue Discount (OID) Instruments.

* Certain distributions attributable to dispositions of U.S. real property
interests. See Distributions Attributable to Dispositions of U.S. Real
Property Interests by Publicly Traded Trusts and Qualified Investment
Entities , later.

* Dividend equivalents. Dividend equivalents have been divided into the
following three income code reporting categories.

1. Substitute dividends that are dividend equivalents (income code 34 or
53).

2. Dividend equivalents with respect to transactions that are section 871(m)
transactions as a result of combining transactions under Regulations
section 1.871-15(n) (income code 56).

3. All other dividend equivalents (income code 40).

* Guarantee of indebtedness. This includes amounts paid, directly or
indirectly, for the provision of a guarantee of indebtedness issued after
September 27, 2010. They must be paid by a noncorporate resident or U.S.
corporation or by any foreign person if the amounts are effectively connected
with the conduct of a U.S. trade or business. Report these amounts using
income code 41.

* Specified federal procurement payments. Report specified federal procurement
payments subject to withholding under section 5000C.

* PTPs. Certain payments of ECI attributable to PTP interests (described
earlier) are subject to reporting on Form 1042-S. See Publicly Traded
Partnerships (Sections 1446(a) and (f) Withholding Tax), later, for
additional information.

AMOUNTS THAT ARE NOT SUBJECT TO REPORTING ON FORM 1042-S

Interest and OID from short-term obligations.

Interest and OID from any obligation payable 183 days or less from the date of
original issue are generally not required to be reported on Form 1042-S. See,
however, the reporting requirements for deposit interest described in Interest
on deposits paid to certain nonresident aliens in the bullet list under Amounts
Subject to Reporting on Form 1042-S, earlier.

Registered obligations targeted to foreign markets.

Interest on a registered obligation that is targeted to foreign markets and that
qualifies as portfolio interest is not subject to reporting if it is paid to a
registered owner that is a financial institution or member of a clearing
organization and you have received the required certifications.

Reporting will be required on interest paid on any registered obligation
(regardless of whether targeted to foreign markets) if the registered obligation
is issued after December 31, 2015.

Bearer obligations targeted to foreign markets.

Do not file Form 1042-S to report interest not subject to withholding on bearer
obligations if a Form W-8 is not required.

Withholding is required on interest paid on any bearer obligations targeted to
foreign markets if the obligation is issued after March 18, 2012. You must file
Form 1042-S to report this interest paid on an obligation issued after that
date.

Notional principal contract payments that are not ECI or dividend equivalents.

Do not report on Form 1042-S amounts paid on a notional principal contract,
other than an SNPC, if the amounts are not effectively connected with the
conduct of a trade or business in the United States. All amounts paid on an SNPC
that are treated as dividend equivalents should be reported as such on Form
1042-S.

Accrued interest and OID.

Interest paid on obligations sold between interest payment dates and the part of
the purchase price of an OID obligation that is sold or exchanged in a
transaction other than a redemption is not subject to reporting unless the sale
or exchange is part of a plan, the principal purpose of which is to avoid tax,
and the withholding agent has actual knowledge or reason to know of such plan.

Certain withholdable payments.

Withholdable payments not subject to reporting for chapter 3 purposes (other
than bank deposit interest paid to certain nonresident aliens) are not required
to be reported if withholding is not applied (or required to be applied) under
chapter 4.

Certain amounts realized.

An amount realized that is excepted from withholding under Regulations section
1.1446(f)-4(b)(3) (less than 10% effectively connected gain by partnership).

DISTRIBUTIONS ATTRIBUTABLE TO DISPOSITIONS OF U.S. REAL PROPERTY INTERESTS BY
PUBLICLY TRADED TRUSTS AND QUALIFIED INVESTMENT ENTITIES

Publicly traded trusts.

In general, when a publicly traded trust makes a distribution to a foreign
person attributable to the disposition of a U.S. real property interest, it must
withhold tax under section 1445. However, this withholding liability is shifted
to the person who pays the distribution to a foreign person (or to the account
of the foreign person) if the special notice requirement of Regulations section
1.1445-8(f) and other requirements of Regulations section 1.1445-8(b)(1) are
satisfied.

The amount subject to withholding for a distribution by a publicly traded trust
is determined under the rules of Regulations section 1.1445-5(c)(3).

Qualified investment entities (QIEs).

Special rules apply to QIEs. A QIE is one of the following.

* A REIT.

* A RIC that is treated as a U.S. real property holding corporation (after
applying certain rules in section 897(h)(4)(A)(ii)).

Look‐through rule for QIEs.

In most cases, any distribution from a QIE to a nonresident alien, foreign
corporation, or other QIE that is attributable to the QIE’s gain from the sale
or exchange of a U.S. real property interest is treated as gain recognized by
the nonresident alien, foreign corporation, or other QIE from the sale or
exchange of a U.S. real property interest.

A distribution by a QIE to a nonresident alien or foreign corporation that is
treated as gain from the sale or exchange of a U.S. real property interest by
the shareholder is subject to withholding at 21%.

Certain exceptions apply to the look‐through rule for distributions by QIEs. Any
distribution by a QIE with respect to stock regularly traded on an established
securities market in the United States is not treated as gain from the sale or
exchange of a U.S. real property interest if the shareholder did not own more
than 5% of that stock (or 10% of that stock in the case of REITs) at any time
during the 1‐year period ending on the date of the distribution. A distribution
by a REIT is generally not treated as gain from the sale or exchange of a U.S.
real property interest if the shareholder is a qualified shareholder (as
described in section 897(k)(3)). These distributions may be included in the
shareholder's gross income as a dividend (income code 06) from the QIE, not as
long‐term capital gain.

In addition, a qualified foreign pension fund or an entity all of the interests
of which are held by a qualified foreign pension fund is generally not subject
to the look‐through rule for distributions by QIEs for purposes of section
897(h).

Use Forms 1042‐S and 1042 to report and pay over the withheld amounts. All other
withholding required under section 1445 is reported and paid over using Form
8288, U.S. Withholding Tax Return for Certain Dispositions by Foreign Persons,
and Form 8288‐A.

For more information on reporting income from real property interests, see U.S.
Real Property Interest in Pub. 515.

PUBLICLY TRADED PARTNERSHIPS (SECTIONS 1446(A) AND (F) WITHHOLDING TAX)

Although a PTP is a withholding agent for a distribution it makes to its
partners, an entity receiving the distribution and acting as a nominee for the
distribution is also treated as a withholding agent for the distribution and is
required to withhold and report on Form 1042-S with respect to the amounts
subject to withholding attributable to the distribution paid to foreign partners
of the PTP. A nominee for this purpose is a person holding a PTP interest on
behalf of a foreign person and that is a domestic person, a U.S. branch of a
foreign corporation treated as a U.S. person for the distribution, or a QI
assuming primary withholding responsibility for the distribution. See
Regulations section 1.1446-4(b)(3). If you are the nominee for a PTP
distribution, enter the PTP's name and other required information in boxes 16a
through 16e with respect to the PTP on a Form 1042-S to report the amount of a
distribution subject to section 1446(a) (income code 27), to report an amount
realized on the distribution under section 1446(f) (income code 57), or when
income code 58 applies to the distribution (for income not determinable by the
nominee on the distribution), including when the 30% withholding rate under
chapter 3 applies under regulations section 1.1446-4(d). For a payment reported
with income code 27 or 57, or income code 58 when withholding is at the rate
under section 1446(a), report chapter 4 exemption code 14 (effectively connected
income). If withholding is instead applied at a 30% rate on a payment reported
with income code 58, report chapter 4 exemption code 21 (other payment not
subject to chapter 4 withholding). See Regulations section 1.1446-4(d)(1). For
income attributable to the distribution that is subject to withholding under
chapter 3 or 4, report using the income code that would otherwise apply to
report the payment to the recipient on a Form 1042-S for the year. Thus, unlike
for other payments described in this paragraph, you need not associate the
income subject to chapter 3 or 4 withholding with the PTP making the
distribution for purposes of reporting on an additional Form 1042-S. These
reporting requirements apply to a PTP distribution paid to a QI except that you
need not associate any income attributable to a PTP distribution with the PTP
making the distribution for reporting on Form 1042-S when you report in
reporting pools to a QI to which you pay the distribution.

As a result of the above reporting for PTP distributions, in certain cases a
nominee may need to issue several Forms 1042-S with respect to a foreign partner
based on the income codes associated with PTP distributions paid to the partner
during the year and (in certain cases) the PTP making the distribution.

For purposes of section 1446(f), a broker is generally required to report on
Form 1042-S an amount realized from the transfer of a PTP interest that is paid
to a foreign partner that is the transferor of the interest or to an NQI (other
than when the broker agrees to report the NQI's account holders on Form 1042-S),
a QI (other than a disclosing QI), or U.S. branch or territory financial
institution that is treated as a U.S. person for the payment. A broker should
report the aggregate of the amounts realized from sales of PTP interests paid to
each of these recipients using income code 57 and chapter 4 exemption code 14
(effectively connected income). For the reporting of amounts attributable to PTP
distributions (including distributions subject to section 1446(f) withholding),
see boxes 16a through 16e, later. For further information on reporting of
amounts realized and PTP distributions paid to QIs, see Payment to QI of PTP
distributions or amounts realized, later. For further information on reporting
of amounts realized and PTP distributions paid to nonqualified intermediaries,
see Amounts paid to an NQI or flow-through entity of amounts realized and PTP
distributions, later. For when an amount realized is reportable on Form 1042-S
for section 1446(f) purposes, see Regulations section 1.1461-1(c)(2)(i).

In a case in which a partner that is a U.S. person was treated as a foreign
partner for purposes of withholding under section 1446(a) or (f) (including an
allocation of a payment to the person made on a withholding statement), a Form
1042-S may be used to report the payment (and withholding) with respect to the
U.S. person. The applicable Form 1099 must also be furnished when otherwise
required of the withholding agent with respect to the payment but should not
report the withholding that was applied under section 1446(a) or (f). For
reporting requirements for Form 1099, see the General Instructions for Certain
Information Returns.

Partnerships (other than PTPs) that have effectively connected gross income
allocable to foreign partners must file Form 8804, Annual Return for Partnership
Withholding Tax (Section 1446). If these partnerships have effectively connected
taxable income allocable to foreign partners, they must also pay a withholding
tax under section 1446 and report these amounts on Form 8804 and the partners'
allocable shares of these amounts on Form 8805.

REQUIREMENT TO WITHHOLD

Chapter 3 withholding.

For purposes of sections 1441 and 1442, a withholding agent must withhold 30% of
any payment of an amount subject to withholding under chapter 3 (defined above)
made to a payee that is a foreign person (or is presumed to be a foreign person)
unless it can associate the payment with documentation to treat the payment as
made to a foreign person entitled to a reduced rate of or exemption from
withholding. For more information, see Chapter 3 Responsibilities under
Responsibilities of a Withholding Agent To Obtain Form W-8 in the Instructions
for the Requester of Forms W-8BEN, W-8BEN-E, W-8ECI, W-8EXP, and W-8IMY. Also
see Pub. 515.

Chapter 4 withholding.

For purposes of chapter 4, a withholding agent must withhold 30% of a
withholdable payment (defined earlier) made to an FFI that is or is presumed to
be a nonparticipating FFI (defined earlier). It also applies to withholdable
payments made to certain NFFEs that fail to identify their substantial U.S.
owners (or to certify that they have none) under Regulations section
1.1472-1(b). For more information, see Chapter 4 Responsibilities under
Responsibilities of a Withholding Agent To Obtain Form W-8 in the Instructions
for the Requester of Forms W-8BEN, W-8BEN-E, W-8ECI, W-8EXP, and W-8IMY. Also
see Pub. 515.

A payment will be subject to withholding under either chapter 3 or chapter 4 but
not both. If the payment is of an amount subject to both chapter 3 and chapter 4
withholding, chapter 4 withholding takes precedence.

BEFORE COMPLETING FORM 1042-S

You must complete the following steps before completing Form 1042-S.

Step 1.

Determine if you have a Form 1042-S filing obligation. If you make a payment
described under Amounts Subject to Reporting on Form 1042-S , earlier, you are
required to file Form 1042-S for that payment. Note that you may have a Form
1042-S reporting obligation even if withholding is not required.

Step 2.

Determine whether the payment is:

* A “withholdable payment” under chapter 4,

* An “amount subject to withholding under chapter 3,”

* Both a withholdable payment and an amount subject to withholding under
chapter 3, or

* Neither a withholdable payment nor an amount subject to withholding under
chapter 3.

Be sure to carefully read through the exceptions to “withholdable payment”
and the exemptions from withholding or taxation provided under chapter 3 that
are included in Pub. 515. Note that reporting and withholding are done either
under chapter 3 or chapter 4, not both. However, even if reporting is done
under chapter 3, you may be required to provide certain chapter 4
information.

Step 3.

Determine the chapter indicator to be entered in box 3. The chapter indicator is
generally based on whether amounts were withheld (or paid by the withholding
agent) under chapter 3 or chapter 4. For example, if the payment is a
withholdable payment and it is subject to chapter 4 withholding (see Requirement
To Withhold , earlier), enter “4” in box 3. If no withholding was required on
the payment, enter “3” in box 3. For additional information, see the
instructions for box 3, later.

NOTE.

You must always complete boxes 4a (chapter 4 exemption code) and 4b (chapter 4
withholding tax rate) regardless of the chapter indicator entered in box 3.

NOTE.

If a payment is a withholdable payment under chapter 4, you must complete boxes
4a (chapter 4 exemption code), 4b (chapter 4 withholding tax rate), and 13g
(recipient chapter 4 status code), even if the payment is properly classified
with a chapter 3 indicator in box 3.

Be sure to complete a separate Form 1042-S for:

* Each recipient of income,

* Each income type paid to the same recipient, and

* Each amount to which a separate tax rate was applied (if you withheld at more
than one tax rate for a specific type of income that you paid to the same
recipient).

PAYMENTS BY U.S. WITHHOLDING AGENTS

In general.

U.S. withholding agents making payments described under Amounts Subject to
Reporting on Form 1042-S , earlier, must file a separate Form 1042-S for each
recipient who receives the income. Furthermore, withholding agents are not
permitted to report multiple types of income on a single Form 1042-S (or
substitute Form 1042-S) furnished to a recipient or on Copy A filed with the
IRS. These filers must use a separate Form 1042-S (or substitute form) for
information reportable on a single type of income.

See Payments Made to Persons Who Are Not Recipients, later, if the payment is
made to a foreign person that is not a recipient.

PAYMENTS TO RECIPIENTS

Payments directly to beneficial owners or partners.

A U.S. withholding agent making a payment subject to withholding under chapter 3
or 4 directly to a beneficial owner must complete Form 1042-S and treat the
beneficial owner as the recipient. Boxes 15a through 15i should be left blank.
The Form 1042-S must also include the appropriate chapter 3 and chapter 4
exemption codes, if applicable, in boxes 3a and 4a, as well as the appropriate
recipient codes for the chapter 3 and chapter 4 status codes for a payment that
is a withholdable payment and an amount subject to chapter 3 withholding. A U.S.
withholding agent should complete boxes 16a through 16e only if it is completing
Form 1042-S as a paying agent acting pursuant to an agreement to act as an
authorized agent for filing and reporting Forms 1042 and 1042-S.

In the case of foreign joint owners, you may provide a single Form 1042-S made
out to the owner whose status you relied upon to determine the applicable rate
of withholding (the owner subject to the highest rate of withholding). If,
however, any one of the owners requests its own Form 1042-S, you must furnish a
Form 1042-S to the person who requests it. If the request is made after a Form
1042-S was filed reporting the payment and tax withheld to only one of the joint
owners, you should amend the originally filed Form 1042-S to allocate the
payment and tax withheld among the joint owners accordingly and provide copies
of the amended forms to each recipient. If more than one Form 1042-S is issued
for a single payment, the aggregate amount paid and tax withheld that is
reported on all Forms 1042-S cannot exceed the total amounts paid to joint
owners and the tax withheld on those payments. In any event, each Form 1042-S
can only include the recipient information (boxes 13a through 13d) for one of
the beneficial owners. Form 1042-S must not be completed with more than one of
the joint owners as the recipient.

In the case of joint owners, Form 1042-S can only list one of the owners as the
recipient in box 13a. Form 1042-S must not be completed with more than one of
the joint owners as the recipient.

Example 1.

WA, a U.S. withholding agent, makes a withholdable payment of U.S. source
dividends to A, a foreign individual from whom it has received a Form W-8BEN and
who is not eligible for a reduced rate of chapter 3 withholding under a treaty.
WA must file a Form 1042-S for A, enter “3” in box 3,“06” in box 1 (income
code), “00” in box 3a (chapter 3 exemption code), “30.00” in box 3b (chapter 3
tax rate), “15” in box 4a (payee not subject to chapter 4 withholding), “00.00”
in box 4b (chapter 4 tax rate), “16” in box 13f (individual), and “23” in box
13g (individual).

See Appendix C for a comprehensive analysis of this Example 1 fact pattern,
including a step-by-step guide on how to complete Form 1042-S in its entirety.

A U.S. withholding agent making a payment directly to a foreign partner in a PTP
and that is either acting as a nominee for a PTP distribution subject to
withholding under section 1446(a) or as a broker paying an amount realized
subject to reporting on Form 1042-S for section 1446(f) purposes must complete a
Form 1042-S and treat the partner as a recipient. Thus, the withholding agent
must treat a foreign upper-tier partnership in the PTP or a foreign simple trust
as a recipient for reporting of these payments on Form 1042-S. With respect to
an upper-tier partnership, the reporting described in the preceding sentence
applies regardless of whether the withholding agent determines its withholding
on the payment based on the statuses of the partners in the upper-tier
partnership (when permitted under applicable regulations to section 1446(a) or
(f) for determining the rate of withholding).

Payments to a QI (including a QDD), WP, or WT under chapter 3 or 4.

A U.S. withholding agent that makes payments to a QI subject to withholding
under chapter 3 or 4 (whether or not the QI assumes primary withholding
responsibility), a QI acting as a QDD with respect to a payment, a WP, or a WT
should complete Form 1042-S in most cases, treating the QI, QDD, WP, or WT as
the recipient.

If a payment is being made to a QI that is acting as a QDD with respect to the
payment, a U.S. withholding agent should report the QDD as the recipient showing
the QDD as the recipient in box 13a (identifying the QDD by the name used for
the QDD on the Form W-8IMY it provides, which should include a branch
identifier, if applicable) and using recipient code 35 (qualified derivatives
dealer) as the chapter 3 status code. See Payments allocated, or presumed made,
to U.S. nonexempt recipients , later, for exceptions.

A QI that does not assume primary withholding responsibility for chapters 3 and
4 purposes is required to provide information regarding the allocations of
income subject to a particular withholding rate to the withholding agent on the
withholding statement associated with its Form W-8IMY. In such a case, the U.S.
withholding agent must complete a separate Form 1042-S for each withholding rate
pool associated with the QI. For purposes of chapter 4, a QI may provide a
single pool of recalcitrant account holders (rather than separate pools for each
class). In such a case, the withholding agent may use chapter 4 pooled reporting
code 49 (QI-Recalcitrant Pool-General). A QI that assumes primary withholding
responsibility, a WP, or a WT is not required to provide withholding rate pool
information to a withholding agent but will report such information directly to
the IRS.

A U.S. withholding agent making a withholdable payment to an FFI that is a QI
(that assumes primary withholding responsibility and is not acting as a QDD with
respect to the payment), a WP, or a WT must use recipient code 12 (qualified
intermediary), 09 (withholding foreign partnership), or 11 (withholding foreign
trust) as the chapter 3 status code and must use recipient code 05
(participating FFI - other), 06 (participating FFI - reporting Model 2 FFI), 07
(registered deemed-compliant FFI - reporting Model 1 FFI), 09 (registered
deemed-compliant FFI - other) for an FFI treated as deemed-compliant under an
IGA, 31 (nonreporting IGA FFI), or, for a payment to a QI, 27 (exempt beneficial
owner) as the chapter 4 status code. A U.S. withholding agent must use chapter 4
recipient code 48 (U.S. Payees Pool) when reporting a reportable amount
allocated to a chapter 4 withholding rate pool of U.S. payees of a QI and report
the chapter 3 recipient code 12 (qualified intermediary). A U.S. withholding
agent must not use any chapter 3 pooled reporting code (codes 27 through 32) as
such codes are only to be used by a withholding agent that is a QI, WP, or WT.
See Amounts Paid by QIs , later, and the instructions for boxes 13f and 13g,
later. Use of an inappropriate recipient code may cause a notice to be
generated.

A QI is generally required to act in such capacity only for designated accounts
for purposes of chapters 3, 4, and 61. Therefore, such an entity may also
provide a Form W-8IMY in which it certifies that it is acting as an NQI for
other accounts and, if it is an FFI that is receiving a withholdable payment,
that it is a participating FFI, registered deemed-compliant FFI, or FFI treated
as deemed-compliant under an IGA. A U.S. withholding agent that receives a Form
W-8IMY on which the foreign person providing the form indicates that it is not
acting as a QI may not treat the foreign person as a recipient except as
otherwise provided in these instructions. A withholding agent must not use the
EIN that a QI provides in its capacity as such to report payments that are
treated as made to an entity in its capacity as an NQI. In that case, use the
GIIN, if any, and EIN that is provided by the entity on its Form W-8IMY in which
it claims that it is acting as an NQI or flow-through entity.

NOTE.

