Certificate of Foreign Status for Individuals (Form W-8BEN) - Deanne Cuico
This document is a fully completed IRS Form W-8BEN (Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting – Individuals). The form certifies that Deanne Cuico, a Philippine citizen residing permanently at Consolacion, Cebu (postal code 6001), is a non‑U.S. person and therefore eligible for reduced or exempt U.S. withholding tax under the U.S.–Philippines income tax treaty. The form records her personal details (name, citizenship, permanent address, foreign tax identifying number 420530714, date of birth 08‑11‑1984), a reference identifier, and a claim of treaty benefits (line 9). The certification section (Part III) includes a per‑jury declaration that the information is true, that she is not a U.S. person, and that the income to which the form applies is not effectively connected with a U.S. trade or business. The form is signed and dated 03‑20‑2024 by Deanne Cuico. The document is intended to be provided to a U.S. withholding agent, not the IRS, to substantiate foreign status and claim treaty‑based reduced withholding rates.
Topics
Purpose and Legal Role of Form W-8BEN
Explanation of the form’s function as a certificate of foreign status for individuals, used by U.S. withholding agents to apply appropriate tax withholding and reporting.
Beneficial Owner Identification Details
All personal data supplied for Deanne Cuico: name, citizenship, permanent residence address, foreign tax identifying number, reference number, and date of birth.
Claim of Tax Treaty Benefits – Philippines
Declaration that the beneficial owner is a resident of the Philippines and is invoking the U.S.–Philippines income tax treaty to claim reduced withholding, with space for specifying article, paragraph, and rate (left blank in this instance).
Certification, Perjury Declaration, and Signature
Part III statements affirming the truthfulness of the information, non‑U.S. person status, applicability to non‑effectively connected income, and the signer’s authority, followed by the signature and date.