【翻訳あり】ストックフォトユーザーのための米国納税フォーム「W-8BEN」の書き方・記入の仕方

1　Name of individual who is the beneficial owner　

2　Country of citizenship

3　Permanent residence address (street, apt, or suite no, or rural route). Do not use a P. O. box or in-care-of address.

City or Town, state or province. Include postal code where appropriate.　Country

4　Mailling address (if different from above)

City or Town, state or province. Include postal code where appropriate.　Country

5　U.S. taxpayer identification number (SSN or ITIN), if required (see instructions)

6　Foreign tax identifying number (see instructions)

7　Reference number(s) (see instructions)

8　Date of birth (MM-DD-YYYY) (see instructions)

9　I certify that the beneficial owner is a resident of within the meaning of the income tax treaty between the United States and that country.

10　 The beneficial owner is claiming the provisions of Article and paragraph 　　 #12(1) 　of the treaty identified on line 9 above to claim a 0 % rate of withholding on (specify type of income): Royalties .

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that:

• I am the individual that is the beneficial owner (or am authorized to sign for the individual that is the beneficial owner) of all the income to which this form relates or am using this form to document myself for chapter 4 purposes,

• The person named on line 1 of this form is not a U.S. person,

• The income to which this form relates is:
  (a) not effectively connected with the conduct of a trade or business in the United States,
  (b) effectively connected but is not subject to tax under an applicable income tax treaty, or
  (c) the partner’s share of a partnership’s effectively connected income,

• The person named on line 1 of this form is a resident of the treaty country listed on line 9 of the form (if any) within the meaning of the income tax treaty between the United States and that country, and

• For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.