A withholding agent is required to use chapter 4 reporting pool codes as the
chapter 4 status code in the case of withholdable payments made to:

* A QI that does not assume primary withholding responsibility;

* A participating FFI or registered deemed-compliant FFI that is an NQI, NWP,
or NWT; or

* An NQI, NWP, or NWT (other than a nonparticipating FFI) that provides a pool
of nonparticipating FFIs,

if the QI, NQI, NWP, or NWT provides chapter 4 withholding rate pool information
in the withholding statement associated with its Form W-8IMY. See Amounts paid
to an NQI or flow-through entity of wihholdable payments, later, and the
presumption rules under Regulations section 1.1471-3(f) when such information is
not provided for a withholdable payment made to an entity.

EXAMPLE 2.

WA, a U.S. withholding agent, makes a withholdable payment of U.S. source
dividends to QI, a qualified intermediary that does not assume primary chapters
3 and 4 withholding responsibility and that is a participating FFI. QI provides
WA with a valid Form W-8IMY with which it associates a withholding statement
that allocates 95% of the payment to a chapter 3, 15% withholding rate pool with
a single chapter 4 exemption code, and 5% of the payment to a chapter 4, 30%
withholding rate pool of recalcitrant account holders. WA must complete a Form
1042-S for the dividends allocated to the chapter 3, 15% withholding rate pool,
showing “3” in box 3, “00” in box 3a (chapter 3 exemption code), “15.00” in box
3b (chapter 3 tax rate), chapter 4 exemption code 15 (payee not subject to
chapter 4 withholding) in box 4a, “00.00” in box 4b (chapter 4 tax rate), and QI
as the recipient in box 13a along with recipient code 12 (qualified
intermediary) as the chapter 3 status code, and recipient code 05 (participating
FFI-other) as the chapter 4 status code. WA must also complete a Form 1042-S for
the dividends allocated to the chapter 4, 30% withholding rate pool, showing “4”
in box 3, chapter 3 exemption code 12 (payee subjected to chapter 4 withholding)
in box 3a, “00.00” in box 3b (chapter 3 tax rate), “00” in box 4a (chapter 4
exemption code), and “30.00” in box 4b with QI as the recipient in box 13a, and
recipient code 12 (qualified intermediary) as the chapter 3 status code, and
recipient code 49 (QI‐Recalcitrant Pool‐General) as the chapter 4 status code.

PAYMENTS ALLOCATED BY QIS, OR PRESUMED MADE, TO U.S. NONEXEMPT RECIPIENTS.

A QI may provide Forms W-9 or other information regarding U.S. nonexempt
recipients that the QI (or other entity maintaining the account) is required to
report under chapter 61 and for which the QI does not assume primary Form 1099
reporting responsibility. A QI may also provide information regarding U.S.
nonexempt recipients on whom the QI elects to backup withhold under section 3406
instead of withholding under chapter 4 on payments made to an account holder. If
Forms W-9 or other information is provided together with information allocating
all or a part of the payment to U.S. nonexempt recipients, you must report
income allocable to the U.S. nonexempt recipients on the appropriate Form 1099
and not on Form 1042-S even though you are paying that income to a QI. The QI
may also provide information regarding U.S. nonexempt recipients in a chapter 4
withholding rate pool that the withholding agent must report on Form 1042-S.

You may also be required under the presumption rules to treat a payment made to
a QI as made to a payee that is a U.S. nonexempt recipient from which you must
withhold on the payment under the backup withholding provisions. In this case,
you must report the payment on the appropriate Form 1099. See the General
Instructions for Certain Information Returns, available at
IRS.gov/1099GeneralInstructions.

EXAMPLE 3.

WA, a U.S. withholding agent, makes a withholdable payment of U.S. source
dividends to QI, a qualified intermediary and registered deemed-compliant FFI
that is a local FFI described in Regulations section 1.1471-5(f)(1)(i)(A). QI
provides WA with a valid Form W-8IMY certifying that it is transmitting Forms
W-9 for U.S. nonexempt recipients and with which it associates a withholding
statement that allocates 95% of the payment to a chapter 3, 15% withholding rate
pool with a single chapter 4 exemption code, and 5% of the payment to C, a U.S.
individual. QI also provides WA with C's Form W-9. C is a direct account holder
of QI and a U.S. citizen that is a resident of QI's local jurisdiction that QI
is not required to report under chapter 4 (see Regulations section
1.1471-5(f)(1)(i)(A)) and thus cannot be included in a chapter 4 withholding
rate pool of U.S. payees. See Regulations section 1.6049-4(c)(4). WA must
complete a Form 1042-S, showing QI as the recipient in box 13a, and WA should
use recipient code 12 (qualified intermediary) as the chapter 3 status code and
recipient code 09 (registered deemed-compliant FFI – other) as the chapter 4
status code for the dividends allocated to the 15% withholding rate pool. WA
must also complete a Form 1099-DIV issued to C reporting the part of the
dividend allocated to C.

EXAMPLE 4.

WA, a withholding agent, makes a withholdable payment of U.S. source dividends
to QI, a qualified intermediary that is a reporting Model 1 FFI. QI provides WA
with a valid Form W-8IMY with which it associates a withholding statement that
allocates 40% of the payment to a chapter 3, 15% withholding rate pool and 40%
to a chapter 3, 30% withholding rate pool. QI does not provide any withholding
rate pool information regarding the remaining 20% of the payment. WA must apply
the presumption rule to the part of the payment (20%) that has not been
allocated. Under the presumption rules of Regulations section 1.1471-3(f) for a
withholdable payment made to an entity, 20% of the payment is treated as paid to
a nonparticipating FFI. WA must complete three Forms 1042-S. First, a Form
1042-S for dividends subject to 15% withholding, showing “3” in box 3, “00” in
box 3a (chapter 3 exemption code), “15.00” in box 3b (chapter 3 tax rate),
chapter 4 exemption code 15 (payee not subject to chapter 4 withholding) in box
4a, “00.00” in box 4b (chapter 4 tax rate), QI as the recipient in box 13a,
recipient code 12 (qualified intermediary) as the chapter 3 status code, and
recipient code 07 (registered deemed-compliant FFI-reporting Model 1 FFI) as the
chapter 4 status code (because the payment is a withholdable payment). Second, a
Form 1042-S for dividends subject to 30% withholding, showing “3” in box 3, “00”
in box 3a (chapter 3 exemption code), “30.00” in box 3b (chapter 3 tax rate),
chapter 4 exemption code 15 (payee not subject to chapter 4 withholding) in box
4a, “00.00” in box 4b (chapter 4 tax rate), QI as the recipient in box 13a,
recipient code 12 (qualified intermediary) as the chapter 3 status code, and
recipient code 07 (registered deemed-compliant FFI – reporting Model 1 FFI) as
the chapter 4 status code. Third, a Form 1042-S for dividends subject to 30%
withholding, showing “4” in box 3, chapter 3 exemption code 12 (payee subjected
to chapter 4 withholding) in box 3a, “00.00” in box 3b (chapter 3 tax rate),
“00” in box 4a (chapter 4 exemption code), “30.00” in box 4b (chapter 4 tax
rate), “Unknown Recipient” as the recipient name in box 13a, recipient code 21
(unknown recipient) as the chapter 3 status code, and recipient code 29 (unknown
recipient) as the chapter 4 status code. Also, QI's name, status codes, country
code, address, GIIN, and QI-EIN must be entered in boxes 15a through 15i.

Payment to QI of PTP distributions or amounts realized.

A U.S. withholding agent making a payment to a QI that is subject to withholding
on a PTP distribution or an amount realized subject to reporting for section
1446(f) purposes should generally treat the QI as the recipient and report as
described directly above for a U.S. withholding agent making payments to a QI
for chapters 3 and 4 purposes (including when the QI does not assume primary
withholding responsibly and provides withholding rate pool information). In a
case of a QI acting as a disclosing QI for a payment of a PTP distribution or an
amount realized subject to reporting under section 1446(f), however, a U. S.
withholding agent should report the account holder of the QI as the recipient
and the QI as a disclosing QI (using chapter 3 status code 39 and reporting the
QI's information in boxes 15a through 15i, including its QI-EIN). In a case in
which a U.S withholding agent makes a payment of a PTP distribution or amount
realized through multiple QIs acting as disclosing QIs, the withholding agent
should report in boxes 15a through 15i with respect to the disclosing QI
maintaining a direct account for the partner in the PTP. For payments of PTP
distributions made to a QI, the U.S. withholding agent should report these
payments with respect to the PTP making the distribution to the extent required
as discussed in Publicly Traded Partnerships (Sections 1446(a) and (f)
Withholding Tax), earlier.

Although a payment to a disclosing QI is reported as made to a specified account
holder of the QI (as the recipient), a U.S. withholding agent is required to
provide a recipient copy of the Form 1042-S to the disclosing QI maintaining the
direct account for the partner in the PTP (in addition to the recipient copy
issued to the account holder of the QI receiving the payment).

Substitute dividends paid to qualified securities lenders (QSLs).

A withholding agent that makes payments of substitute dividends to a QSL should
complete Form 1042-S treating the QSL as the recipient. Use income code 34 or
53. Use recipient code 13 or 14 (qualified securities lender – qualified
intermediary or qualified securities lender – other) as the chapter 3 status
code and include the applicable chapter 4 status code of the QSL.

The withholding agent is not required to withhold on a substitute dividend
payment if it receives, at least annually, a certificate from the QSL that
includes a statement with the following information.

* The recipient of the substitute dividend is a QSL.

* With respect to the substitute dividend it receives from the withholding
agent, the QSL states that it will withhold and remit or pay the proper
amount of U.S. gross-basis tax.

If the withholding agent receives a certificate from the QSL that includes a
statement that contains the above information, use chapter 3 exemption code 11.

If the QSL is also a QI with primary withholding responsibility, use chapter 3
exemption code 11 and not exemption code 06 for chapter 3 purposes.

Amounts paid to certain U.S. branches or territory FIs.

A U.S. withholding agent making a payment to a U.S. branch of an FFI or NFFE
completes Form 1042-S as follows.

* If a withholding agent makes a payment to a U.S. branch that has provided the
withholding agent with a Form W-8IMY stating that it has agreed to be treated
as a U.S. person, the U.S. withholding agent treats the U.S. branch as the
recipient using chapter 3 recipient code 05 (U.S. branch - treated as a U.S.
person) and chapter 4 recipient code 17 (U.S. branch - treated as a U.S.
person).

* If a withholding agent makes a payment to a U.S. branch that has provided a
Form W-8IMY to transmit information regarding its chapter 4 reporting pools
when the payment is a withholdable payment or the branch provides a chapter 4
withholding rate pool of U.S. payees and, to the extent applicable, recipient
specific information for chapter 3 purposes, the U.S. withholding agent must
complete a separate Form 1042-S for each chapter 4 reporting pool treating
the U.S. branch as the recipient or, for chapter 3 purposes, for each
recipient that is a foreign person whose documentation is associated with the
U.S. branch's Form W-8IMY. If a payment cannot be reliably associated with
recipient documentation, the U.S. withholding agent must complete Form 1042-S
in accordance with the presumption rules. If a U.S. branch not treated as a
U.S. person fails to certify that it will meet the requirements under
Regulations section 1.1471-4(d)(2)(iii)(C), a withholding agent must report
the branch as a nonparticipating FFI.

* If a withholding agent cannot reliably associate a payment with a Form W-8IMY
from a U.S. branch, and if a withholding agent has an EIN for the branch,
then the payment may be reported on a single Form 1042-S treating the U.S.
branch as the recipient and reporting the income as ECI.

* If a withholding agent makes a payment to a territory FI acting as an
intermediary or that is a flow-through entity, the withholding agent should
report on Form 1042-S using the chapter 3 status codes for payments to U.S.
branches (with the code used depending on whether the territory FI agrees to
be treated as a U.S. person). If the territory FI agrees to be treated as a
U.S. person, the withholding agent should similarly use the chapter 3
exemption code for a U.S. branch treated as a U.S. person. For chapter 4
purposes, the withholding agent should use the applicable chapter 4 status
code for a territory FI (with the code used depending on whether the
territory FI agrees to be treated as a U.S. person). In any case in which a
payment is made to a territory FI described in this paragraph, the
withholding agent should report the applicable territory in which the FI is
resident for purposes of box 13b (recipient's country code).

Amounts paid to a foreign estate.

If a U.S. withholding agent makes a payment to a foreign estate, a Form 1042-S
must be completed showing the estate as the recipient. Use recipient code 17
(estate) as the chapter 3 status code and the applicable recipient code for the
chapter 4 status code.

Dual claims.

A U.S. withholding agent may make a payment to a foreign entity (for example, a
hybrid entity) that is simultaneously claiming an exemption from chapter 4
withholding and a reduced rate of tax under chapter 3 on its own behalf for a
part of the payment and an exemption from chapter 4 withholding and a reduced
rate of tax under chapter 3 on behalf of persons in their capacity as interest
holders in that entity on the remaining part. If the claims are consistent and
the withholding agent has accepted the multiple claims, a separate Form 1042-S
must be filed for the entity for those payments for which the entity is treated
as claiming a reduced rate of withholding, and separate Forms 1042-S must be
filed for each of the interest holders for those payments for which the interest
holders are claiming a reduced rate of withholding. The Forms 1042-S must
include the chapter 4 status of the payee (including the applicable chapter 4
exemption). If the claims are consistent but the withholding agent has not
chosen to accept the multiple claims, or if the claims are inconsistent, a
separate Form 1042-S must be filed for the person(s) being treated as the
recipient(s).

Special instructions for U.S. trusts and estates.

Report the entire amount of income subject to reporting, regardless of estimates
of distributable net income.

PAYMENTS MADE TO PERSONS WHO ARE NOT RECIPIENTS

Disregarded entities and hybrid entities.

If a U.S. withholding agent makes a payment to a disregarded entity that is not
a hybrid entity making a treaty claim, and receives a valid Form W-8BEN-E or
W-8ECI from a foreign person that is the single owner of the disregarded entity,
the withholding agent must file a Form 1042-S in the name of the foreign single
owner. The TIN on the Form 1042-S, if required, must be the foreign single
owner's TIN. However, in box 13h, include the GIIN of the disregarded entity
provided in Part II of Form W-8BEN-E if the owner is an FFI.

Example 5.

WA, a withholding agent, makes a withholdable payment of interest to LLC, a
foreign limited liability company that is not an FFI. LLC is wholly owned by FC,
a foreign corporation that is an excepted nonfinancial foreign entity. LLC is
treated as a disregarded entity. WA has a Form W-8BEN-E from FC on which it
states that it is the beneficial owner of the income paid to LLC. WA reports the
interest payment on Form 1042-S showing FC as the recipient. The result would be
the same if LLC was a domestic entity.

A disregarded entity can, however, claim to be the beneficial owner of a payment
if it is a hybrid entity claiming treaty benefits. See Form W-8BEN and its
instructions for more information. If a disregarded entity claims on a valid
Form W-8BEN-E to be the beneficial owner, the U.S. withholding agent must
complete a Form 1042-S treating the disregarded entity as a recipient and using
recipient code 26 (hybrid entity making treaty claim) as the chapter 3 status
code and the applicable recipient code for the chapter 4 status code of the
single owner when the payment is a withholdable payment and chapter 4
withholding does not apply.

A hybrid entity with multiple owners may also claim treaty benefits. See Form
W-8BEN-E and its instructions for more information on documentation requirements
that apply in such cases. If a hybrid entity treated as a resident of a treaty
country claims treaty benefits on a valid Form W-8BEN-E associated with a
withholdable payment (and chapter 4 withholding does not apply with respect to
any of its owners to such payment or portion of such payment), the U.S.
withholding agent should complete a Form 1042-S treating the hybrid entity as a
recipient, use code 26 (hybrid entity making treaty claim) as the chapter 3
recipient status code, and leave blank the chapter 4 recipient status code. To
the extent, however, that a portion of a withholdable payment is allocated to an
owner of the hybrid entity for which chapter 4 withholding must be applied, the
U.S. withholding agent must issue a separate Form 1042-S to such owner using the
applicable recipient codes for the owner's chapters 3 and 4 status codes and
report the hybrid entity as the intermediary. The withholding agent must do so
for each such owner for which chapter 4 withholding applies and must exclude
amounts allocable to such owners from the Form 1042-S issued to the hybrid
entity.

If an owner of a reverse hybrid entity claims treaty benefits on a valid Form
W-8BEN-E or W-8BEN (and chapter 4 withholding does not apply with respect to the
payment to the reverse hybrid entity), the U.S. withholding agent should issue a
Form 1042-S for the portion of the payment allocable to each such owner treating
the owner as the recipient, using the applicable recipient codes for the
chapters 3 and 4 status codes, and report the reverse hybrid entity as the
intermediary in boxes 15a through 15i. In such a case, the U.S. withholding
agent must issue a Form 1042-S to the reverse hybrid entity for the remainder of
the payment treating such entity as the recipient and using the applicable
chapters 3 and 4 status codes. However, if chapter 4 withholding applies with
respect to the payment to the reverse hybrid entity, the U.S. withholding agent
must instead issue a Form 1042-S to the reverse hybrid entity for the entire
payment and withhold accordingly.

Example 6.

WA, a withholding agent, makes a withholdable payment of interest to FP, a
hybrid entity organized in Country X. FP is treated as a partnership under the
Internal Revenue Code but is treated as a company resident in Country X for
Country X purposes. WA has a Form W-8BEN-E from FP on which it claims treaty
benefits. WA also has a Form W-8IMY from FP that includes its chapters 3 and 4
statuses and a W-8BEN-E from each of FP's owners, FC1 and FC2, which certify
that FC1 is a PFFI and FC2 is a nonparticipating FFI. The attached withholding
statement allocates 80% of the payment to FC1 and 20% of the payment to FC2. WA
must issue a Form 1042-S for 80% of the payment to FP as the recipient using
recipient code 26 (hybrid entity making treaty claim) as the chapter 3 status
code, and leaving blank the recipient code for the chapter 4 status code. WA
must withhold under chapter 4 on the remaining 20% of the payment allocated to
FC2 and issue a Form 1042-S to FC2 as the recipient using recipient code 15
(corporation) as the chapter 3 status code and recipient code 15
(nonparticipating FFI) as the chapter 4 status code and must report FP as the
intermediary in boxes 15a through 15i.

Amounts paid to an NQI or flow-through entity of withholdable payments.

If a U.S. withholding agent makes a payment to an NQI or a flow-through entity
(other than a nonparticipating FFI) with respect to a withholdable payment, it
must complete a separate Form 1042-S for each recipient on whose behalf the NQI
or flow-through entity acts as indicated by its withholding statement and the
documentation associated with its Form W-8IMY. If a payment is made through
tiers of NQIs or flow-through entities, the withholding agent must nevertheless
complete Form 1042-S for the recipients to which the payments are remitted. A
withholding agent completing Form 1042-S for a recipient that receives a payment
through an NQI or a flow-through entity must include in boxes 15a through 15i of
Form 1042-S the name, country code, address, TIN (if any), GIIN (if any), and
status codes of the NQI or flow-through entity from whom the recipient directly
receives the payment.

If, however, a U.S. withholding agent makes withholdable payments to an NQI or a
flow-through entity that is a participating FFI or registered deemed-compliant
FFI that is allocable to a chapter 4 withholding rate pool as indicated by the
FFI’s withholding statement, the U.S. withholding agent should complete a
separate Form 1042-S for each chapter 4 reporting pool (that is, pool of
recalcitrant account holders, pool of nonparticipating FFIs, or pool of payees
that are U.S. persons) treating the participating FFI or registered
deemed-compliant FFI as the recipient and must include the GIIN and chapter 3
status code of the FFI and the applicable chapter 4 reporting pool code as the
chapter 4 status code. If a payment is made through tiers of NQIs or
flow-through entities that are participating FFIs or registered deemed-compliant
FFIs, the withholding agent must nevertheless complete Form 1042-S for each
chapter 4 reporting pool to which the payments are allocated and must report, as
the recipient, the FFI from whom the recipients included in the chapter 4
reporting pool directly receive the payment.

Example 7.

WA, a withholding agent, makes a withholdable payment of interest to FFI1, a
reporting Model 1 FFI. FFI1 provides WA with a valid Form W-8IMY with which it
associates a withholding statement that allocates 80% of the payment to FFI2, a
participating FFI, and 20% of the payment to a pool of nonparticipating FFIs.
FFI1 also provides WA with FFI2's Form W-8IMY with which it associates a
withholding statement that allocates 100% of the payment to recalcitrant pool-no
U.S. indicia. WA must complete a Form 1042-S for the interest allocated to a
pool of nonparticipating FFIs with FFI1 as the recipient and must complete
another Form 1042-S for the interest allocated to a pool of recalcitrant account
holders-no U.S. indicia with FFI2 as the recipient.

If a U.S. withholding agent makes a withholdable payment to an NQI or
flow-through entity that is a participating FFI or deemed-compliant FFI, and
cannot reliably associate the payment, or any part of the payment, with a
withholding statement, or to the extent required, a valid withholding
certificate (Form W-8 or W-9) or other valid appropriate documentation from a
recipient, the withholding agent must follow the appropriate presumption rules
for that payment which, if the payment is a withholdable payment, will generally
require the withholding agent to withhold 30% under chapter 4 because such
payment is presumed made to a nonparticipating FFI. See Regulations section
1.1471-3(f)(5). For this purpose, if the allocation information provided to the
withholding agent indicates an allocation of more than 100% of the payment, then
no part of the payment should be considered to be associated with a Form W-8,
Form W-9, or other appropriate documentation. The Form 1042-S should be
completed by entering “Unknown Recipient” in box 13a and recipient code 21
(unknown recipient) as the chapter 3 status code and recipient code 29 (unknown
recipient) as the chapter 4 status code. Also, the name, country code, address,
TIN (if any), GIIN (if any), and status codes of the FFI should be entered in
boxes 15a through 15i.

