I am not a U.S. citizen (including dual citizen) or resident.
My birthplace is not in the U.S.
I do not have a current U.S. mailing or residence address (including a U.S. post office box or U.S. “in-care-of” address).
I do not have a current U.S. telephone number.
I do not have standing instructions to transfer funds to an account maintained in the United States.
I do not have currently effective power of attorney or signatory authority granted to a person with a U.S. address.
I do not have an “in-care-of” or “hold mail” address that is the sole address for the Account Holder. The Investor needs to note that in the case of a Pre-existing Individual Account that is a Lower Value Account, an “in-care-of” address outside the United States is not to be treated as U.S. indicia.
I do not possess a U.S. TIN (hereafter “Tax Identification Number”).
Please close this notice after you've read it and check as appropriate:
I am in agreement with the above declaration
I am not in agreement with the above declaration
In case you are in agreement with the above declaration, thank you for your time and assistance in this process, you are now one step closer to proceeding in trading with our Company.
In case that you are not in agreement with the above declaration, please consider the following: As per your declaration, you are considered as a U.S. Reportable person. The Company is obligated to report specific information to the U.S. IRS in relation to our U.S. Reportable persons.
In this respect, we would like to notify you that the following information is to be reported: U.S. TIN (hereafter “Tax Identification Number”), takes into account U.S. Reportable person and entities with U.S. substantial ownership above 10%.
Please provide us with the information depicted above, so as to be able to construct the client profile that is to be reported to the U.S. IRS department.