www.computershare/au/selfcertification : Tax Residency Self-Certification Form
Self-certification is the way in which we collect information from you so that we are able to determine what country/countries you are a tax resident of.
As a result of the Australian Government agreeing to participate in the exchange of information with other jurisdictions under the Foreign Account Tax Compliance Act (FATCA)1 and Common Reporting Standard (CRS)2 , Financial Institutions are required to undertake due diligence to determine account holders’ jurisdiction of tax residence.
If the account is in the name of individuals or joint individuals, complete this form. If the account is in the name of an entity (including an Australian Retirement Fund) you will need to complete the form for entities.
This form can be obtained from www-au.computershare.com/Investor/help/printableforms and select ‘Tax Residency Self-Certification Form Entity’. If you have received this form it is important the account holder’s jurisdiction of tax residence is certified.
If not certified, the Financial Institution in which you are a securityholder may be required to report the account holder’s name, address, amounts paid to the account and value of securities to the Australian Taxation Office who may report those details to the Internal Revenue Service of the United States and possibly other tax authorities.
If you certify you are a tax resident outside of Australia, the Financial Institution in which you are a securityholder may be required to report the securityholder’s name, address, amounts paid to the securityholder and value of securities to the Australian Taxation Office who may report those details to the tax authority in which the securityholder is a tax resident. If the investment is held by individuals jointly, a separate form is required from each individual.
How does self-certification work?
- Review and accept the terms and conditions
- Select ‘Complete a form’*
- Fill in the requested details
- Submit your form
Alternatively, you can also complete the process offline – please email to request a paper form.
*You can save your progress and complete the form over multiple logins – choose ‘Continue a form’ when you wish to do this.
Guide for completing the Tax Residency Self-Certification form
a. If the investment is held by individuals jointly write the name of the individual completing the form.
b. Write your date of birth.
c. If your residence address is NOT the same as the registered address on your securityholding, write the residence address in these boxes.
Note: a residence address cannot include a Post Office Box or a Care of address.
a. If you are a U.S. citizen or resident of the U.S. for tax purposes, tick the ‘YES’ box, otherwise tick the ‘NO’ box. If you ticked the ‘YES’
box, write your U.S. Taxpayer Identification Number.
b. Please indicate all jurisdictions you are a tax resident in (i.e. where you are treated as a resident of the jurisdiction for the purposes of its income tax). If you are a tax resident in more than 3 jurisdictions, write additional information on a copy of this form or on a separate statement. If you are a tax resident in Australia, do not provide your Australian Tax File Number.
c. If you completed the table in 2 b) and did not provide a TIN for one of those jurisdictions and you selected reason code B for not providing a TIN, write the reason you have not provided a TIN here.
a. By signing this form, the securityholder (or their attorney) agrees to the certification acknowledgement, undertaking and declaration in Section 3a.
b. Write the contact name, telephone number and date the form was executed.