If a U.S. withholding agent makes a withholdable payment to an NQI or
flow-through entity that is a nonparticipating FFI, the withholding agent must
treat the payments as made to an unknown recipient regardless of whether it can
reliably associate the payment, or any part of the payment, with a valid
withholding certificate (Form W-8 or W-9) or other valid appropriate
documentation from a recipient (see Regulations section 1.1471-3(d)(8)). The
withholding agent should complete a Form 1042-S showing “Unknown Recipient” in
box 13a and recipient code 21 (unknown recipient) as the chapter 3 status code
and recipient code 29 (unknown recipient) as the chapter 4 status code. Also,
the name, country code, address, chapter 4 status code, and TIN (if any) of the
nonparticipating FFI should be entered on Form 1042-S in boxes 15a through 15i.

If, however, an NQI or flow-through entity that is a nonparticipating FFI
provides documentation described in Regulations section 1.1471-3(d)(8)(ii) to
establish that the withholdable payment or a portion of the payment is
beneficially owned by an exempt beneficial owner, then the withholding agent
should complete a Form 1042-S for each exempt beneficial owner showing the
chapter 4 exemption code 15 (payee not subject to chapter 4 withholding), the
exempt beneficial owner as the recipient in box 13a, and the name, country code,
address, chapter 4 status code, and TIN (if any) of the nonparticipating FFI in
boxes 15a through 15i. For any remaining portion of the payment, the withholding
agent should complete a Form 1042-S to an unknown recipient as described
directly above.

PRO-RATA REPORTING TO NQI.

If the withholding agent has agreed that an NQI (other than a nonparticipating
FFI) may provide information allocating a payment to its account holders under
the alternative procedure of Regulations section 1.1441-1(e)(3)(iv)(D) (no later
than February 14, 2025) and the NQI fails to allocate more than 10% of the
payment in a withholding rate pool to the specific recipients in the pool or an
applicable chapter 4 withholding rate pool, the withholding agent must file a
Form 1042-S for each recipient in the pool on a pro-rata basis. The withholding
agent must check box 15 (pro-rata basis reporting) on each Form 1042-S. For
example, if there are four account holders in a withholding rate pool that
receives a $100 payment and the NQI fails to allocate more than $10 of the
payment, the withholding agent must file four Forms 1042-S, one for each account
holder in the pool, showing $25 of the income to each and box 15 checked. If,
instead, the NQI fails to timely allocate 10% or less of the payment in a
withholding rate pool to the specific recipients in a pool, the withholding
agent must file a Form 1042-S for each recipient for which it has allocation
information and report the unallocated part of the payment on a Form 1042-S as
made to an “unknown recipient.” In this case, the withholding agent does not
check box 15 on any of the Forms 1042-S.

PAYMENTS ALLOCATED, OR PRESUMED MADE, TO U.S. NONEXEMPT RECIPIENTS.

You may be given Forms W-9 or other information regarding U.S. nonexempt
recipients from an NQI or flow-through entity together with information
allocating all or a part of the payment to U.S. nonexempt recipients. You must
report income allocable to a U.S. nonexempt recipient on the appropriate Form
1099 and not on Form 1042-S, even though you are paying that income to an NQI or
a flow-through entity. If, however, a participating FFI or registered
deemed-compliant FFI provides a withholding statement allocating all or part of
the payment to a chapter 4 withholding rate pool of U.S. payees along with the
certification provided on Form W-8IMY required for reporting such pool (as
described in Regulations section 1.1471-3(c)(3)(iii)(B)), you must report the
income allocable to such pool on Form 1042-S.

Example 8.

FP is an NWP (flow-through entity) that is a certified deemed-compliant FFI. FP
receives from WA, a U.S. withholding agent, a withholdable payment of interest
described by income code 01 (interest paid by U.S. obligors – general). FP has
three partners, A, B, and C, all of whom are individuals. FP provides WA with a
Form W-8IMY certifying that it is transmitting Forms W-9 for U.S. nonexempt
recipients and Forms W-8BEN from A and B and a Form W-9 from C, a U.S. nonexempt
recipient. In addition, FP provides a complete withholding statement in
association with its Form W-8IMY that allocates the interest payments among A,
B, and C. WA must file two Forms 1042-S, one each for A and B, treating FP as
the intermediary in boxes 15a through 15i. WA should also file a Form 1099-INT
for C.

Example 9.

The facts are the same as in Example 8, except that FP does not provide any
documentation from its partners. Because WA cannot reliably associate the
withholdable payment of interest with documentation from a payee, it must apply
the presumption rules of Regulations section 1.1471-3(f) to treat the interest
as paid to a nonparticipating FFI. A Form 1042-S should be completed by entering
“4” in box 3, “Unknown Recipient” in box 13a, recipient code 21 (unknown
recipient) as the chapter 3 status code, and recipient code 29 (unknown
recipient) as the chapter 4 status code. Also, the name, country code, address,
status codes, and TIN (if any) of FP should be entered in boxes 15a through 15i.

Example 10.

The facts are the same as in Example 9, except that FP is a participating FFI
and provides WA with a Form W-8IMY certifying that it is reporting its U.S.
accounts under chapter 4 and a withholding statement allocating 33% of the
payment to a pool of U.S. payees. With respect to the U.S. pool of payees, WA
must file a Form 1042-S showing FP as the recipient in box 13a and include FP's
GIIN, recipient code 08 as the chapter 3 status code (partnership other than a
withholding foreign partnership or publicly traded partnership), and recipient
code 48 (U.S. payees pool) as the chapter 4 status code. WA should enter “3” in
box 3 as the chapter indicator, leave boxes 3a and 3b blank, and enter exemption
code 18 (U.S. payees of a participating FFI or registered deemed-compliant FFI)
in box 4a, and “00.00” in box 4b.

Amounts paid to an NQI or flow-through entity of amounts realized and PTP
distributions.

A U.S. withholding agent making a payment to an NQI that is subject to
withholding on a PTP distribution other than under section 1446 should generally
report the NQI and the recipient of the distribution on Form 1042-S in
accordance with the requirements applicable to withholdable payments made to
NQIs (described earlier). In the case of a PTP distribution paid to a
flow-through entity, however, the withholding agent should report the
flow-through entity as the recipient for an amount subject to section 1446(a)
unless it is a grantor trust (with the trust grantors or owners treated as the
recipients). In either case the U.S. withholding agent must provide a Form
1042-S that is associated with the PTP distribution to the extent that PTP
information is required to be included on Form 1042-S in accordance with Boxes
16a Through 16e, Payer's Name, TIN, GIIN, and Status Code, later, and as
described in Publicly Traded Partnerships (Sections 1446(a) and (f) Withholding
Tax), earlier.

A U.S. withholding agent making a payment to an NQI of an amount realized
subject to reporting for purposes of section 1446(f) (including on a PTP
distribution) should generally treat the recipient as an unknown recipient
because section 1446(f) withholding applies to an NQI without regard to the
statuses of its account holders receiving the amount realized. A single Form
1042-S may be issued to the NQI in this case regardless of the number of NQI
account holders. If the withholding agent agrees to report the NQI account
holders on Form 1042-S, however, it may report the amount realized and
withholding applied under section 1446(f) with respect to each NQI account
holder on Form 1042-S. See the instructions for Form W-8IMY for the requirements
for such an agreement (including that the withholding agent issue a recipient
copy of the Form 1042-S to the NQI with respect to each Form 1042-S issued to an
NQI account holder for an amount realized).

A U.S. withholding agent making a payment to a flow through entity of an amount
realized reportable on Form 1042-S must report the flow-through entity as the
recipient except to the extent it is treated as a grantor trust (in which case
the trust’s grantor or owner is the recipient).

AMOUNTS PAID BY QIS

In general.

For purposes of chapter 4, a QI must complete a Form 1042-S for payments
withheld under chapter 4 determined in accordance with the income codes used to
file Form 1042-S. A QI that is a participating FFI or registered
deemed-compliant FFI may use the chapter 4 pooled reporting codes 42 through 48
to allocate payments made to its recalcitrant account holders, payees that are
nonparticipating FFIs, and payees that are U.S. persons. A QI should not use
chapter 4 reporting pool 49 (QI‐ Recalcitrant Pool‐General) to report its
accounts but may use it to report accounts maintained by another QI. A QI that
is an NFFE or an FFI treated as deemed-compliant under an applicable IGA (as
described in Regulations section 1.1441-1(e)(5)(ii)(A)) may use chapter 4
reporting pool code 47 to report payments allocable to a pool of
nonparticipating FFIs. A QI may also use the chapter 4 pooled reporting codes to
report payments allocable to account holders, payees, or owners of another
participating FFI or registered deemed-compliant FFI that is an NQI, NWP, or
NWT, and it must provide its chapter 4 withholding rate pools on its withholding
statement. In such case, the QI must include the NQI, NWP, or NWT as the
recipient in box 13a and the applicable recipient code for such entity as the
chapter 3 status code. For payments subject to chapter 3 withholding that are
exempt from chapter 4 withholding and made by the QI directly to foreign
beneficial owners (or that are treated as paid directly to beneficial owners),
the QI may report on the basis of chapter 3 reporting pools, in most cases. A QI
may not report on the basis of reporting pools in the circumstances described in
Recipient-by-Recipient Reporting by QIs , later. For payments not subject to
chapter 4 withholding, a QI may use a single chapter 4 exemption code 15 (payee
not subject to chapter 4 withholding) and a single chapter 3 reporting pool code
27 (withholding rate pool – general) as the chapter 3 status code for all
reporting pools, except for amounts paid to foreign tax-exempt recipients for
which chapter 3 reporting pool code 28 should be used. Note, however, that a QI
should use recipient code 28 only for pooled account holders that have claimed
an exemption based on their tax-exempt status and not some other exemption (tax
treaty or other Internal Revenue Code section). If a QI uses a chapter 3 pooled
reporting code (because chapter 4 withholding does not apply and the QI is not
allocating the payment to a U.S. pool of payees), it should leave blank the
recipient code for the chapter 4 status code.

Example 11.

QI, a qualified intermediary and participating FFI, has four direct account
holders, A and B, foreign individuals, and X and Y, foreign corporations. The
withholdable payments made to these direct account holders are exempt from
chapter 4 withholding because of the chapter 4 status of each account holder. A
and X are residents of a country with which the United States has an income tax
treaty and have provided documentation that establishes that they are entitled
to a lower treaty rate of 15% on withholding of dividends from U.S. sources. B
and Y are not residents of a treaty country and are subject to 30% withholding
on dividends. QI receives U.S. source dividends on behalf of its four customers.
QI must file one Form 1042-S for the 15% withholding rate pool. This Form 1042-S
must show income code 06 (dividends paid by U.S. corporations – general) in box
1, “00” in box 3a (chapter 3 exemption code), “15.00” in box 3b (chapter 3 tax
rate), chapter 4 exemption code 15 (payee not subject to chapter 4 withholding)
in box 4a, “00.00” in box 4b (chapter 4 tax rate), “Withholding rate pool” in
box 13a (recipient's name), chapter 3 reporting pool code 27 (withholding rate
pool – general) as the chapter 3 status code, and a blank chapter 4 status code.
QI must also file one Form 1042-S for the 30% withholding rate pool that
contains the same information as the Form 1042-S filed for the 15% withholding
rate pool, except that it will show “30.00” in box 3b (chapter 3 tax rate).

Example 12.

The facts are the same as in Example 11, except that Y is an organization that
has tax-exempt status in the United States and in the country in which it is
located, and B is a recalcitrant account holder with U.S. indicia. QI must file
three Forms 1042-S. One Form 1042-S (for amounts allocable to A and X) will
contain the same information as in Example 11. The second Form 1042-S (for
amounts allocable to Y) will contain information for the withholding rate pool
consisting of the amounts paid to Y. This Form 1042-S will show income code 06
(dividends paid by U.S. corporations – general) in box 1, exemption code 02
(exempt under IRC) in box 3a, “00.00” in box 3b (chapter 3 tax rate), chapter 4
exemption code 15 (payee not subject to chapter 4 withholding) in box 4a,
“00.00” in box 4b (chapter 4 tax rate), “Zero rate withholding pool-exempt
organizations” or similar designation in box 13a (recipient's name), chapter 3
code 28 (withholding rate pool – exempt organization) in box 13f, and a blank
chapter 4 status code in box 13g. The third Form 1042-S will contain information
for the recalcitrant pool consisting of amounts paid to B. This Form 1042-S will
show income code 06 (dividends paid by U.S. corporations-general) in box 1, code
12 (payee subjected to chapter 4 withholding) in box 3a (chapter 3 exemption
code), “00.00” in box 3b (chapter 3 tax rate), “00” in box 4a (chapter 4
exemption code), “30.00” in box 4b (chapter 4 tax rate), “recalcitrant pool –
U.S. indicia” or similar designation in box 13a (recipient's name), chapter 4
recipient code 43 (recalcitrant pool-U.S. indicia) as the chapter 4 status code
in box 13g, and a blank chapter 3 status code in box 13f.

Under the terms of its QI agreement with the IRS, a QI that is an FFI may be
required to report the amounts paid to U.S. nonexempt recipients on Form 1099 or
Form 8966 using the name, address, and TIN of the payee to the extent those
items of information are known. These amounts must be reported on Form 1042-S if
allocated to a chapter 4 withholding rate pool of U.S. payees.

A QI acting as a QDD must separately report on Forms 1042-S payments that it
makes in its QDD capacity. The QI should report the name of the QDD that makes
the payment as the withholding agent in box 12d (following the naming protocol
used for applying to be a QDD) and should use withholding agent code 35 as the
chapter 3 status code.

Similarly, if the QDD is a partnership or branch of a partnership, that QDD must
separately report allocations to its partners of QDD items on Forms 1042-S,
entering the name of the QDD as the withholding agent in box 12d (following the
naming protocol).

A QI acting as a QDD with respect to a payment may only use chapter 3 pooled
reporting codes 27 and 28.

AMOUNTS PAID TO PAIS

In most cases, a QI must report payments subject to withholding under chapter 3
or 4 made to each private arrangement intermediary (PAI) (defined under
Definitions , earlier) as if the PAI's direct account holders were its own. For
purposes of chapter 4, a QI that is a participating FFI, registered
deemed-compliant FFI, or an FFI treated as deemed-compliant under an applicable
IGA (as described in Regulations section 1.1441-1(e)(5)(ii)(A)) may use the
chapter 4 reporting pool code 47 to allocate payments made to the PAI's payees
that are nonparticipating FFIs, and may treat the PAI as the recipient on Form
1042-S with respect to each such pool. For chapter 3 purposes, if the payment is
made directly by the PAI to the recipient, the QI may report the payment on a
pooled basis. A QI may not, however, report on a pooled basis as described in
the preceding sentence when acting as a QDD because, under the QI agreement, a
QI may not enter into a private arrangement with any account holder for which it
acts as a QDD. A separate Form 1042-S is required for each withholding rate pool
of each PAI (unless the QI is acting as a QDD with respect to the payment).
However, the QI must include the name and address of the PAI and use pooled
reporting code 29 (PAI withholding rate pool-general) or 30 (PAI withholding
rate pool-exempt organization) as the chapter 3 status code. If the PAI is
providing recipient information from an NQI or flow-through entity, the QI may
not report the payments on a pooled basis for chapter 3 purposes. Instead, it
must follow the same procedures as a U.S. withholding agent making a payment to
an NQI or flow-through entity.

Example 13.

QI, a qualified intermediary, pays U.S. source dividends to direct account
holders that are foreign persons and beneficial owners. It also pays a part of
the U.S. source dividends to two private arrangement intermediaries, PAI1 and
PAI2. The private arrangement intermediaries pay the dividends they receive from
QI to foreign persons that are beneficial owners and direct account holders of
PAI1 or PAI2. All payees are exempt from chapter 4 withholding based on their
respective chapter 4 statuses and the dividends paid are subject to a 15% rate
of withholding. QI must file a Form 1042-S for the dividends paid to its own
direct account holders that are beneficial owners. QI must also file two Forms
1042-S, one for the dividends paid to the direct account holders of each of PAI1
and PAI2. Each of the Forms 1042-S that QI files for payments made to PAI1 and
PAI2 must contain the name and address of PAI1 or PAI2, recipient code 29 (PAI
withholding rate pool – general) as the chapter 3 status code, and a blank
chapter 4 status code, and should use chapter 4 exemption code 15 (payee not
subject to chapter 4 withholding) in box 4a.

AMOUNTS PAID BY QIS TO CERTAIN PARTNERSHIPS AND TRUSTS

A QI that is applying the special pool reporting allowance provided in the QI
agreement for certain partnerships or trusts (Agency Option) must file separate
Forms 1042-S reflecting reporting pools for each partnership or trust that has
provided reporting pool information in its withholding statement. A QDD cannot
use the Agency Option. For purposes of chapter 4, a QI that is an FFI may use
the chapter 4 reporting pool code 47 to allocate payments made to the
partnership’s or trust's payees that are nonparticipating FFIs and should report
the partnership or trust as the recipient on Form 1042-S. For chapter 3
purposes, if the payment is made directly by the partnership or trust to the
recipient, the QI may use reporting pool code 31 (Agency withholding rate pool -
general) or 32 (Agency withholding rate pool - exempt organization) as the
chapter 3 status code (unless the QI is acting as a QDD with respect to the
payment). However, to the extent required in the QI agreement, the QI must file
separate Forms 1042-S for partners, beneficiaries, or owners of such partnership
or trust that are indirect partners, beneficiaries, or owners, and for direct
partners, beneficiaries, or owners of such partnership or trust that are
intermediaries or flow-through entities.

RECIPIENT-BY-RECIPIENT REPORTING BY QIS

If a QI is not permitted to report on the basis of reporting pools, it must
follow the same rules that apply to a U.S. withholding agent. For chapter 3
purposes, a QI may not report the following payments on a reporting pool basis,
but rather must complete Form 1042-S for each appropriate recipient and must
provide the applicable chapter 4 exemption code.

Payments made by QIs to another QI, QDD, QSL, WP, or WT.

The QI must complete a Form 1042-S treating the other QI, QDD (when a QI is
acting as a QDD with respect to a payment), QSL, WP, or WT as the recipient. A
QI must not treat a QI as a recipient, however, when the other QI is acting as a
disclosing QI. See Payment to QI of PTP distributions or amounts realized,
earlier, for information on reporting of PTP distributions and amounts realized
paid to disclosing QIs.

Payments made to an NQI (including an NQI that is an account holder of a PAI).

For chapter 3 purposes, the QI must complete a Form 1042-S for each recipient
who receives the payment from the NQI. A QI that is completing Form 1042-S for a
recipient that receives a payment through an NQI must include in boxes 15a
through 15i the name, country code, address, TIN (if any), GIIN (if any), and
status codes of the NQI from whom the recipient directly receives the payment.
In the case of an NQI that is a participating FFI or registered deemed-compliant
FFI, the QI must complete a Form 1042-S for the chapter 4 withholding rate pool
of the NQI provided in a withholding statement associated with its Form W-8IMY
and must report the NQI as the recipient. In such a case, the QI must include
the name and address of the NQI as the recipient and use chapter 4 pool
reporting codes 42 through 48 as the chapter 4 status code and chapter 3 status
code 25 (nonqualified intermediary). If the NQI fails to provide sufficient
allocation information with respect to a withholdable payment, the QI must
complete a Form 1042-S with the recipient as “Unknown Recipient” using chapter 4
status code 29 (unknown recipient) and must include the NQI's information in
boxes 15a through 15i.

Example 14.

QI, a qualified intermediary, has NQI, a nonqualified intermediary that is a
participating FFI, as an account holder. NQI has two account holders, A and B,
both recalcitrant account holders with U.S. indicia who receive a withholdable
payment of U.S. source dividends from QI. NQI provides QI with a valid Form
W-8IMY and a complete withholding statement that allocates the dividends paid to
NQI to recalcitrant pool – U.S. indicia for both A and B. QI must complete one
Form 1042-S reporting NQI as the recipient and using reporting pool code 43
(recalcitrant pool – U.S. indicia) as the chapter 4 status code.

Example 15.

QI has NQI, a nonqualified intermediary that is a reporting Model 2 FFI, as an
account holder. NQI has two account holders, A and B, who receive a withholdable
payment of U.S. source dividends from QI. A is a nonparticipating FFI. NQI
treats B as a nonconsenting U.S. account under the applicable IGA and is not
required to withhold on payments to B under chapter 4. NQI provides QI with a
valid Form W-8IMY and a complete withholding statement that allocates 50% of the
dividends paid to A and 50% to B. NQI designates B as an individual exempt from
withholding under an IGA but cannot include B in a chapter 4 withholding rate
pool of U.S. payees because the payment is subject to chapter 3 withholding and
under the presumption rules of Regulations section 1.1441-1(b)(3) the payment is
presumed made to an unknown, undocumented foreign payee. QI must complete two
Forms 1042-S. One Form 1042-S must show NQI as the recipient and use reporting
pool code 47 (nonparticipating FFI pool). The second Form 1042-S must show the
recipient as “Unknown Recipient,” NQI's information in boxes 15a through 15i,
chapter 4 exemption code 19 (exempt from withholding under IGA), chapter 4
status code 34 (nonconsenting U.S. account), chapter 3 status code 21 (unknown
recipient), and 30% withholding under chapter 3 for the payment allocated to B
as a presumed foreign person under chapter 3.

Payments made by QIs to a flow-through entity.

The QI must complete a Form 1042-S for each recipient who receives the payment
from the flow-through entity for purposes of chapters 3 and 4. A QI that is
completing a Form 1042-S for a recipient that receives a payment through a
flow-through entity must include in boxes 15a through 15i the name, country
code, address, TIN (if any), GIIN (if any), and status codes of the flow-through
entity from which the recipient directly receives the payment.

For chapter 4 purposes and in the case of a flow-through entity that is a
participating FFI or registered deemed-compliant FFI (other than a WP or WT),
the QI must complete a Form 1042-S for each chapter 4 withholding rate pool
provided in the withholding statement associated with the Form W-8IMY of the
flow-through entity. The QI must include the name, address, and GIIN of the
flow-through entity as the recipient and the applicable chapter 3 status code
for the flow-through entity and use pooled reporting codes 42 through 48 as the
chapter 4 status code.

Example 16.

QI, a qualified intermediary, has FP, a nonwithholding foreign partnership that
is a registered deemed-compliant FFI, as an account holder. QI pays interest
that is a withholdable payment described by income code 01 (interest paid by
U.S. obligors – general) to FP. FP has three partners, A, B, and C, all of whom
are exempt from withholding under chapter 4 based on their respective chapter 4
statuses. FP provides QI with a Form W-8IMY with which it associates the Forms
W-8BEN from each of A, B, and C. In addition, FP provides a complete withholding
statement in association with its Form W-8IMY that allocates the interest
payments among A, B, and C. QI must file three Forms 1042-S, one each for A, B,
and C. The Forms 1042-S must show information relating to FP in boxes 15a
through 15i along with the chapters 3 and 4 status codes and chapter 4 exemption
code 15 (payee not subject to chapter 4 withholding) for A, B, and C.

See section 8 of the 2023 QI agreement in Rev. Proc. 2022-43 for information on
Form 1042-S reporting requirements when QIs make payments of PTP distributions
or amounts realized, or when a QI acting as a QDD is a partnership required to
report on Form 1042-S with respect to its foreign partners. For when a QI pays a
PTP distribution or amount realized to a partner through more than one
disclosing QI and the QI is required to issue a Form 1042-S under section 8 of
the 2023 QI agreement to report the payment, see Payment to QI of PTP
distributions or amounts realized, earlier, for the disclosing QI to which the
QI is required to issue a recipient copy of Form 1042-S.

AMOUNTS PAID BY WITHHOLDING FOREIGN PARTNERSHIPS AND TRUSTS

In general.

For chapter 4 purposes, payments that are made by a withholding foreign
partnership (WP) or withholding foreign trust (WT) that is a participating FFI
or a registered deemed-compliant FFI directly to its partners, owners, or
beneficiaries that are recalcitrant account holders, payees that are
nonparticipating FFIs, and payees that are U.S. persons may be reported on the
basis of chapter 4 reporting pools. A WP or WT may also use the chapter 4 pooled
reporting codes to report payments allocable to account holders, payees, or
owners of another participating FFI or registered deemed-compliant FFI that is
an NQI, NWP, or NWT and provides its chapter 4 withholding rate pools on its
withholding statement when the WP or WT applies section 9.03 of its agreement to
such entity. In such case, the WP or WT must include the NQI, NWP, or NWT as the
recipient in box 13a. If a WP or WT has not made a pooled reporting election for
chapter 3 purposes, a WP or WT must file a separate Form 1042-S for each direct
partner, beneficiary, or owner that is exempt from chapter 4 withholding and to
whom the WP or WT distributes, or in whose distributive share is included, an
amount subject to withholding under chapter 3, in the same manner as a U.S.
withholding agent. However, if the WP or WT has made a pooled reporting election
in its WP or WT agreement, the WP or WT may instead report payments to such
direct partners, beneficiaries, or owners on the basis of chapter 3 reporting
pools and file a separate Form 1042-S for each reporting pool. For payments not
subject to chapter 4 withholding, a WP or WT may use a single chapter 4
exemption code 15 (payee not subject to chapter 4 withholding) and a single
chapter 3 reporting pool code 27 (withholding rate pool – general) as the
chapter 3 status code for all chapter 3 reporting pools, except for amounts paid
to foreign tax-exempt recipients for which a separate recipient code 28 must be
used. For this purpose, a foreign tax-exempt recipient includes any organization
that is not subject to withholding and is not liable to tax in its country of
residence because it is a charitable organization, pension fund, or foreign
government. See the WP and WT agreements for when a WP and WT can pool report
payments to an indirect partner, a beneficiary, or an owner. See section 9 of
the WP or WT agreement.

AMOUNTS PAID BY NONQUALIFIED INTERMEDIARIES AND FLOW-THROUGH ENTITIES

An NQI and a flow-through entity are withholding agents and must file Forms
1042-S for amounts paid to recipients. However, an NQI or flow-through entity is
not required to file Form 1042-S if it is not required to file Form 1042-S under
the Multiple Withholding Agent Rule , later. An NQI or flow-through entity may
report payments made to recipients to the extent it has failed to provide to
another withholding agent the appropriate documentation and complete withholding
statement for either chapter 3 or 4 purposes or when an NQI receives a payment
of an amount realized subject to section 1446(f) withholding from a broker that
does not agree to report on Form 1042-S the NQI account holders receiving the
payment. See the instructions for Form W-8IMY for the requirements for such an
agreement. If the NQI or flow-through entity chooses to or must file Form
1042-S, as described above, the NQI or flow-through entity must also file Form
1042 and, if applicable, attach the Form 1042-S it received from the withholding
agent to establish any credit for amounts withheld by the withholding agent. See
the Instructions for Form 1042.

If another withholding agent has withheld tax on an amount that should have been
exempt (for example, where the withholding agent applied the presumption rules
because it did not receive proper documentation or other required information
from the NQI or flow-through entity), and the payee or beneficial owner will
make a claim for refund, the NQI or flow-through entity must report on Form
1042-S the correct tax rate and the combined amount of U.S. federal tax withheld
with respect to all recipients and should enter the applicable chapters 3 and 4
exemption codes.

If another withholding agent underwithholds, regardless of whether it received
proper documentation from the NQI or flow-through entity, the NQI or
flow-through entity must withhold additional amounts to bring the total
withholding to the correct amount.

If an NQI receives an amount realized withheld on under section 1446(f), it may
issue Forms 1042-S to report the payment and withholding even if the account
holder is a U.S person.

SPECIFIED FEDERAL PROCUREMENT PAYMENTS MADE TO FOREIGN PERSONS

Section 5000C imposes a 2% tax on any foreign person that receives a specified
federal procurement payment. A specified federal procurement payment is a
payment made to a foreign person pursuant to a contract with the U.S. Government
for (1) the provision of goods that are manufactured or produced in a country
that does not have an international procurement agreement with the United
States, or (2) the provision of services in a country that does not have an
international procurement agreement with the United States.

For purposes of section 5000C, a payer of a specified federal procurement
payment to a foreign person must complete a Form 1042-S for payments withheld
upon in the name of the foreign person. Use income code 44 to report payments
subject to withholding under section 5000C. box 2 should include the amount of
the specified federal procurement payments subject to withholding and box 7
should include the amount of tax withheld under section 5000C.

If you are reporting tax withheld under section 5000C, enter “3” in box 3 as if
the tax were a chapter 3 tax, enter “00” in box 3a, and report the tax withheld
in box 7. You do not need to complete box 4a, 4b, or any box for a chapter 3 or
4 status code. In boxes 13a through 13d, include the name and the address of the
foreign person withheld upon. If known, include the TIN (if any) in box 13e.

MULTIPLE WITHHOLDING AGENT RULE

A withholding agent is not required to file Form 1042-S if a return is filed by
another withholding agent reporting the same amount and the withholding agent
has withheld correctly.

The multiple withholding agent rule does not relieve withholding agents from
Form 1042-S reporting responsibility in the following circumstances.

* Any withholding agent making a payment to a QI, QSL, WP, or WT must report
that payment as made to the QI, QSL, WP, or WT.

* Any withholding agent making a payment to a U.S. branch treated as a U.S.
person must report the payment as made to that branch.

* Any withholding agent that withholds an amount from a payment under chapter 3
or 4 must report that amount to the recipient from whom it was withheld.

Furthermore, the multiple withholding agent rule does not relieve the following
from Form 1042-S reporting responsibility.

* Any QI, WP, or WT required to report an amount to a chapter 4 withholding
rate pool or chapter 3 withholding rate pool.

* An NQI or flow-through entity that knows, or has reason to know, that the
correct amount has not been withheld by another withholding agent.

Under the multiple withholding agent rule, a withholding agent reporting amounts
withheld by another withholding agent must use box 8 (Tax withheld by other
agents) to report such amounts and must provide the name and EIN of the
withholding agent that withheld in boxes 14a and 14b (Primary Withholding
Agent's Name and EIN). See the instructions for boxes 14a and 14b, later.

Example 17.

NQI, a foreign bank that is a participating FFI, acts as a nonqualified
intermediary for four different foreign persons (A, B, C, and D) who own
securities from which they receive interest that is a withholdable payment. The
interest is paid by a U.S. withholding agent (WA) as custodian of the securities
for NQI. A, B, C, and D each own a 25% interest in the securities. NQI has
furnished WA with a Form W-8IMY to which it certifies its status as a
participating FFI and has attached Forms W-8BEN from A and B. NQI's Form W-8IMY
contains an attachment stating that 25% of the securities are allocable to each
of A and B and 50% to a pool of recalcitrant account holders with U.S. indicia.
WA pays $100 of interest during the calendar year. WA treats the $25 of interest
allocable to A and the $25 of interest allocable to B as portfolio interest and
completes Forms 1042-S for A and for B as the recipients. WA includes
information relating to NQI in boxes 15a through 15i on the Forms 1042-S for A
and B. WA subjects the remaining $50 of interest to 30% withholding under
chapter 4 and reports the interest on a Form 1042-S by treating NQI as the
recipient in box 13a and uses chapter 3 status code 25 (nonqualified
intermediary), chapter 4 status code 43 (recalcitrant pool – U.S. indicia),
“30.00” in box 4b (chapter 4 tax rate), and $15 as the amount withheld in boxes
7 and 10. Under the multiple withholding agent rule, NQI is not required to file
a Form 1042-S, but must file a Form 1042-S if, for example, C and D seek to make
a claim for refund and NQI has not filed a collective refund claim on behalf of
C and D for the tax withheld under chapter 4 on the payment (see Regulations
section 1.1471-4(h)).

Example 18.

WA, a U.S. withholding agent, makes a $100 dividend payment that is a
withholdable payment to a foreign bank (NQI) that is a participating FFI and
acts as a nonqualified intermediary. NQI receives the payment on behalf of A,
documented as a foreign individual exempt from chapter 4 withholding and a
resident of a treaty country who is entitled to a 15% rate of withholding under
chapter 3, and B, documented as a foreign individual exempt from chapter 4
withholding and a resident of a country that does not have a tax treaty with the
United States and who is subject to 30% withholding under chapter 3. NQI
provides WA with its Form W-8IMY that certifies its status as a participating
FFI to which it associates the Forms W-8BEN from both A and B and a complete
withholding statement that allocates 50% of the dividend to A and 50% to B. A's
Form W-8BEN claims a 15% treaty rate of withholding. B's Form W-8BEN does not
claim a reduced rate of withholding. WA, however, mistakenly withholds only 15%,
$15, from the entire $100 payment. WA completes a Form 1042-S for each A and B
as the recipients, showing on each form $50 of dividends in box 2, a withholding
rate of “15.00” in box 3b (chapter 3 tax rate), and $7.50 as the amount withheld
in boxes 7 and 10. Under the multiple withholding agent rule, NQI is not
required to file a Form 1042-S for A. However, because NQI knows (or should
know) that B is subject to a 30% rate of withholding, and assuming it knows that
WA only withheld 15%, the multiple withholding agent rule does not apply to the
dividend paid to B, and NQI must withhold an additional 15% from the payment to
B. NQI must then file a Form 1042-S for B showing $50 of dividends in box 2,
“00” in box 3a (chapter 3 exemption code), “30.00” in box 3b (the correct
chapter 3 tax rate), $7.50 withheld by NQI in box 7, $7.50 withheld by WA in box
8, and $15 in box 10 (the combined amount withheld). NQI must also enter chapter
4 exemption code 15 (payee not subject to chapter 4 withholding) in box 4a and
“00.00” in box 4b (chapter 4 tax rate). See the instructions for box 3b, later.

PENALTIES

The following penalties apply to the person required to file Form 1042-S. The
penalties apply to both paper filers and electronic filers.

Late filing of correct Form 1042-S.

A penalty may be imposed for failure to file each correct and complete Form
1042-S when due (including extensions), unless you can show that the failure was
due to reasonable cause and not willful neglect. The penalty, based on when you
file a correct Form 1042-S, is the following.

* $60 per Form 1042-S if you correctly file within 30 days after the required
filing date; the maximum penalty is $664,500 per year ($232,500 for a small
business). A small business, for this purpose, is defined as having average
annual gross receipts of $5 million or less for the 3 most recent tax years
(or for the period of its existence, if shorter) ending before the calendar
year in which the Forms 1042-S are due.

* $130 per Form 1042-S if you correctly file more than 30 days after the due
date but by August 1; the maximum penalty is $1,993,500 per year ($664,500
for a small business).

* $330 per Form 1042-S if you file after August 1 or you do not file correct
Forms 1042-S; the maximum penalty is $3,987,000 per year ($1,329,000 for a
small business).

If you intentionally disregard the requirement to report correct information,
the penalty per Form 1042-S is increased to the greater of $660 or 10% of the
total amount of items required to be reported, with no maximum penalty.

Failure to furnish correct Form 1042-S to recipient.

If you fail to provide Forms 1042-S to recipients and cannot show reasonable
cause, a penalty of up to $330 may be imposed for each failure to furnish Form
1042-S to the recipient when due. The penalty may also be imposed for failure to
include all required information or for furnishing incorrect information on Form
1042-S. The maximum penalty is $3,987,000 for all failures to furnish correct
recipient statements during a calendar year. If you provide the correct
statement on or before August 1, reduced penalties similar to those for failing
to file a correct Form 1042-S with the IRS may be imposed. See Late filing of
correct Form 1042-S , earlier. If you intentionally disregard the requirement to
report correct information, each $330 penalty is increased to the greater of
$660 or 10% of the total amount of items required to be reported, with no
maximum penalty.

Failure to file electronically.

If you are required to file electronically but fail to do so, and you do not
have an approved waiver on record, penalties may apply unless you establish
reasonable cause for your failure.

AVOID COMMON ERRORS

To ensure that your Forms 1042-S can be correctly processed, be sure that you do
the following.

* Carefully read the information provided in Pub. 515 and these instructions.

* Comply with the requirements in Pub. 1187 if you are an electronic filer.

* Complete all required fields. At a minimum, you must provide your unique form
identifier at the top of the form as well as the information requested in
boxes 1, 2, 3, 7a, 12a, 12b, 12c, 12d, 12f, 12h, 12i, 13a, 13b, 13c, and 13d.
Other boxes must be completed if the nature of the payment requires it.

* If the amount reported in box 2 is a withholdable payment, you must also
enter information in boxes 4a, 4b, and 13g. If the amount reported in box 2
is an amount subject to chapter 3 withholding, you must enter information in
boxes 12b, 12c, and 13f.

* If the amount reported in box 2 is not subject to chapter 4 withholding or is
not a withholdable payment, you must enter “00.00” in box 4b and provide the
applicable exemption code in box 4a.

* If the amount reported in box 2 is a withholdable payment and an amount
subject to chapter 3 withholding and the tax rate in box 4b is 00.00, you
must enter information in boxes 3a and 3b. If the rate entered in box 4b is
30.00, you may enter information in boxes 3a and 3b.

* If you are a QI, WP, or WT that is pool reporting for its direct account
holders only, either a chapter 3 status code (box 13f) or chapter 4 status
code (box 13g) is required.

* If the recipient in box 13 or entity in box 15 is a participating FFI,
registered deemed-compliant FFI, sponsored FFI, direct reporting NFFE, or
sponsored direct reporting NFFE, you must enter the entity's GIIN or the GIIN
of the sponsoring entity in box 13h or 15e (to the extent that you may rely
on a sponsored entity's GIIN under the chapter 4 regulations or an applicable
IGA for withholding purposes).

* Use only income, status, and exemption codes specifically listed in these
instructions.

* Use only tax rates that are allowed by statute, regulations, or treaty. Do
not attempt to “blend” rates. Instead, if necessary, submit multiple Forms
1042-S to show changes in tax rate. See the Valid Tax Rate Table.

All information you enter when reporting the payment must correctly reflect the
intent of the statute and regulations. In most cases, you should rely on the
withholding documentation you have collected (Form W-8 series, Form 8233, etc.)
to complete your Form 1042-S submissions.

Also note the following.

NOTE.

If you use exemption code 04 (exempt under tax treaty), the country code that
you report in box 13b must be a valid treaty country. Countries with which the
United States has a tax treaty are listed at
IRS.gov/Businesses/International-Businesses/United-States-Income-Tax-Treaties-A-to-Z.

* The gross income you report in box 2 cannot be zero.

* The income code you report in box 1 must correctly reflect the type of income
you pay to the recipient.

* The withholding agent's name, address, chapters 3 and 4 status codes, EIN,
QI-EIN, WP-EIN, WT-EIN, and GIIN (if any) must be reported in boxes 12a
through 12i.

* The recipient's name, address, U.S. TIN (if any), GIIN (if any), and country
code must be reported in boxes 13a through 13e and 13h. In most cases, you
must report a foreign address. See the instructions for box 13, later.

* In the case of joint owners, Form 1042-S can only list one of the owners as
the recipient in box 13a. Form 1042-S must not be completed with more than
one of the joint owners as the recipient.

* The country code that you report in boxes 13b and 15f must be present and
correctly coded and cannot be “US” (unless the intermediary identified in
line 15 is a U.S. branch that is not treated as a U.S. person). Additionally,
do not use “OC” except as specifically allowed in these instructions.

* For direct account holders, you must report the recipient's account number in
box 13k. You may also be required to report the recipient's FTIN, an LOB code
(for an entity claiming treaty benefits), and the recipient's date of birth
in boxes 13j and 13l (see the instructions for box 13j and box 13l, later).

* The exemption code you report in box 3a must correctly identify the proper
tax status for the type of income you pay to the recipient. The exemption
code you report in box 4a must correctly identify the proper tax status for
the type of income you pay to the recipient or if exemption code 15 is used
(payee not subject to chapter 4 withholding), the chapter 4 status code of
the recipient must correctly reflect this exemption.

* When reporting to Unknown Recipients, ensure that 30% tax is withheld for
amounts subject to chapter 3 or 4 withholding, remitted to the IRS, and
correctly reported on Form 1042-S. In such cases, the recipient's name should
be "Unknown Recipient." The recipient's chapter 3 and 4 status codes should
also reflect "Unknown Recipient," and the recipient country should be left
blank. Do not use country code "UC" to indicate unknown country. Only use
country code "UC" when the recipient country is Curacao.

* Foreign source income generally is not required to be reported on Form
1042-S. As a result, exemption code 03 (income is not from U.S. sources)
should be used for reporting income only in limited circumstances (for
example, when withholding is applied in error). See Regulations section
1.1461-1(c)(2) for when reporting on Form 1042-S is required.

You, the withholding agent, are liable for the tax if you know, or should have
known, that underwithholding on a payment has occurred.

SPECIFIC INSTRUCTIONS FOR WITHHOLDING AGENTS

All amounts must be reported in U.S. dollars.

ROUNDING OFF TO WHOLE DOLLARS

You must round off cents to whole dollars. To round off amounts to the nearest
whole dollar, drop amounts under 50 cents and increase amounts from 50 to 99
cents to the next dollar. For example, $1.39 becomes $1 and $2.50 becomes $3. If
you have to add two or more amounts to figure the amount to enter on a line,
include cents when adding and only round off the total.

UNIQUE FORM IDENTIFIER

A withholding agent must provide a unique form identifier number on each Form
1042-S that it files in the box provided at the top of the form. The unique form
identifier must:

* Be numeric (for example, 1234567891),

* Be exactly 10 digits, and

* Not be the recipient's U.S. or foreign TIN.

If a withholding agent is filing an amended Form 1042-S, it must include the
same unique form identifier that was reported by the withholding agent on the
original Form 1042-S that is being amended. The unique form identifier will be
used to identify which information return is being corrected or amended when
multiple information returns are filed by a withholding agent with respect to
the same recipient. The identifying number must be unique to each original Form
1042‐S filed for the current year. The identifying number can be used on a new
original form in a subsequent year.

AMENDED CHECKBOX

See Amended Forms, later.

AMENDMENT NUMBER

If you are filing an amended Form 1042-S, you must provide an amendment number.
The amendment number must be numeric and the length must be exactly one digit.
Each time that you amend the same form (as determined by the unique form
identifier), you must provide the amendment number in the box provided on the
form (using “1” for the first amendment and increasing sequentially for each
subsequent amendment).

BOX 1, INCOME CODE

All filers must enter the appropriate two-digit income code from the list in
Appendix A , later. Use the income code that is the most specific. See Pub. 515
for further explanation of the income codes. Below are examples on how to use
some of the income codes.

1. Use code 06 for dividends, including any deemed dividends (such as deemed
dividends arising under section 305(c)). However, use other codes for
dividends (including deemed dividends) paid on actively traded securities
and for dividend equivalents.

2. Use code 09 for the following types of capital gain.

a. Gains on disposal of timber, coal, or domestic iron ore with a retained
economic interest, unless an election is made to treat those gains as
income effectively connected with a U.S. trade or business.

b. Gains on contingent payments received from the sale or exchange after
October 4, 1966, of patents, copyrights, secret processes and formulas,
goodwill, trademarks, trade brands, franchises, and other like
property.

c. Gains on certain transfers of all substantial rights to, or an
undivided interest in, patents if the transfers were made before
October 5, 1966.

d. Certain gains from the sale or exchange of OID obligations issued after
March 31, 1972.

3. Use code 17 for payments for independent personal services performed by a
foreign person (including payments made to an entity). This includes
payments that are subject to the business profits article of a treaty.

4. Use code 29 (deposit interest) if you are paying bank deposit interest, not
code 01 (interest paid by U.S. obligors-general).

5. Use code 24 (qualified investment entity (QIE) distributions of capital
gains) for distributions of capital gains from a QIE. Use code 36 (capital
gains distributions) for capital gain distributions (dividends) paid or
credited by mutual funds (or other RICs). Include long-term and short-term
capital gain dividends (use exemption code 02 (exempt under IRC) in box
3a).

NOTE.

Exempt-interest dividends and interest-related dividends should be reported
under income code 01 (interest paid by U.S. obligors-general) (use
exemption code 02 (exempt under IRC) in box 3a).

6. Use code 28 for gambling winnings. These are proceeds from a game other
than blackjack, baccarat, craps, roulette, or big-6 wheel. For more
information, see Pub. 515.

7. Use code 33, 34, 35, 53, or 54 for all substitute payment transactions. For
more information, see Regulations sections 1.861-2(a)(7) and 1.861-3(a)(6).
For payments of interest or substitute interest made by a withholding agent
to a QI that assumes primary withholding responsibilities for substitute
interest, the withholding agent and the QI should use code 33 or 54. For
payments of substitute dividends, a withholding agent should use code 34 or
53. See Rev. Proc. 2022-43 for more information on when a QI assumes
primary withholding responsibilities for substitute interest or dividend
equivalents.

8. Use code 37 (return of capital) for a nondividend distribution. This is a
distribution that is not paid out of the earnings and profits of a
corporation. It represents a distribution in part or full payment in
exchange for stock.

9. Use codes 38 and 39 for payments to covered expatriates. Use code 38 for a
payment of eligible deferred compensation subject to section 877A(d)(1) and
use code 39 for a distribution from a nongrantor trust subject to section
877A(f)(1). For more information, see Notice 2009-85, 2009-45 I.R.B. 598,
available at IRS.gov/irb/2020-03_IRB#NOT-2020-2.

10. There are three categories of dividend equivalent codes. For substitute
dividends, use code 34 or 53. See example 7 of this list for additional
instructions related to substitute dividends. For dividend equivalents with
respect to a transaction that is a section 871(m) transaction as a result
of combining transactions under Regulations section 1.871-15(n) (including
as modified by transition relief under Notice 2022-37, when applicable) (a
“combined transaction”), use code 56 (dividend equivalents under IRC
section 871(m) as a result of applying the combined transaction rules). For
all other dividend equivalents, use code 40 (other dividend equivalents
under IRC section 871(m)).

11. Use code 41 (guarantee of indebtedness) for certain guarantee of
indebtedness payments. These are amounts paid for the provision of a
guarantee of indebtedness that was issued after September 27, 2010.

12. Use either code 42 (earnings as an artist or athlete – no central
withholding agreement) or 43 (earnings as an artist or athlete – central
withholding agreement) for payments to an artist or athlete. A central
withholding agreement is Form 13930, Application for Central Withholding
Agreement, plus additional information specified in the instructions for
such form, that is entered into by the artist or athlete, a designated
withholding agent, and the IRS. For more details, see Pub. 515.

13. Use code 50 (income previously reported under escrow procedure) with
respect to a recalcitrant account holder of a dormant account for which a
participating FFI reported the income on Form 1042-S in a prior calendar
year but for which the participating FFI was not required to deposit the
tax withheld or determined that withholding was not required until the
current calendar year under an applicable escrow procedure. For additional
information on the escrow procedure for dormant accounts, see Regulations
section 1.1471-4(b)(6). Also use code 50 for income reported on a Form
1042-S in a prior calendar year for which tax withheld was not deposited
pursuant to the escrow procedure for undetermined amounts of income and
such withheld tax is now required to be deposited in the current calendar
year. For additional information on the escrow procedure for undetermined
amounts of income, see Regulations section 1.1441-3(d)(1). For instructions
on reporting amounts withheld during the current calendar year that you are
not depositing pursuant to the escrow procedure, see the instructions for
box 7, later.

14. Use code 52 (dividends paid on certain actively traded or publicly offered
securities), 53 (substitute payments-dividends paid from certain actively
traded or publicly offered securities), 51 (interest paid on certain
actively traded or publicly offered securities), 54 (substitute
payments-interest from certain actively traded or publicly offered
securities), and 13 (royalties paid on certain publicly offered securities)
if the income paid is described in Regulations section 1.1441-6(c)(2) and
you have reduced the rate of withholding under an income tax treaty without
the recipient providing a U.S. or foreign TIN. See codes 40 and 56 for
dividend equivalents other than substitute dividends and example 10 of this
list for additional information.

15. Use code 55 (taxable death benefits on life insurance contracts) to report
taxable death benefits, such as benefits paid on an insurance contract that
was acquired on a transfer for valuable consideration. See section 101 for
when death benefits are taxable.

16. Use income code 57 to report an amount realized under section 1446(f)
(regardless of whether paid on a sale or PTP distribution).

17. Use income code 58 to the extent you cannot determine the income
attributable to a PTP distribution and apply Regulations section
1.1446-4(d)(1) to determine the withholding absent a qualified notice
indicating the amount.

18. Income code 23 (other income) should be used only to report U.S. source
FDAP income that is not reportable under any other available income code.

If you paid more than one type of income to or on behalf of the same recipient,
you must complete a separate Form 1042-S for each income type.

NOTE.

Although income codes are provided for short-term OID and notional principal
contract income, those items are not always subject to reporting on Form 1042-S.
For example, short-term OID may need to be reported by an NQI or flow-through
entity if those amounts are paid to foreign persons and another withholding
agent backup withheld on those amounts under the presumption rules. Notional
principal contract income is reportable if it is effectively connected with the
conduct of a trade or business in the United States or results in the payment of
interest under Regulations section 1.446-3(g)(4) or a dividend equivalent under
section 871(m) and the regulations thereunder (for which a Form 1042-S is
required). For more information, see the regulations under chapter 3 and Pub.
515.

BOX 2, GROSS INCOME

For each income type, enter the gross amount you paid (in whole dollars) to or
on behalf of the recipient during the calendar year, including withheld tax.
See, however, the instructions for boxes 16a through 16e, later, for when you
must issue a separate Form 1042-S (or several Forms 1042-S) for income
attributable to a PTP distribution. The following other special procedures apply
to the reporting of gross income.

* You must report the entire amount of a corporate distribution made with
respect to stock even if you elect to reduce the amount of withholding on the
distribution because all or a part of the distribution is nontaxable or
represents a capital gain dividend.

* You must report the entire amount of a payment if you do not know at the time
of payment the amount that is subject to withholding because the
determination of the source of the income or the calculation of the amount of
income subject to tax depends upon facts that are not known at the time of
payment.

* If you applied the escrow procedure under chapters 3 and 4, report the entire
amount of a payment that you previously reported in a prior calendar year for
which you withheld tax but did not deposit such tax under the escrow
procedure if the liability is due in the current calendar year.

* You must report the entire amount of gains relating to the disposal of
timber, coal, or domestic iron ore with a retained economic interest, and
gains relating to contingent payments received from the sale or exchange of
patents, copyrights, and similar intangible property.

* You must report only the amount of cash paid on notional principal contracts.

* If reporting payments to artists or athletes who have signed a central
withholding agreement (income code 43), you must report the gross amount paid
to the artist or athlete in box 2 (without any consideration to the expenses
to be taken into account for purposes of determining the amount of
withholding tax pursuant to the central withholding agreement).

* You must report the entire amount of any dividend equivalent as determined
under Regulations sections 1.871-15(i) and (j).

BOX 3

Chapter indicator.

If you are reporting amounts in boxes 7 through 9, enter either a “3” or “4” to
indicate whether the amounts were withheld (or paid by the withholding agent)
pursuant to chapter 3 or chapter 4. If you are reporting tax withheld under
section 5000C, or backup withholding was applied under the presumption rules,
enter “3” as if the tax were a chapter 3 tax.

NOTE.

Either a “3” or “4” (but not both) must be entered on each Form 1042-S. If you
are not reporting amounts in boxes 7 through 9 because you did not withhold
under chapter 3 or 4, you should enter “3.”

If you are reporting payments to U.S. payees, enter “3” and leave boxes 3a and
3b blank.

BOXES 3A AND 4A, CHAPTER 3 AND CHAPTER 4 EXEMPTION CODES

In most cases, if the tax rate you entered in box 3b or 4b is 00.00, you may be
required to enter the appropriate exemption code (01 through 24) from Appendix B
, later, as applicable for chapter 3 and 4 purposes. In certain cases, more than
one exemption code will apply. See the instructions below for the applicable
codes to determine which code to use.

If an amount was withheld under chapter 4 (the tax rate you entered in box 4b is
greater than zero and is not due to backup withholding), enter “00” in box 4a.
If the tax rate you entered in box 4b is 00.00, you must enter the applicable
exemption code (13 through 21) in box 4a. If an amount was withheld under
chapter 3 (the tax rate you entered in box 3b is greater than zero and is not
due to backup withholding), enter “00” in box 3a. If the tax rate you entered in
box 3b is due to backup withholding, leave box 3a blank.

If exemption code 01 or 14 (effectively connected income) applies, you must
enter the recipient's U.S. TIN in box 13e if you report the income as
effectively connected with a U.S. trade or business. If the recipient's U.S. TIN
is unknown or unavailable, you must withhold tax at the rate of 30% (30.00) and
enter “00” in boxes 3a and 4a.

CHAPTER 3 EXEMPTION CODES

A withholding agent should use chapter 3 exemption code 02, Exempt under IRC,
only if none of the other chapter 3 exemption codes apply.

A withholding agent should use exemption code 06 (QI that assumes primary
withholding responsibility) only if it is making a payment to a QI that has
represented on its Form W-8IMY that it is assuming primary withholding
responsibility under chapters 3 and 4. However, if the payment is made to a QI
that is acting as a QDD with respect to the payment, the withholding agent
should instead use exemption code 22 (QDD that assumes primary withholding
responsibility).

A withholding agent should use exemption code 07 (WP or WT) only if it is making
a payment to a foreign partnership or trust that has represented on its Form
W-8IMY that it is a WP or WT.

A withholding agent should use exemption code 08 (U.S. branch treated as U.S.
person) for chapter 3 purposes only if it is making a payment to a U.S. branch
or to a territory FI and it has represented on its Form W-8IMY that it agrees to
be treated as a U.S. person.

A withholding agent should use exemption code 10 (QI represents that income is
exempt) for chapter 3 purposes only if it makes a payment to a QI that has not
assumed primary withholding responsibility under chapters 3 and 4 or primary
backup withholding responsibility, but has represented on a withholding
statement associated with its Form W-8IMY that the income is exempt from
withholding.

A withholding agent should use exemption code 11 (QSL that assumes primary
withholding responsibility) for chapter 3 purposes only if the withholding agent
makes a substitute dividend payment to a financial institution (including a QI)
that represented on its Form W-8IMY that it is acting as a QSL for the account
associated with the form.

A withholding agent should use exemption code 12 (payee subjected to chapter 4
withholding) for chapter 3 purposes if the recipient has been withheld upon
under chapter 4 and thus chapter 3 withholding does not apply. When reporting a
payment subject to chapter 4 withholding, ensure that 30% tax is withheld,
remitted to the IRS, and correctly reported on Form 1042-S. See Special
instructions for use of chapter 3 exemption codes , later.

A withholding agent should use chapter 3 exemption code 23 for distributions
made by a QIE to a qualified foreign pension fund (or an entity all of the
interests of which are held by a qualified foreign pension fund) that are exempt
under section 897(l).

A withholding agent should use chapter 3 exemption code 24 for income paid to a
foreign government or an international organization that is exempt under section
892.

CHAPTER 4 EXEMPTION CODES

A withholding agent should use exemption code 13 (grandfathered payment) for
chapter 4 purposes only if the withholding agent makes a payment under a
grandfathered obligation (as defined in Regulations section 1.1471-2(b)(2)) and
exemption code 13 is the only exemption code that applies. If another exemption
code applies, it should be used instead of exemption code 13.

A withholding agent should use exemption code 15 (payee not subject to chapter 4
withholding) for chapter 4 purposes if the payment is a withholdable payment (as
defined in Regulations section 1.1473-1(a)) but has not been withheld upon under
chapter 4 because of the payee's chapter 4 status. Also, if the withholding
agent applies the 90-day grace period for a withholdable payment following a
change in circumstances, use exemption code 15 (payee not subject to chapter 4
withholding).

A withholding agent should use exemption code 16 (excluded nonfinancial payment)
for chapter 4 purposes for payments described in Regulations section
1.1473-1(a)(4)(iii). However, the withholding agent should only use exemption
code 16 if it is the only exemption code that applies. If another exemption code
applies, it should be used instead of exemption code 16.

A withholding agent should use exemption code 17 (foreign entity that assumes
primary withholding responsibility) for chapter 4 purposes only if it makes a
payment to a QI that assumes primary withholding responsibility, a WP, or a WT.

A withholding agent should use exemption code 18 (U.S. payees – of participating
FFI or registered deemed-compliant FFI) for chapter 4 purposes only if it makes
a payment to a participating FFI or registered deemed-compliant FFI and only to
the extent represented on such FFI's withholding statement associated with its
Form W-8IMY that the payment is allocable to a chapter 4 withholding rate pool
of U.S. payees and the FFI certifies on its withholding certificate that the FFI
meets the requirements to include the account holder in a withholding rate pool
of U.S. payees.

A withholding agent should use exemption code 20 (dormant account) for chapter 4
purposes only if it makes a withholdable payment to a participating FFI or
registered deemed-compliant FFI that represented on its withholding statement
associated with its Form W-8IMY that the payment is allocable to a dormant
account holder for which the escrow procedure of Regulations section
1.1471-4(b)(6) applies.

A withholding agent should use exemption code 21 (Other–payment not subject to
chapter 4 withholding) for chapter 4 purposes if the payment is exempt from
chapter 4 withholding and no other chapter 4 exemption code applies. A
withholding agent should also use exemption code 21 (Other–payment not subject
to chapter 4 withholding) when using income code 37 (return of capital) to
report nondividend payments.

If you have failed to provide a withholding agent with appropriate information
regarding the status of the person to whom you are making a payment, the other
withholding agent may be required to withhold on the payment based on the
presumption rules. If the income is in fact exempt from withholding or subject
to a reduced rate of withholding, and the account holder requests a corrected
form, you must submit a Form 1042-S providing the correct information. In this
situation, you must:

* Indicate the correct rate of withholding that should have been applied to the
income in boxes 3b or 4b;

* Enter the appropriate exemption codes, if any, in boxes 3a and 4a;

* Enter the actual amount of U.S. federal tax withheld by the other withholding
agent in box 8;

* Provide the name and address of the actual recipient in boxes 13a through 13d
along with the other required information for the recipient;

* Provide the name and EIN of the other withholding agent that actually
withheld and deposited the tax (primary withholding agent) in boxes 14a and
14b; and

* Report the account holder's U.S. TIN, if provided.

If you submit Form 1042-S as described above, you must also submit Form 1042 and
issue a Form 1042-S to each recipient (including any unknown recipient or U.S.
payee) of the income to which withholding was applied.

Special instructions for use of chapter 3 exemption codes.

If an amount was withheld under chapter 4, you may also include a chapter 3
exemption code and tax rate in boxes 3a and 3b to show the rate that would
otherwise apply as if the payment had been later determined to be exempt from
withholding under chapter 4. This may be done, for example, to assist the
beneficial owner in pursuing a claim for refund. In such a case, enter “4” as
the chapter indicator in box 3 to show that withholding was applied under
chapter 4.

BOXES 3B AND 4B, CHAPTER 3 AND CHAPTER 4 TAX RATES

Enter the correct rate of withholding that applies to the income in box 2 (gross
income) or box 6 (net income), as appropriate. In the case of a payment subject
to chapter 4 withholding, the correct rate of withholding is “30.00.” If the
amount reported in box 2 is not subject to chapter 4 withholding or is not a
withholdable payment, you must enter “00.00” in box 4b and provide the
applicable exemption code in box 4a. For purposes of chapter 3 withholding, see
Valid Tax Rate Table. The correct tax rate should be included even if you
withheld at a different rate. For example, if an NQI that is a participating FFI
is reporting dividends paid to a beneficial owner who is exempt from withholding
under chapter 4 and a resident of a country with which the United States does
not have a tax treaty and a U.S. withholding agent paid the dividend and
incorrectly withheld only 15% under chapter 3 (rather than the required 30%) and
the NQI withholds an additional 15% under chapter 3, the NQI should report
“30.00” in box 3b. See Example 18, earlier, under Multiple Withholding Agent
Rule . The tax rate on dividends paid to a corporation created or organized in,
or under the law of, the Commonwealth of Puerto Rico may be 10%, rather than
30%. See Pub. 515 for more information.

In the case of a specified federal procurement payment subject to section 5000C
withholding, the correct rate of withholding is 2% or “02.00.” For Form 1042-S
purposes, report tax withheld under section 5000C in box 3b as if the tax were a
chapter 3 tax.

Enter the tax rate using the following format: two digits, a decimal point, and
two digits (for example, “30.00” for 30%). However, if the income is exempt from
tax under a U.S. tax treaty or the Internal Revenue Code, enter “00.00.” If the
tax rate is less than 10%, enter a zero before the tax rate (for example,
“04.00” for 4%).

If you withheld at more than one tax rate for a specific type of income that you
paid to the same recipient, you must file a separate Form 1042-S for each amount
to which a separate rate was applied.

Valid Tax Rate Table

00.00 10.00 24.00 02.00 12.00 25.00 04.00 12.50 27.50 04.90 14.00 28.00 04.95
15.00 30.00 05.00 17.50 37.00 07.00 20.00 08.00 21.00

Exception for central withholding agreements.

If you are the designated withholding agent who has entered into a central
withholding agreement and you report an amount in box 2 using income code 43
(earnings as an artist or athlete – central withholding agreement), you must
enter a tax rate in box 3b and you must include a chapter 4 exemption code 16
(excluded nonfinancial payment) in box 4a.

BOX 5, WITHHOLDING ALLOWANCE

This box should be completed only if the income code reported in box 1 is 16
(scholarship or fellowship grants), 17 (compensation for independent personal
services), 18 (compensation for dependent personal services), 19 (compensation
for teaching), 20 (compensation during studying and training), or 42 (earnings
as an artist or athlete-no central withholding agreement), and there is a valid
treaty claim that provides an exemption from withholding up to a specific
amount. Report the amount exempt from withholding here. This box should not be
used for reporting a personal exemption. If you are a designated withholding
agent that has entered into a central withholding agreement with the IRS, leave
this box blank and report the gross amount paid to the recipient in box 2. See
Pub. 515 for more information.

BOX 6, NET INCOME

Complete this box only if you entered an amount in box 5. Otherwise, leave it
blank.

BOXES 7A THROUGH 11, FEDERAL TAX WITHHELD

Box 7a.

Enter the total amount of U.S. federal tax you actually withheld in box 7a under
chapter 3 or 4. If you did not withhold any tax, enter “-0-.”

Box 7a must be completed in all cases, even if no tax has been deposited.

Box 7b.

A withholding agent that withheld tax during the calendar year and that was not
required to deposit with the IRS the tax withheld during the calendar year
pursuant to the escrow procedure under Regulations sections 1.1471-2(a)(5)(ii)
and/or 1.1441-3(d) must check box 7b (federal tax withheld was not deposited
with the IRS because escrow procedures were applied). A withholding agent
reporting payments pursuant to the escrow procedure must report such payments on
separate Forms 1042-S. Box 7b must only be checked when using the escrow
procedures as specified above.

If you are a participating FFI or registered deemed-compliant FFI that, for
chapter 4 purposes, applied the escrow procedure for dormant accounts, if the
payment is also an amount subject to chapter 3 withholding and tax is withheld
and deposited under chapter 3, do not check box 7b. Instead, enter “3” in box 3
and complete box 3b to report the tax withheld under chapter 3.

Box 7c.

Check box 7c if you are a partnership that received an amount subject to
withholding during the 2024 calendar year (preceding year) and you are
withholding on the amount includible in a foreign partner’s share after March 15
of the subsequent year (2025). Only check this box if you designated the deposit
as attributable to the preceding year (2024). In such a case, the partnership
will be required to report the associated income and tax withheld on Forms 1042
and 1042-S for the preceding year. If a partnership withholds on a foreign
partner’s share of income after March 15 of the subsequent year, the due date
for filing and furnishing the applicable Form(s) 1042-S is September 15 of the
subsequent year (2025). For example, if a partnership withholds on April 1,
2025, with respect to a foreign partner’s share of undistributed income for the
2024 calendar year, the partnership may designate the deposit as made for 2024
and report the liability and tax withheld on the 2024 Form 1042 and the 2024
Form 1042-S for the partner. The partnership must also ensure that its chapter 3
status code on such forms properly reflects its status as a partnership
(including as a WP). The extended deadline of September 15, 2024, is also
applicable when a partnership is reporting on Form 1042-S an allocation of
income made after March 15 of the subsequent year to a foreign partner for the
prior year, but no withholding is required on the income. In such a case, box 7c
must also be checked even if there is no withholding. For more information, see
proposed regulations issued on December 18, 2018 (REG-132881-17).

Box 8.

If you are a withholding agent filing a Form 1042-S to report income that has
already been subject to withholding by another withholding agent, enter the
amount actually withheld by the other agent(s) in box 8.

Box 9, Overwithheld tax repaid to recipient pursuant to adjustment procedures.

This box should be completed only if you repaid a recipient under the
reimbursement or set-off procedure during the 2025 calendar year in accordance
with the requirements of Regulations section 1.1461-2(a)(2) or (3) (for
withholding under chapter 3), or Regulations section 1.1474-2(a)(3) or (4) (for
withholding under chapter 4).

If you repaid the recipient under the reimbursement or set-off procedure during
the 2024 calendar year, do not complete box 9. Instead, reduce the amount of
withholding reported in box 7a.

In most cases, an intermediary or flow-through entity should not enter an amount
in box 9 unless it is a QI that represented on its Form W-8IMY that it is
assuming primary withholding responsibility or is a WP or WT.

The adjustment for amounts overwithheld applies to partnerships, brokers, or
nominees required to withhold under sections 1446(a) and (f) starting in 2023.

NOTE.

If the withholding agent meets the above requirements, the withholding agent may
make adjustments to overwithholding using either the reimbursement or set-off
procedure until the extended due date for filing Form 1042-S (or, if earlier,
the date on which the Form 1042-S is either filed or furnished). Additionally, a
withholding agent may use the extended due date for filing a Form 1042 to claim
a credit for any adjustments made to overwithholding.

Box 10.

Enter in box 10 the combined amounts reported in box 7a (federal tax withheld),
box 8 (tax withheld by other agents), and box 9 (overwithheld tax repaid to
recipient pursuant to adjustment procedures).

Example.

If the box 7a amount is $600, the box 8 amount is $120, and the box 9 amount is
($50), the box 10 amount will equal $670.

Box 10 must be completed in all cases, even if no tax has been deposited.

Box 11, Tax paid by withholding agent (amounts not withheld).

Enter the total amount of tax paid by you and not withheld from the payment to
the recipient. The amounts reported in box 11 should be the amounts paid by the
withholding agent from its own funds rather than through withholding from the
payment to the recipient. Any amount reported in this box must not be included
in box 10.

BOX 12A, WITHHOLDING AGENT'S EMPLOYER IDENTIFICATION NUMBER (EIN)

You are required to enter your EIN. However, if you are filing Form 1042-S as a
QI, WP, or WT, enter your QI-EIN, WP-EIN, or WT-EIN. The withholding agent's EIN
cannot be truncated.

If you don’t have an EIN, you may apply for one online by visiting
IRS.gov/businesses/small-businesses-self-employed/employer-id-numbers. If you
are outside the United States, you may also apply for an EIN by calling
267-941-1099 (not a toll-free number). You may also apply for an EIN by faxing
or mailing Form SS-4 to the IRS. File amended Forms 1042-S when you receive your
EIN.

To get a QI-EIN, WP-EIN, or WT-EIN, submit Form SS-4 with your application for
that status. (See the definitions for Qualified intermediary (QI) and
Withholding foreign partnership (WP) or withholding foreign trust (WT) under
Definitions , earlier, for more information.)

BOXES 12B AND 12C, WITHHOLDING AGENT'S CHAPTER 3 AND CHAPTER 4 STATUS CODE

Enter the withholding agent status code(s) from the list of Recipient Status
Codes in Appendix B , later. You must enter both a chapter 3 and a chapter 4
withholding agent status code regardless of the type of payment being made. If
you are a U.S. financial institution (USFI), indicate your chapter 4 status code
as 01, except when a foreign branch of a USFI issues Form 1042-S (in such a
case, indicate the chapter 4 status code as 50).

NOTE.

Withholding agents that are U.S. governmental entities or U.S. tax-exempt
entities, including colleges and universities, and other U.S. tax-exempt
entities under the Internal Revenue Code other than under section 501(c), may
use chapter 3 status code 20 (Tax exempt organization (Section 501(c) entities))
for box 12b.

NOTE.

A withholding agent should in general select the chapter 3 status code that most
closely applies with its status based on the available codes. For example, if a
U.S. financial institution (which checks chapter 4 status code 01, as such,
unless it is a foreign branch) is a corporation, it should use chapter 3 status
code 15 (Corporation).

BOXES 12D THROUGH 12I, WITHHOLDING AGENT'S NAME, GIIN, COUNTRY CODE, FOREIGN TIN
(IF ANY), AND ADDRESS

Enter your name and address in the appropriate boxes. If your post office does
not deliver mail to the street address and you have a P.O. box, show the box
number instead of the street address.

NOTE.

On statements furnished to individual recipients of U.S. source deposit
interest, in addition to your name and address, you must include the telephone
number of a person to contact. This number must provide direct access to an
individual who can answer questions about the statement. The telephone number is
not required on Copy A of paper forms or on electronically filed forms.

Box 12e, Withholding agent's GIIN.

The GIIN provided, if any, should be the GIIN issued to the branch of, or
disregarded entity owned by, the participating FFI or registered
deemed-compliant FFI that is making the payment.

Box 12f, Country code.

You must enter the code (from the list at IRS.gov/CountryCodes) for the country
for which you are resident under that country's tax laws. Enter “OC” (other
country) only when the country of residence does not appear on the list.

NOTE.

If the withholding agent is a U.S. person or a foreign branch of a U.S. person,
enter “US” in box 12f (even though “US” is not a code on the list at
IRS.gov/CountryCodes).

BOXES 13A THROUGH 13D, RECIPIENT'S NAME, COUNTRY CODE, AND ADDRESS

Box 13a, Recipient's name.

Enter the complete name of the recipient in box 13a.

* If you do not know the name of the recipient, or are required to use the
recipient status codes for an unknown recipient, enter “Unknown Recipient.”
Also enter "Unknown Recipient" if you pay an amount realized subject to
section 1446(f) withholding to an NQI and you do not agree with the NQI to
report the NQI's account holders on Form 1042-S.

* If Form 1042-S is being completed by a QI, WP, or WT for a chapter 3
withholding rate pool or chapter 4 withholding pool, enter “Withholding rate
pool” if withholding under chapter 3 was applied, or, if chapter 4
withholding was applied, a description of the chapter 4 reporting pool (for
example, “Nonparticipating FFI Pool”) in box 13a.

* A withholding agent reporting payments made to a participating FFI or
registered deemed-compliant FFI with respect to a chapter 4 reporting pool
must include the name and address of the FFI in boxes 13a through 13g as well
as the FFI's GIIN and country code. The GIIN reported must be the GIIN of the
branch to whom the withholding agent is making the payment.

* A QI reporting payments made to a PAI on a withholding rate pool basis must
include the name and address of the PAI in boxes 13a through 13g.

* In the case of foreign joint owners, Form 1042-S can only list one of the
owners as the recipient in box 13a. Form 1042-S must not be completed with
more than one of the joint owners as the recipient.

* If the recipient is a QI acting as a QDD with respect to the payment, enter
the name of the QDD (identifying the QDD by the name used for the QDD on the
Form W-8IMY it provides, which should include a branch identifier, if
applicable).

* If a disregarded entity (or a branch) that is required to provide a TIN on
Form W-8IMY is identified in Part II of the Form W-8BEN-E, include the name
of the disregarded entity (or the jurisdiction of the branch) in a
parenthetical after the name of the recipient.

Box 13b, Recipient's country code.

You must enter the code (from the list at IRS.gov/CountryCodes) for the country
of which the recipient claims residency under that country's tax laws. Enter
“OC” (other country) only when the country of residence does not appear on the
list or the payment is made to an international organization (for example, the
United Nations). If the recipient is unknown, leave box 13b blank and enter
"Unknown Recipient" in box 13a, Recipient's name. If you are making a payment to
a QI, QSL, WP, or WT, or if you are a QI, QSL, WP, or WT and are making a
payment to a QI, WP, or WT withholding rate pool, enter the country code of the
QI, QSL, WP, or WT. Also, if you are making a payment to a participating FFI or
registered deemed-compliant FFI's chapter 4 reporting pool, enter the country
code of the participating FFI or registered deemed-compliant FFI or branch of or
disregarded entity owned by such FFI receiving the withholdable payment and that
was listed on Part II of either the Form W-8BEN-E or W-8IMY.

If exemption code 04 (exempt under tax treaty) appears in box 3a or if a reduced
rate of withholding based on a tax treaty is entered in box 3b, the country code
entered in box 13b must be a country with which the United States has entered
into an income tax treaty.

Boxes 13c and 13d, Recipient's address.

In most cases, you must enter a foreign address in boxes 13c and 13d. However,
there are limited exceptions. For example, you may enter a U.S. address when
reporting payments of scholarship or fellowship grants (income code 16).

For addresses outside the United States or its commonwealths and territories,
follow the foreign country's practice for entering the postal code.

For addresses within the United States, use the U.S. Postal Service two-letter
abbreviation for the state name. Do not enter “United States” or “U.S.”

If you want to enter the recipient's account number, use box 13k.

BOXES 13E AND 13H, RECIPIENT'S U.S. TIN AND GIIN

You must obtain and enter a U.S. TIN for any of the following recipients.

* Any recipient whose income is effectively connected with the conduct of a
trade or business in the United States. For these recipients (excluding a
recipient receiving a payment subject to section 1446(a) or (f) withholding),
enter exemption code 01 in box 3a or exemption code 14 in box 4a.

* Any foreign person claiming a reduced rate of, or exemption from, tax under a
tax treaty between a foreign country and the United States, unless the
recipient provides an FTIN (in such case, use box 13i), or unless the income
is an unexpected payment (as described in Regulations section 1.1441-6(g)) or
consists of dividends and interest from stocks and debt obligations that are
actively traded; dividends from any redeemable security issued by an
investment company registered under the Investment Company Act of 1940
(mutual fund); dividends, interest, or royalties from units of beneficial
interest in a unit investment trust that are (or were, upon issuance)
publicly offered and are registered with the Securities and Exchange
Commission under the Securities Act of 1933; and amounts paid with respect to
loans of any of the above securities. In the latter case, you must use income
code 13, 51, 52, 53, or 54.

* Any nonresident alien individual claiming exemption from tax under section
871(f) for certain annuities received under qualified plans.

* A foreign organization claiming an exemption from tax solely because of its
status as a tax-exempt organization under section 501(c) or as a private
foundation.

* Any QI other than a disclosing QI (which is not a recipient).

* Any WP or WT.

* Any nonresident alien individual claiming exemption from withholding on
compensation for independent personal services.

* Any U.S. branch of an FFI or territory FI that is treated as a U.S. person.

* Any QSL that was paid a substitute dividend.

In all other cases, if you know the recipient's TIN or if a foreign person
provides a TIN on Form W-8, but is not required to do so, you must include the
TIN on Form 1042-S. A U.S. TIN is also required on a Form 1042-S used by a
recipient to claim credit for (or a refund of) the withholding.

You must include a GIIN if you are required to collect a GIIN for the recipient
under the requirements documenting the payee under chapter 4. If you make a
payment to a disregarded entity or branch that is identified in Part II of Form
W-8BEN-E, then report the GIIN of the disregarded entity or branch provided in
that section.

BOXES 13F AND 13G, RECIPIENT’S CHAPTER 3 AND CHAPTER 4 STATUS CODES

Enter the recipient status code from the list of Recipient Status Codes in
Appendix B , later. The following special instructions apply for chapter 3
status codes.

* If income code 42 (earnings as an artist or athlete – no central withholding
agreement) or 43 (earnings as an artist or athlete – central withholding
agreement) is used in box 1, use recipient code 22 (artist or athlete)
instead of recipient code 16 (individual), 15 (corporation), or 08
(partnership other than withholding foreign partnership or publicly traded
partnership).

* If you are making a payment to an NQI or flow-through entity, in most cases
you must use the recipient code that applies to the type of recipient who
receives the income from the NQI or flow-through entity.

* Use recipient code 08 (partnership other than withholding foreign partnership
or publicly traded partnership) only if you are reporting a payment of income
that is effectively connected with the conduct of a trade or business of an
NWP in the United States or that is subject to reporting under section
1446(f). You may, however, use recipient code 08 as the chapter 3 status code
if you are using a chapter 4 pooled reporting code with respect to a payment
made to an NWP. See the instructions later on use of recipient codes when
reporting pools. Otherwise, follow the rules that apply to payments to
flow-through entities.

* Use recipient code 21 (Unknown Recipient) only if you have not received a
withholding certificate or other documentation for a recipient or you cannot
determine how much of a payment is reliably associated with a specific
recipient, or you pay an amount realized subject to section 1446(f)
withholding to an NQI and you do not agree with the NQI to report the NQI's
account holders on Form 1042-S. Do not use this code because you cannot
determine the recipient's status as an individual, corporation, etc. The
regulations under chapter 3 provide rules on how to determine a recipient's
status when a withholding agent does not have the necessary information.

* Use recipient code 13 (qualified securities lender – qualified intermediary)
or 14 (qualified securities lender – other) if you make a payment to a QSL.

* Only a QI may use recipient codes 29 (PAI withholding rate pool – general)
and 30 (PAI withholding rate pool – exempt organizations). Only a QI, WP, or
WT that made a pooled reporting election for chapter 3 purposes may use
recipient codes 31 (agency withholding rate pool – general), 32 (agency
withholding rate pool – exempt organization), 27 (withholding rate pool –
general), and 28 (withholding rate pool – exempt organization) for chapter 3
purposes. Recipient code 28 or 30 should be used only for pooled account
holders that have claimed an exemption based on their tax-exempt status and
not some other exemption (for example, treaty or other Internal Revenue Code
exception). A QI acting as a QDD may use only pooled reporting codes 27 and
28. If you are a QI (including a QI acting as a QDD), WP, WT, or QSL using a
chapter 3 pooled reporting code with respect to a payment, do not include a
chapter 4 status code unless making such payment to a PAI or certain
partnerships or trusts. See Amounts Paid to PAIs and Amounts Paid by QIs to
Certain Partnerships and Trusts , earlier.

* Use recipient code 35 (qualified derivatives dealer) if you make a payment to
a QI that is acting as a QDD with respect to the payment.

* A U.S. withholding agent making a payment to any other QI (other than a
disclosing QI) should use recipient code 12 and recipient code 09 or 11 if it
is making a payment to a WP or WT, respectively.

* Use recipient code 05 (U.S. branch-treated as U.S. person) if you make a
payment to a U.S. branch or territory FI treated as a U.S. person.

A chapter 4 status code is required only if the payment is a withholdable
payment or when a participating FFI or registered deemed-compliant FFI provides
a chapter 4 withholding rate pool of U.S. payees. The chapter 4 status code may
be determined under the applicable IGA by a withholding agent that is an FFI
subject to such an agreement. The following special instructions apply for
chapter 4 status codes.

* If you are making a withholdable payment to a U.S. branch of an FFI, use the
applicable chapter 4 status code for the country of residence for an entity
that is a participating FFI or registered deemed-compliant FFI. Otherwise,
use the chapter 4 status code for any other foreign branch of the entity that
is a participating FFI or registered deemed-compliant FFI.

* Only use recipient code 15 (nonparticipating FFI) or 30 (recalcitrant account
holder) if you are reporting directly to the recipient. See Amounts paid to
an NQI or flow-through entity of withholdable payments , earlier. If you are
reporting the chapter 4 reporting pools of recalcitrant account holders of a
participating FFI, registered deemed-compliant FFI, or QI, use codes 42
through 49. Only use chapter 4 reporting pool code 48 (U.S. payees pool) if a
participating FFI or registered deemed-compliant FFI has provided a Form
W-8IMY certifying that it meets the requirements to include the account
holder in a withholding rate pool of U.S. payees and that is associated with
a withholding statement allocating the payment or a portion of the payment to
a chapter 4 withholding rate pool of U.S. payees. Only use chapter 4
reporting pool code 49 (QI-Recalcitrant Pool-General) if you are reporting
recalcitrant account holders of a QI.

* Use recipient code 17 (U.S. branch - treated as a U.S. person) if you are
making a payment to a U.S branch treated as a U.S. person (or recipient code
04 for a Territory FI treated as a U.S. person).

* Use recipient code 26 (excepted NFFE – other) if you are reporting to an NFFE
treated as a U.S. person.

* Only use recipient code 29 (unknown recipient) if you have not received a
withholding certificate or other documentation with respect to a withholdable
payment from an intermediary or flow-through entity. Only use this code if
you also used recipient code 21 (unknown recipient) as the chapter 3 status
code. If you have not received a withholding certificate or other
documentation from an intermediary or flow-through entity, you must include
the entity’s information in boxes 15a through 15i. You may also use recipient
code 29 if you are reporting a withholdable payment to a recipient that is
not subject to withholding under the terms of an IGA and the recipient's
account is not required to be reported as a U.S. account or nonconsenting
U.S. account (for example, an undocumented individual with no U.S. indicia).

* Use recipient code 33 (U.S. reportable account) if you are reporting the
recipient's account as a U.S. reportable account under the terms of a Model 1
IGA and the recipient does not meet the applicable requirements to be
included in a pool of U.S. payees because the account holder is subject to
chapter 3 withholding.

* Use recipient code 34 (Nonconsenting U.S. account) if you are reporting the
recipient's account as a nonconsenting U.S. account under the terms of a
Model 2 IGA and the recipient does not meet the applicable requirements to be
included in a pool of U.S. payees because the account holder is subject to
chapter 3 withholding.

* Use recipient code 37 (undocumented preexisting obligation) for an obligation
that a withholding agent has not documented and the payment being reported
was made before the expiration of the time period allowed for documenting the
obligation and thus the withholding agent was not required to apply the
presumption rules to determine the payee's chapter 4 status.

* Use recipient code 39 (account holder of excluded financial account) if you
are reporting amounts paid with respect to an obligation that is excluded
from the definition of financial account for chapter 4 purposes (see
Regulations section 1.1471-5(b)(2)).

* Use recipient code 41 (NFFE subject to 1472 withholding) if you are reporting
amounts paid to a specific recipient that is an NFFE that you (or another
withholding agent) withheld upon under section 1472 (that is, you are
reporting amounts in boxes 7 through 9) unless the NFFE is treated as a
recalcitrant account holder under Regulations section 1.1471-5(g), in which
case, use code 30 (recalcitrant account holder).

* If you received a withholding certificate or other documentation with respect
to a withholdable payment from an intermediary or flow-through entity that is
a participating FFI or deemed-compliant FFI (other than a WP, WT, or QI that
assumes primary withholding responsibility) and cannot reliably associate the
payment with documentation to determine the payee's chapter 4 status (or with
a chapter 4 withholding rate pool), you must report the recipient as “Unknown
Recipient” and include the entity's information in boxes 15a through 15i (to
the extent provided).

* If you are reporting a chapter 4 pooled reporting code with respect to a
withholdable payment to an intermediary or flow-through entity, use the
chapter 3 status code for the intermediary or flow-through entity as the
recipient code.

* If you are a QI, WP, or WT reporting direct account holders, do not include a
chapter 3 status code for the recipient if you are using a chapter 4
reporting pool code as the recipient’s chapter 4 status code.

* If you are making a withholdable payment to a recipient that is a restricted
distributor (as defined in Regulations section 1.1471-5(f)(4)), use recipient
code 10 (certified deemed-compliant FFI - other).

BOX 13I, RECIPIENT'S FOREIGN TAX IDENTIFICATION NUMBER

Use box 13i to enter the recipient’s identification number used in the
recipient’s country of residence for tax purposes.

You must obtain and enter an FTIN for any of the following recipients.

* Any foreign person claiming a reduced rate of, or exemption from, tax under a
tax treaty between a foreign country and the United States if such person did
not provide a U.S. TIN and the income is not the type for which an exemption
from the TIN requirement applies (see the instructions for boxes 13e and 13h,
earlier).

* Any recipient of a payment made with respect to a financial account (as
defined in Regulations section 1.1471-5(b)) maintained at your U.S. office or
branch, if you are a financial institution, to the extent that such recipient
has furnished a withholding certificate that provides an FTIN, or you obtain
the FTIN under the alternative procedures described in Regulations section
1.1441-1(e)(2)(ii)(B), or the recipient's FTIN is identified in any of your
electronically searchable information. See Regulations section
1.1441-1(e)(2)(ii) for more information regarding a withholding agent's
obligation to obtain and report a recipient's FTIN.

BOX 13J, LOB CODE

If you are making a payment for which a beneficial owner that is an entity has
claimed a reduced rate of withholding under an income tax treaty and has
provided documentation that establishes the limitation on benefits (LOB) article
under which the beneficial owner qualifies, enter the applicable LOB code from
Appendix B , later. See the Instructions for Form W-8BEN-E for a description of
each of the LOB codes. If you are a QI, WP, or WT reporting a chapter 3 pool for
which a reduced rate of withholding under an income tax treaty applies, do not
include an LOB code.

BOX 13K, RECIPIENT’S ACCOUNT NUMBER

If you are a financial institution reporting amounts paid to your direct account
holder with respect to an account maintained by you at your U.S. office or U.S.
branch, you must report the recipient’s account number in box 13k. If the amount
is paid through an NQI or flow-through entity, you are not required to use this
box.

NOTE.

A U.S. financial institution or a U.S. branch of an FFI is required to report
payments of the same type of income (as determined by the income code in box 1)
made to multiple financial accounts held by the same beneficial owner at a U.S.
office of such institution on a separate Form 1042-S for each account. For this
purpose, a financial account is an account described in Regulations section
1.1471-5(b)(1). Report the identifying number assigned to such account (or its
functional equivalent in the absence of an account number for the recipient).

BOX 13L, RECIPIENT’S DATE OF BIRTH

Use box 13l to enter the recipient’s date of birth. The correct format if
entered is YYYYMMDD (for example, enter “20001205” for a date of birth of
December 5, 2000). A financial institution making a payment with respect to a
financial account (as defined in Regulations section 1.1471-5(b)) maintained at
its U.S. office or U.S. branch must report the recipient's date of birth (if the
recipient is an individual) to the extent that such recipient has furnished
documentation that provides a date of birth or the recipient's date of birth is
identified in any of the withholding agent's files. See Regulations section
1.1441-1(e)(2)(ii)(B) for more information regarding a withholding agent's
obligation to obtain and report a recipient's date of birth.

BOXES 14A AND 14B, PRIMARY WITHHOLDING AGENT'S NAME AND EIN

If you are an intermediary or flow-through entity reporting amounts withheld by
another withholding agent (the primary withholding agent) in box 8, you must
provide the name and EIN of the withholding agent that withheld the tax. If
multiple withholding agents withheld amounts reported on the same Form 1042-S,
report the name of any one of the withholding agents that withheld amounts.
Otherwise, leave blank.

BOX 15, PRO-RATA BASIS REPORTING CHECKBOX

Withholding agents must check box 15 to notify the IRS that an NQI that used the
alternative procedures of Regulations section 1.1441-1(e)(3)(iv)(D) failed to
properly comply with those procedures. See Pro-rata reporting to NQI, earlier,
for additional information.

BOXES 15A THROUGH 15I, INTERMEDIARY/FLOW-THROUGH ENTITY'S NAME, STATUS CODE,
COUNTRY CODE, ADDRESS, EIN, GIIN, AND FOREIGN TAX IDENTIFICATION NUMBER

If you are reporting amounts subject to reporting for chapter 3 or 4 purposes
paid to a recipient whose withholding certificates or other documentation has
been submitted to you (or should have been submitted to you) with a Form W-8IMY
provided by an intermediary or flow-through entity, you must include the name
and address of the intermediary or flow-through entity with whose Form W-8IMY
the recipient's Form W-8 or other documentation is associated.

You must also include the intermediary or flow-through entity's chapter 3 and
chapter 4 status codes and, if any, the TIN and GIIN of the intermediary or
flow-through entity when provided or required to be collected by the withholding
agent. If the intermediary or flow-through entity completed Part II of Form
W-8IMY, then report the GIIN provided in that section. If you are making a
payment to a U.S. branch not treated as a U.S. person that has certified that it
is applying the rules in Regulations section 1.1471-4(d)(2)(iii)(C) (in order to
avoid being withheld upon under chapter 4), use chapter 4 intermediary code 18
(U.S. branch - not treated as a U.S. person (reporting under section 1471)).

NOTE.

A withholding agent that is an intermediary or flow-through entity will leave
these boxes blank unless it is making the payment to an intermediary or
flow-through entity.

Box 15f, Country code.

You must enter the country code (from the list at IRS.gov/CountryCodes) for the
country where the intermediary or flow-through entity is located.

Box 15g, Intermediary or flow-through entity's foreign tax identification
number.

Use box 15g to enter the intermediary or flow-through entity's identifying
number used in the country of residence for tax purposes. Box 15g is optional.

BOXES 16A THROUGH 16E, PAYER'S NAME, TIN, GIIN, AND STATUS CODE

See the definition of authorized agent, earlier, under Definitions. Include the
payer's name, TIN, and GIIN if different from the withholding agent shown in
boxes 12a, 12d, and 12e.

If payment is being made by a transfer agent or a paying agent acting as a
withholding agent on behalf of a payer, enter the chapters 3 and 4 status codes
applicable to the status of the payer in boxes 16d and 16e.

If you are a nominee that is the withholding agent for the amount of a PTP
distribution subject to withholding under section 1446(a) (reporting income code
27), enter the PTP's information in boxes 16a through 16e. However, you must
enter the PTP's EIN, GIIN (if any), and chapter 4 status only if included in
your records for the PTP interest that relates to the distribution. This
includes information in your securities master file (or similar document), or
that is reported in a qualified notice issued by the PTP during the year of the
distribution. A nominee should also enter the PTP information when using income
code 58 (undetermined income) to report a PTP distribution or when using income
code 57 to report an amount realized attributable to a PTP distribution.

NOTE.

You must issue a separate Form 1042-S to complete boxes 16a through 16e for each
PTP that makes a distribution of any of these types of income to the recipient.
This requirement does not apply to a withholding agent or QI when reporting on a
Form 1042-S using reporting pools.

A PTP may report the same amount of a PTP distribution on a qualified notice as
subject to both section 1446(f) withholding and other chapter 3 or 4 withholding
(such as under section 1446(a)). See Regulations sections 1.1446-4(b)(4) and
1.1446(f)-4(c)(2)(iii). In this case, you must report the same amount on
separate Forms 1042-S, with the appropriate income code and associated amount of
withholding included on each form. Therefore, the total amounts reported on
Forms 1042-S in box 2 (gross income) resulting from the distribution may, in
some cases, exceed the actual amount of the distribution.

BOXES 17A THROUGH 17C, STATE INCOME TAX WITHHELD AND RELATED INFORMATION

Include in these boxes information relating to any state income tax withheld.

AMENDED FORMS

If you filed a Form 1042-S with the IRS and later discover you made an error on
it, you must correct it as soon as possible. To correct a previously filed Form
1042-S, you will need to file an amended Form 1042-S. The amended form must have
the same unique form identifier as the original form that is being amended. You
must check the “Amended” box and provide the amendment number. The amendment
number must be numeric and the length must be exactly one digit. Each time that
you amend the same form (as determined by the unique form identifier), you must
provide the amendment number in the box provided on the form (using “1” for the
first amendment and increasing sequentially for each subsequent amendment).

If you provide an amended Form 1042-S to a recipient, you must also file the
amended form with the IRS.

Do not file an amended return if you provided Form 1042-S to the recipient
(Copies B, C, and D) and need to make corrections to such form prior to filing
with the IRS. In such a case, you should file an original Form 1042-S with the
correct information. Do not check the “Amended” box or indicate any amendment
number. Provide a copy of the corrected Form 1042-S to the recipient. Note that
the copies of the Form 1042-S provided to the recipients (Copies B, C, and D)
must match the copy of the Form 1042-S that is filed with the IRS.

If any information you correct on Form(s) 1042-S changes the information you
previously reported on Form 1042, you must also correct the Form 1042 by filing
an amended return. To do this, see the Form 1042 instructions.

If you are not filing electronically, follow these steps to amend a previously
filed Form 1042-S.

Step 1.

Prepare a paper Form 1042-S.

* Enter all the correct information on the form, including the recipient name
and address, money amounts, and codes.

* Enter an “X” in the “Amended” box at the top of the form and enter the
amendment number.

Amended checkbox.

Enter an “X” in the “Amended” checkbox of Copies A, B, C, D, and E only if you
are amending a Form 1042-S you previously filed with the IRS. You must provide
statements to recipients showing the corrections as soon as possible regardless
of the change to the Form 1042-S.

Step 2.

File the amended paper Form 1042-S with a Form 1042-T. See the Form 1042-T
instructions for information on filing these forms.

If you fail to correct Form(s) 1042-S, you may be subject to a penalty. See
Penalties, earlier.

INSTRUCTIONS FOR FORM 1042-S - NOTICES

PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE.

We ask for the information on this form to carry out the Internal Revenue laws
of the United States. Sections 1441, 1442, 1446 (for PTPs), 1471, and 1472
require withholding agents to report and pay over to the IRS taxes withheld from
certain U.S. source income. Form 1042-S is used to report the amount of income
and withholding to the payee. Form 1042 is used to report the amount of
withholding that must be paid over to the IRS. Section 6109 requires you to
provide your identification number. Routine uses of this information include
giving it to the Department of Justice for civil and criminal litigation, and to
cities, states, the District of Columbia, and U.S. commonwealths and territories
for use in administering their tax laws. We may also disclose this information
to other countries under a tax treaty, to federal and state agencies to enforce
federal nontax criminal laws, or to federal law enforcement and intelligence
agencies to combat terrorism. If you fail to provide this information in a
timely manner, you may be liable for penalties and interest.

You are not required to provide the information requested on a form that is
subject to the Paperwork Reduction Act unless the form displays a valid OMB
control number. Books or records relating to a form or its instructions must be
retained as long as their contents may become material in the administration of
any Internal Revenue law. Generally, tax returns and return information are
confidential, as required by section 6103.

The time needed to complete and file this form will vary depending on individual
circumstances. The estimated average time is 34 minutes.

If you have comments concerning the accuracy of these time estimates or
suggestions for making this form simpler, we would be happy to hear from you.
You can send us comments from IRS.gov/FormComments. Or you can write to Internal
Revenue Service, Tax Forms and Publications, 1111 Constitution Ave. NW, IR-6526,
Washington, DC 20224. Do not send the form to this address. Instead, see Where,
When, and How To File , earlier.

INSTRUCTIONS FOR FORM 1042-S - ADDITIONAL MATERIAL

INDEX

Account holder, Account holder. Account number, Box 13k, Recipient’s Account
Number Account-by-account reporting, Account-by-Account Reporting by Certain
Financial Institutions Additional information, Additional Information Amended
checkbox, Amended Checkbox, Amended checkbox. Amendment number, Amendment Number
Amount realized, Amount realized. Amount subject to withholding, Amount subject
to chapter 3 withholding. Amounts not subject to reporting, Amounts That Are Not
Subject to Reporting on Form 1042-S Amounts paid by QIs, Amounts Paid by QIs
Amounts paid by QIs to certain partnerships and trusts, Amounts Paid by QIs to
Certain Partnerships and Trusts Amounts paid to PAIs, Amounts Paid to PAIs
Amounts subject to reporting, Amounts Subject to Reporting on Form 1042-S
Appendix D Comprehensive example of how to complete Form 1042-S for gambling
winnings, Appendix D Assistance, Need assistance? Authorized agent, Authorized
agent.

Before completing Form 1042-S, Before Completing Form 1042-S Beneficial owner,
Beneficial owner.

Chapter 3 or 4 status code, Boxes 12b and 12c, Withholding Agent's Chapter 3 and
Chapter 4 Status Code, Boxes 13f and 13g, Recipient’s Chapter 3 and Chapter 4
Status Codes Chapter indicator, Box 3 Combined reporting, Combined Reporting
Procedures Common errors, Avoid Common Errors Country code, Box 13b, Recipient's
country code., Box 15f, Country code.

Deemed-compliant FFI, Deemed-compliant FFI. Definitions, Definitions Deposit
requirements, Deposit Requirements Disregarded entity, Disregarded entity.
Dividend equivalent, Dividend equivalent.

Electronic filing, Electronic filing requirement. Electronic reporting,
Electronic Reporting Hardship waiver, Hardship waiver. Excepted nonfinancial
foreign entity, Excepted NFFE. Exempt beneficial owner, Exempt beneficial owner.
Exempt recipient, Exempt recipient. Exemption , recipient, and LOB codes,
Appendix B Exemption code, Boxes 3a and 4a, Chapter 3 and Chapter 4 Exemption
Codes Expatriate, Expatriate. Extension of time to file, Extension of time to
file.

Federal tax withheld, Boxes 7a Through 11, Federal Tax Withheld Financial
institution, Financial institution. FIRE System, Filing Information Returns
Electronically (FIRE) System. Fiscally transparent entity, Fiscally transparent
entity. Flow-through entity, Flow-through entity. Foreign Account Tax Compliance
Act, Foreign Account Tax Compliance Act (FATCA). Foreign country codes, List of
foreign country codes. Foreign financial institution, Foreign financial
institution (FFI). Foreign person, Foreign person. Future developments, Future
Developments

Global intermediary identification number, Global intermediary identification
number (GIIN). Gross income, Box 2, Gross Income

Income code, Box 1, Income Code Income Codes, Appendix A Instructions for
withholding agents, Specific Instructions for Withholding Agents Intermediary,
Intermediary.

LOB code, Box 13j, LOB Code

Multiple withholding agent rule, Multiple Withholding Agent Rule

Net income, Box 6, Net Income Non-exempt recipient, Nonexempt recipient.
Nonfinancial foreign entity, Nonfinancial foreign entity (NFFE).
Nonparticipating FFI, Nonparticipating FFI. Nonqualified intermediaries and
flow-through entities, Amounts Paid by Nonqualified Intermediaries and
Flow-Through Entities Nonqualified intermediary, Nonqualified intermediary
(NQI). Nonresident alien, Nonresident alien individual. Nonwithholding foreign
partnership or nonwithholding foreign trust, Nonwithholding foreign partnership
(NWP) or nonwithholding foreign trust (NWT).

Participating FFI, Participating FFI. Payee, Payee. Payments by U.S. withholding
agents, Payments by U.S. Withholding Agents Payments made to non-recipients,
Payments Made to Persons Who Are Not Recipients Payments to recipients, Payments
to Recipients Penalties, Penalties Failure to file electronically, Failure to
file electronically. Failure to furnish to recipient, Failure to furnish correct
Form 1042-S to recipient. Late filing, Late filing of correct Form 1042-S.
Presumption rules, Presumption rules. Privacy Act and Paperwork Reduction Act
Notice, Privacy Act and Paperwork Reduction Act Notice. Private arrangement
intermediary, Private arrangement intermediary (PAI). Pro-rata basis reporting
checkbox, Box 15, Pro-Rata Basis Reporting Checkbox PTP distribution, PTP
distribution. PTP interest, PTP interest. Publicly traded partnership, Publicly
traded partnership (PTP)., Publicly Traded Partnerships (Sections 1446(a) and
(f) Withholding Tax) Publicly traded trusts, Publicly traded trusts. Purpose of
form, Purpose of Form

Qualified derivatives dealer, Qualified derivatives dealers (QDDs)., Qualified
derivatives dealer (QDD). Qualified intermediary, Qualified intermediary (QI).
Qualified investment entities, Qualified investment entities (QIEs). Qualified
securities lender, Qualified securities lender (QSL).

Recalcitrant account holder, Recalcitrant account holder. Recipient, Recipient.
Recipient copies, Recipient copies. Recipient-by-recipient reporting,
Recipient-by-Recipient Reporting by QIs Record retention, Record Retention
Reminders, Reminders Requirement to withhold, Requirement To Withhold Chapter 3
withholding, Chapter 3 withholding. Chapter 4 withholding, Chapter 4
withholding. Rounding off to whole dollars, Rounding Off to Whole Dollars

Specified federal procurement payments made to foreign persons, Specified
Federal Procurement Payments Made to Foreign Persons Specified notional
principal contract, Specified notional principal contract (SNPC). Specified U.S.
person, Specified U.S. person. Substantial U.S. owner, Substantial U.S. owner.
Substitute forms, Substitute Forms Penalty for filing incorrect substitute form,
Penalty for filing incorrect substitute form.

Tax rates, Boxes 3b and 4b, Chapter 3 and Chapter 4 Tax Rates Territory FI,
Territory FI. Truncation of TIN rules, Truncation of TIN Rules

U.S. branch treated as a U.S. person, U.S. branch treated as a U.S. person.
Unique form identifier, Unique form identifier., Unique Form Identifier

Where, when, and how to file, Where, When, and How To File Who must file, Who
Must File Withholdable payment, Withholdable payment. Withholding agent,
Withholding agent. Withholding agent’s EIN, Box 12a, Withholding Agent's
Employer Identification Number (EIN) Withholding allowance, Box 5, Withholding
Allowance Withholding certificate, Withholding certificate. Withholding foreign
partnership or withholding foreign trust, Withholding foreign partnership (WP)
or withholding foreign trust (WT)., Amounts Paid by Withholding Foreign
Partnerships and Trusts Withholding rates, Withholding rates.

APPENDIX A

Box 1 Income Codes Code Interest Income 13 Royalties paid on certain publicly
offered securities1 01 Interest paid by U.S. obligors – general 14 Real property
income and natural resources royalties 02 Interest paid on real property
mortgages 15 Pensions, annuities, alimony, and/or insurance premiums 03 Interest
paid to controlling foreign corporations 16 Scholarship or fellowship grants 04
Interest paid by foreign corporations 17 Compensation for independent personal
services2 05 Interest on tax-free covenant bonds 18 Compensation for dependent
personal services2 22 Interest paid on deposit with a foreign branch of a
domestic corporation or partnership 19 Compensation for teaching2 29 Deposit
interest 20 Compensation during studying and training2 30 Original issue
discount (OID) 23 Other income 31 Short-term OID 24 Qualified investment entity
(QIE) distributions of capital gains 33 Substitute payment – interest 25 Trust
distributions subject to IRC section 1445 51 Interest paid on certain actively
traded or publicly offered securities1 26 Unsevered growing crops and timber
distributions by a trust subject to IRC section 1445 54 Substitute payments –
interest from certain actively traded or publicly offered securities1 27
Publicly traded partnership distributions subject to IRC section 1446(a) 28
Gambling winnings3 Code Dividend Income 32 Notional principal contract income4
06 Dividends paid by U.S. corporations – general 35 Substitute payment – other
07 Dividends qualifying for direct dividend rate 36 Capital gains distributions
08 Dividends paid by foreign corporations 37 Return of capital 34 Substitute
payment–dividends 38 Eligible deferred compensation items subject to IRC section
877A(d)(1) 40 Other dividend equivalents under IRC section 871(m) 39
Distributions from a nongrantor trust subject to IRC section 877A(f)(1) 52
Dividends paid on certain actively traded or publicly offered securities1 41
Guarantee of indebtedness 53 Substitute payments–dividends from certain actively
traded or publicly offered securities1 42 Earnings as an artist or athlete – no
central withholding agreement5 56 Dividend equivalents under IRC section 871(m)
as a result of applying the combined transaction rules 43 Earnings as an artist
or athlete – central withholding agreement5 44 Specified federal procurement
payments Code Other Income 50 Income previously reported under escrow procedure6
09 Capital gains 55 Taxable death benefits on life insurance contracts 10
Industrial royalties 57 Amount realized under IRC section 1446(f) 11 Motion
picture or television copyright royalties 58 Publicly traded partnership
distributions - undetermined 12 Other royalties (for example, copyright,
software, broadcasting, endorsement payments) 1 This code should
only be used if the income paid is described in Regulations section
1.1441‐6(c)(2) and the withholding agent has reduced the rate of withholding
under an income tax treaty without the recipient providing a U.S. or foreign
TIN. 2 If compensation that would otherwise be covered under Income Codes 17
through 20 is directly attributable to the recipient's occupation as an artist
or athlete, use Income Code 42 or 43 instead. 3 Subject to 30% withholding rate
unless the recipient is from one of the treaty countries listed under Gambling
winnings (Income Code 28) in Pub. 515. 4 Use appropriate Interest Income Code
for interest from a notional principal contract where nonperiodic payment(s) is
treated as a loan. 5 Income Code 43 should only be used if Letter 4492, Venue
Notification, has been issued by the IRS (otherwise, use Income Code 42 for
earnings as an artist or athlete). If Income Code 42 or 43 is used, Recipient
Code 22 (artist or athlete) should be used instead of Recipient Code 16
(individual), 15 (corporation), or 08 (partnership other than withholding
foreign partnership or publicly traded partnership). 6 Use only to report gross
income the tax for which is being deposited in the current year because such tax
was previously escrowed for chapters 3 and 4 and the withholding agent
previously reported the gross income in a prior year and checked the box to
report the tax as not deposited under the escrow procedure. See the instructions
for this form for further explanation.

APPENDIX B

Exemption Codes, Recipient Status Codes, and Box 13j LOB Codes Boxes 3a and 4a.
Exemption code (applies if the tax rate entered in box 3b or 4b is 00.00). Boxes
12b, 12c, 13f, 13g, 15b, 15c, 16d, and 16e. Chapter 3 and Chapter 4 Status Codes
(used to identify the type of Withholding Agent, Recipient, Intermediary, or
Payer). Code Authority for Exemption Chapter 3 Status Codes Chapter 3
05 U.S. branch – treated as U.S. Person10 01 Effectively connected income 06
U.S. branch – not treated as U.S. Person11 02 Exempt under IRC7 07 U.S. branch –
ECI presumption applied 03 Income is not from U.S. sources 08 Partnership other
than Withholding Foreign Partnership or Publicly Traded Partnership 04 Exempt
under tax treaty 09 Withholding Foreign Partnership 05 Portfolio interest exempt
under IRC 10 Trust other than Withholding Foreign Trust 06 QI that assumes
primary withholding responsibility 11 Withholding Foreign Trust 07 WFP or WFT 12
Qualified Intermediary 08 U.S. branch treated as U.S. Person 13 Qualified
Securities Lender – Qualified Intermediary 10 QI represents that income is
exempt 14 Qualified Securities Lender – Other 11 QSL that assumes primary
withholding responsibility 15 Corporation 12 Payee subjected to chapter 4
withholding 16 Individual 22 QDD that assumes primary withholding responsibility
17 Estate 23 Exempt under section 897(l) 18 Private Foundation 24 Exempt under
section 892 19 International Organization 20 Tax Exempt Organization
(Section 501(c) entities) Chapter 4 21 Unknown Recipient 13 Grandfathered
payment 22 Artist or Athlete 14 Effectively connected income 23 Pension 15 Payee
not subject to chapter 4 withholding 24 Foreign Central Bank of Issue 16
Excluded nonfinancial payment 25 Nonqualified Intermediary 17 Foreign Entity
that assumes primary withholding responsibility 26 Hybrid entity making Treaty
Claim 18 U.S. Payees – of participating FFI or registered deemed-compliant FFI
35 Qualified Derivatives Dealer 19 Exempt from withholding under IGA8 36 Foreign
Government – Integral Part 20 Dormant account9 37 Foreign Government –
Controlled Entity 21 Other – payment not subject to chapter 4 withholding 38
Publicly Traded Partnership 39 Disclosing Qualified Intermediary
Pooled Reporting Codes12 27 Withholding Rate Pool – General 28
Withholding Rate Pool – Exempt Organization 29 PAI Withholding Rate Pool –
General 30 PAI Withholding Rate Pool – Exempt Organization 31 Agency
Withholding Rate Pool – General 32 Agency Withholding Rate Pool – Exempt
Organization 7 This code should only be used if no other
specific chapter 3 exemption code applies. 8 Use only to report a U.S.
reportable account or nonconsenting U.S. account that is receiving a payment
subject to chapter 3 withholding. 9 Use only if applying the escrow procedure
for dormant accounts under Regulations section 1.1471‐4(b)(6). 10 This code can
be used by a territory FI that is treated as a U.S. person. 11 This code can be
used by a territory FI that is not treated as a U.S. person. 12 Codes 27 through
32 should only be used by a QI, QSL, WP, or WT. A QI acting as a QDD may use
only code 27 or 28.

APPENDIX B (CONTINUED)

Exemption Codes, Recipient Status Codes, and Box 13j LOB Codes (continued) Boxes
12b, 12c, 13f, 13g, 15b, 15c, 16d, and 16e. Chapter 3 and Chapter 4 Status Codes
(continued). 34 Nonconsenting U.S. account Chapter 4 Status Codes 35
Sponsored direct reporting NFFE 01 U.S. Withholding Agent – FI 36 Excepted
Inter-affiliate FFI 02 U.S. Withholding Agent – Other 37 Undocumented
Preexisting Obligation 03 Territory FI – not treated as U.S. Person 38 U.S.
branch – ECI presumption applied 04 Territory FI – treated as U.S. Person 39
Account Holder of Excluded Financial Account13 05 Participating FFI – Other 40
Passive NFFE reported by FFI14 06 Participating FFI – Reporting Model 2 FFI 41
NFFE subject to 1472 withholding 07 Registered Deemed-Compliant FFI – Reporting
Model 1 FFI 50 U.S. Withholding Agent–Foreign branch of FI 08 Registered
Deemed-Compliant FFI – Sponsored Entity Pooled Reporting Codes 09 Registered
Deemed-Compliant FFI – Other 42 Recalcitrant Pool – No U.S. Indicia 10 Certified
Deemed-Compliant FFI – Other 43 Recalcitrant Pool – U.S. Indicia 11 Certified
Deemed-Compliant FFI – FFI with Low Value Accounts 44 Recalcitrant Pool –
Dormant Account 12 Certified Deemed-Compliant FFI – Nonregistering Local Bank 45
Recalcitrant Pool – U.S. Persons 13 Certified Deemed-Compliant FFI – Sponsored
Entity 46 Recalcitrant Pool – Passive NFFEs 14 Certified Deemed-Compliant FFI –
Investment entity that does not maintain financial accounts 47 Nonparticipating
FFI Pool 15 Nonparticipating FFI 48 U.S. Payees Pool 16 Owner-Documented FFI 49
QI‐Recalcitrant Pool‐General15 17 U.S. Branch – treated as U.S. person 18
U.S. Branch – not treated as U.S. person (reporting under section 1471) Box 13j.
LOB Code (enter the code that best describes the applicable limitation on
benefits (LOB) category that qualifies the taxpayer for the requested treaty
benefits). 19 Passive NFFE identifying Substantial U.S. Owners 20 Passive
NFFE with no Substantial U.S. Owners Code LOB Treaty Category 21 Publicly Traded
NFFE or Affiliate of Publicly Traded NFFE 02 Government – contracting
state/political subdivision/local authority 22 Active NFFE 03 Tax exempt pension
trust/Pension fund 23 Individual 04 Tax exempt/Charitable organization 24
Section 501(c) Entities 05 Publicly traded corporation 25 Excepted Territory
NFFE 06 Subsidiary of publicly traded corporation 26 Excepted NFFE – Other 07
Company that meets the ownership and base erosion test 27 Exempt Beneficial
Owner 08 Company that meets the derivative benefits test 28 Entity Wholly Owned
By Exempt Beneficial Owners 09 Company with an item of income that meets the
active trade or business test 29 Unknown Recipient 10 Discretionary
determination 30 Recalcitrant Account Holder 11 Other 31 Nonreporting IGA FFI 12
No LOB article in treaty 32 Direct reporting NFFE 33 U.S. reportable account
13 This code should only be used if income is paid to an account
that is excluded from the definition of financial account under Regulations
section 1.1471‐5(b)(2) or under Annex II of the applicable Model 1 IGA or Model
2 IGA. 14 This code should only be used when the withholding agent has received
a certification on the FFI withholding statement of a participating FFI or
registered deemed‐compliant FFI that maintains the account that the FFI has
reported the account held by the passive NFFE as a U.S. account (or U.S.
reportable account) under its FATCA requirements. The withholding agent must
report the name and GIIN of such FFI in boxes 15d and 15e. 15 This code should
only be used by a withholding agent that is reporting a payment (or portion of a
payment) made to a QI with respect to the QI’s recalcitrant account holders.

APPENDIX C

> Comprehensive analysis of Example 1 under Payments directly to beneficial
> owners or partners , earlier.

DIRECT PAYMENT TO BENEFICIAL OWNER WA, a U.S. corporate withholding agent who is
an issuer of stock and not a financial institution, makes a $1,000 payment of
U.S. source dividends to A, a foreign individual who has provided a Form W-8BEN
to WA and who is not eligible for a reduced rate of chapter 3 withholding under
a treaty. Before completing Form 1042-S, WA takes the following steps. Step 1:
Because the payment is a payment described under Amounts Subject to Reporting on
Form 1042-S , earlier, WA determines it has a Form 1042-S filing obligation.
Step 2: Because WA is making a payment of U.S. source FDAP income, WA determines
the payment meets the definition of both a “withholdable payment” under chapter
4 and “an amount subject to withholding” under chapter 3. Step 3: Because the
payment is being made to an individual (and not a nonparticipating FFI or an
NFFE that is not an excepted NFFE that has failed to disclose its substantial
U.S. owners (or certify that it has no substantial U.S. owners) (see definitions
of these terms)), WA determines that the payment is not subject to chapter 4
withholding. Because the payment is not subject to chapter 4 withholding but is
an amount subject to withholding under chapter 3, WA determines that chapter 3
is the correct chapter indicator. WA will thus enter a "3" in box 3 (chapter
indicator). Note. Although the payment is properly classified as a chapter 3
payment, WA must complete certain boxes on Form 1042-S that pertain to chapter 4
(see explanations for boxes 4a, 4b, and 13g below). WA must file a Form 1042-S
for A and complete it as follows. Caution: Be sure to read the instructions for
each box or field in its entirety before completing a box or field on Form
1042-S. WA must provide a unique form identifier (UFI) in the applicable entry
field at the top of Form 1042-S. For additional information, including UFI
requirements, see the instructions for Unique Form Identifier, earlier. Box
Description Required Entry Comments 1 Income code “06” WA enters “06” (dividends
paid by U.S. corporations - general), which is the appropriate two-digit code
from the list of Income Codes provided in Appendix A. 2 Gross income “1000” WA
enters the gross amount paid (in whole dollars), including withheld tax. 3
Chapter indicator “3” WA enters “3” to indicate that amounts were withheld
pursuant to chapter 3. 3a Chapter 3 exemption code “00” WA enters “00” because
an amount was withheld under chapter 3 and the tax rate is greater than zero and
is not due to backup withholding (see the instructions for boxes 3a and 4a,
earlier). 3b Chapter 3 tax rate “30.00” WA enters “30.00” consistent with the
formatting specified in the instructions for boxes 3b and 4b, earlier. 4a
Chapter 4 exemption code “15” WA enters “15” (payee not subject to chapter 4
withholding), which is the appropriate two-digit code from the list of Exemption
Codes provided in these instructions.
Note. WA uses exemption code 15 because the payment is a withholdable payment,
but has not been withheld upon under chapter 4 because of the payee's chapter 4
status (an individual and not a person subject to chapter 4 withholding as
explained in the instructions for boxes 3a and 4a, earlier). 4b Chapter 4 tax
rate “00.00” WA enters “00.00” because the amount reported in box 2 is not
subject to chapter 4 withholding. See the instructions for boxes 3b and 4b,
earlier. 5 Withholding allowance WA leaves box 5 blank because the income code
it is reporting in box 1 is not one of the codes specified in the instructions
for which box 5 reporting is required. See the instructions for box 5, earlier.
6 Net income WA leaves box 6 blank because it did not enter an amount in box
5. 7a Federal Tax Withheld “300” WA enters “300” (30% of $1,000). 7b Check if
Federal Tax Withheld was not deposited with the IRS because escrow procedures
were applied WA does not check the box because it is not using an escrow
procedure. 7c Check if withholding occurred in subsequent year with respect to a
partnership interest WA does not check the box because it did not withhold in
a subsequent year. 8 Tax withheld by other agents WA leaves box 8 blank
because tax was not withheld by other withholding agents. 9 Overwithheld tax
repaid to recipient pursuant to adjustment procedures WA leaves box 9 blank
because it did not repay overwithheld tax to the recipient under the
reimbursement procedure or the set-off procedure. For more information, see the
instructions for box 9, earlier. 10 Total withholding credit “300” WA enters
“300” (combining boxes 7a, 8, and 9). 11 Tax paid by withholding agent (amounts
not withheld) WA leaves box 11 blank because it withheld on the payment to the
recipient (as opposed to paying the tax from its own funds). For more
information, see the instructions for box 11, earlier. 12a Withholding agent's
EIN Specific information required Although WA's EIN is not specified in this
example, this is a required field that WA would complete.

APPENDIX C (CONTINUED)

Box Description Required Entry Comments 12b–c Withholding agent's chapter 3 and
chapter 4 status codes “15” and “02” WA enters “15” in box 12b and “02” in box
12c because it is a U.S. corporate withholding agent that is not a financial
institution.
Note. WA must enter both a chapter 3 and a chapter 4 withholding agent status
code regardless of the type of payment being reported. 12d Withholding agent's
name “WA” WA must enter its complete name. 12e Withholding agent's GIIN WA
leaves this box blank because a U.S. withholding agent is generally not required
to obtain a GIIN. See Global intermediary identification number and box 12e,
earlier, for details. 12f Withholding agent's country code “US” WA enters “US”
as the country code because it is a U.S. withholding agent. See the instructions
for box 12f, earlier. 12g Withholding agent's foreign tax identification number,
if any WA leaves this box blank because it is a U.S. withholding agent and it
does not have an FTIN or a country of residence other than the United States.
12h–I Withholding agent's address Specific information required Although WA's
address is not specified in this example, this is a required field that WA would
complete. See boxes 12d Through 12i, earlier, for requirements. 13a Recipient's
name “A” WA enters the recipient's name. 13b Recipient's country code Specific
information required Although the recipient's country of residency is not
specified in this example, this is a required field that WA would complete. See
the instructions for box 13b, earlier, for requirements. 13c–d Recipient's
address Specific information required Although the recipient's address is not
specified in this example, this is a required field that WA would complete. See
boxes 13c and 13d, earlier, for requirements. 13e Recipient's U.S. TIN, if any
The recipient's U.S. TIN is not specified in this example. However, given the
facts used in this example, the recipient's U.S. TIN is generally not required
because A is not a type of recipient described in the instructions for boxes 13e
and 13h, earlier, for which this TIN is required (for example, A is not claiming
a reduced rate of, or exemption from, tax under a tax treaty between the
recipient's country of residence and the United States). However, WA must enter
the recipient's U.S. TIN if WA knows it or if it was provided to WA on a Form
W-8. 13f Recipient's chapter 3 status code “16” WA enters chapter 3 status code
“16” (individual), which is the appropriate two-digit code from the list of
chapter 3 status codes provided in Appendix B.
Note. A withholding agent must enter a chapter 3 status code for all “amounts
subject to reporting under chapter 3.” 13g Recipient's chapter 4 status code
“23” WA enters chapter 4 status code “23” (individual), which is the appropriate
two-digit code from the list of chapter 4 status codes provided in Appendix B.
Note. A withholding agent must enter a chapter 4 status code for the recipient
only if the payment is a withholdable payment (as is the case in this example)
or when a participating FFI or registered deemed-compliant FFI is reporting a
chapter 4 withholding rate pool of U.S. payees. 13h Recipient's GIIN WA leaves
box 13h blank because it only applies for chapter 4 reporting purposes. See
Global intermediary identification number and the instructions for boxes 13e and
13h, earlier. 13i Recipient's foreign tax identification number, if any The
recipient's FTIN is not required because A is not a type of recipient described
in the instructions for box 13i for which the FTIN is required. 13j LOB code
WA leaves box 13j blank because the recipient is an individual (not an entity).
13k Recipient's account number WA leaves box 13k blank because WA is not a
financial institution. 13l Recipient's date of birth WA leaves box 13l blank
because WA is not a financial institution. 14a–b Primary withholding agent's
information WA leaves these boxes blank because tax was not withheld by other
withholding agents. 15a–I Intermediary information WA leaves these boxes blank
because WA is making a direct payment to the recipient and there are no other
withholding agents. 16a–e Payer's information WA leaves these boxes blank
because WA is making a direct payment to the recipient and there are no other
payers involved. 17a–c State income taxes Although not specified in this
example, WA enters in these boxes any information relating to any state income
tax withheld.

APPENDIX D

> Comprehensive example of how to complete Form 1042-S for gambling winnings.

DIRECT PAYMENT TO BENEFICIAL OWNER ABC Casino ("WA"), a U.S. corporate
withholding agent that is not a financial institution, makes a $10,000 payment
of gambling winnings to A, a foreign individual who has provided a Form W-8BEN
to WA establishing foreign status. The gambling winnings are subject to 30%
withholding as there is no exemption available under the Internal Revenue Code
or applicable treaty. Before completing Form 1042-S, WA takes the following
steps. Step 1: Because the payment is a payment described under Amounts Subject
to Reporting on Form 1042-S , earlier, WA determines it has a Form 1042-S filing
obligation. Step 2: Because WA is making a payment of U.S. source FDAP income,
WA determines the payment meets the definition of “an amount subject to
withholding” under chapter 3. Because gambling winnings are not treated as a
“withholdable payment” under chapter 4, as it is an excluded nonfinancial
payment under Regulations section 1.1473-1(a)(4)(iii), WA determines that the
payment is not subject to chapter 4 withholding. Step 3: Because the payment is
not subject to chapter 4 withholding but is an amount subject to withholding
under chapter 3, WA determines that chapter 3 is the correct chapter indicator.
WA will thus enter a "3" in box 3 (chapter indicator). Note. Although the
payment is properly classified as a chapter 3 payment, WA must complete certain
boxes on Form 1042-S that pertain to chapter 4 (see explanations for boxes 4a,
4b, and 13g below). WA must file a Form 1042-S for A, and complete it as
follows. Caution: Be sure to read the instructions for each box or field in its
entirety before completing a box or field on Form 1042-S. WA must provide a
unique form identifier (UFI) in the applicable entry field at the top of Form
1042-S. For additional information, including UFI requirements, see the
instructions for Unique Form Identifier, earlier. Box Description Required Entry
Comments 1 Income code “28” WA enters “28” (Gambling winnings), which is the
appropriate two-digit code from the list of income codes provided in Appendix A.
2 Gross income “10,000” WA enters the gross amount paid (in whole dollars),
including withheld tax. 3 Chapter indicator “3” WA enters “3” to indicate that
amounts were withheld pursuant to chapter 3. 3a Chapter 3 exemption code “00” WA
enters “00” because an amount was withheld under chapter 3 and the tax rate is
greater than zero and is not due to backup withholding (see the instructions for
boxes 3a and 4a, earlier). 3b Chapter 3 tax rate “30.00” WA enters “30.00”
consistent with the formatting specified in the instructions for boxes 3b and
4b, earlier. 4a Chapter 4 exemption code “16” WA enters “16” (excluded
nonfinancial payment), which is the appropriate two-digit code from the list of
Exemption Codes provided in Appendix B. 4b Chapter 4 tax rate “00.00” WA enters
“00.00” because the amount reported in box 2 is not subject to chapter 4
withholding. See the instructions for boxes 3b and 4b, earlier. 5 Withholding
allowance WA leaves box 5 blank because the income code it is reporting in box
1 is not one of the codes specified in the instructions for which box 5
reporting is required. See the instructions for box 5, earlier. 6 Net income
WA leaves box 6 blank because it did not enter an amount in box 5. 7a Federal
Tax Withheld “3,000” WA enters “3,000” (30% of $10,000). 7b Check if Federal Tax
Withheld was not deposited with the IRS because escrow procedures were applied
WA does not check the box because it is not using the escrow procedure. 7c Check
if withholding occurred in subsequent year with respect to a partnership
interest WA does not check the box because it did not withhold in a subsequent
year. 8 Tax withheld by other agents WA leaves box 8 blank because tax was not
withheld by other withholding agents. 9 Overwithheld tax repaid to recipient
pursuant to adjustment procedures WA leaves box 9 blank because it did not
repay overwithheld tax to the recipient under the reimbursement procedure or the
set-off procedure. For more information, see the instructions for box 9,
earlier. 10 Total withholding credit “3,000” WA enters “3,000” (combining boxes
7a, 8, and 9). 11 Tax paid by withholding agent (amounts not withheld) WA
leaves box 11 blank because it withheld on the payment to the recipient (as
opposed to paying the tax from its own funds). For more information, see the
instructions for box 11, earlier. 12a Withholding agent's EIN Specific
information required Although WA's EIN is not specified in this example, this is
a required field that WA would complete. 12b–c Withholding agent's chapter 3 and
chapter 4 status codes “15” and “02” WA enters “15” in box 12b and “02” in box
12c because it is a U.S. corporate withholding agent that is not a financial
institution.
Note. WA must enter both a chapter 3 and a chapter 4 withholding agent status
code regardless of the type of payment being reported.

APPENDIX D (CONTINUED)

Box Description Required Entry Comments 12d Withholding agent's name “ABC
Casino” WA must enter its complete name. 12e Withholding agent's GIIN WA
leaves this box blank because a U.S. withholding agent is generally not required
to obtain a GIIN. See Global intermediary identification number and box 12e,
earlier, for details. 12f Withholding agent's country code “US” WA enters “US”
as the country code because it is a U.S. withholding agent. See the instructions
for box 12f, earlier. 12g Withholding agent's foreign tax identification number,
if any WA leaves this box blank because it is a U.S. withholding agent and it
does not have an FTIN or a country of residence other than the United States.
12h–I Withholding agent's address Specific information required Although WA's
address is not specified in this example, this is a required field that WA would
complete. See boxes 12d Through 12i, earlier, for requirements. 13a Recipient's
name “A” WA enters the recipient's name. 13b Recipient's country code Specific
information required Although the recipient's country of residency is not
specified in this example, this is a required field that WA would complete. See
the instructions for box 13b, earlier, for requirements. 13c–d Recipient's
address Specific information required Although the recipient's address is not
specified in this example, this is a required field that WA would complete. See
boxes 13c and 13d, earlier, for requirements. 13e Recipient's U.S. TIN, if any
The recipient's U.S. TIN is not specified in this example. However, given the
facts used in this example, the recipient's U.S. TIN is generally not required
because A is not a type of recipient described in the instructions for boxes 13e
and 13h, earlier, for which this TIN is required (for example, A is not claiming
a reduced rate of, or exemption from, tax under a tax treaty between the
recipient's country of residence and the United States). However, WA must enter
the recipient's U.S. TIN if WA knows it or if it was provided to WA on a Form
W-8. 13f Recipient's chapter 3 status code “16” WA enters chapter 3 status code
“16” (individual), which is the appropriate two-digit code from the list of
chapter 3 status codes provided in Appendix B.
Note. A withholding agent must enter a chapter 3 status code for all “amounts
subject to reporting under chapter 3.” 13g Recipient's chapter 4 status code
WA is not required to provide the chapter 4 status code of the recipient given
that the payment being reported is not a withholdable payment.
Note. A withholding agent must enter a chapter 4 status code for the recipient
only if the payment is a withholdable payment or when a participating FFI or
registered deemed-compliant FFI is reporting a chapter 4 withholding rate pool
of U.S. payees. 13h Recipient's GIIN WA leaves box 13h blank because it only
applies for chapter 4 reporting purposes. See Global intermediary identification
number and the instructions for boxes 13e and 13h, earlier. 13i Recipient's
foreign tax identification number, if any The recipient's FTIN is not required
because A is not a type of recipient described in the instructions for box 13i,
earlier, for which the FTIN is required. 13j LOB code WA leaves box 13j blank
because the recipient is an individual (not an entity). 13k Recipient's account
number WA leaves box 13k blank because WA is not a financial institution. 13l
Recipient's date of birth WA leaves box 13l blank because WA is not a
financial institution. 14a–b Primary withholding agent's information WA leaves
these boxes blank because tax was not withheld by other withholding agents.
15a–I Intermediary information WA leaves these boxes blank because WA is
making a direct payment to the recipient and there are no other withholding
agents. 16a–e Payer's information WA leaves these boxes blank because WA is
making a direct payment to the recipient and there are no other payers involved.
17a–c State income taxes Although not specified in this example, WA enters in
these boxes any information relating to any state income tax withheld.

Page Last Reviewed or Updated: 05-Feb-2024
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