Instructions For Form 8966 (2015) (Page 12 of 13) in pdf

during the calendar year, including payments in

Line 4a. Enter the aggregate gross amount of interest

redemption (in whole or part) of the account.

paid (or credited to the payee’s account) that is a

withholdable payment for the calendar year.

For reports filed for calendar year 2015, the

payment information on line 4c is not required,

Line 4b. Enter the aggregate gross amount of dividends

TIP

but the information on lines 4a, 4b, and 4d must

paid (or credited to the payee’s account) that is a

be provided. For reports filed for calendar years after

withholdable payment for the calendar year.

2015, all of the information on lines 4a through 4d must be

Line 4c. Enter the aggregate gross proceeds paid (or

provided.

credited to the payee’s account) that is a withholdable

payment for the calendar year.

For calendar years 2015 and 2016, with respect

to a nonparticipating FFI account holder receiving

Line 4d. Enter the aggregate gross amount of all income

TIP

a payment of a foreign reportable amount, report

paid (or credited to the payee’s account) that is a

the total payments of foreign reportable amounts made to

withholdable payment for the calendar year, reduced by

the nonparticipating FFI either divided by type of payment

interest, dividends, and gross proceeds reported on lines

on lines 4a through 4d, or as one amount entered on

4a through 4c.

line 4d. As an alternative to reporting foreign reportable

Direct Reporting NFFEs and Sponsored Direct

amounts the PFFI may instead report all income, gross

proceeds, and redemptions (regardless of source) paid to

Reporting NFFEs

the nonparticipating FFI during the calendar year. Enter

If you are a Direct Reporting NFFE or a Sponsoring Entity

this amount on line 4d.

filing Form 8966 on behalf of a Sponsored Direct

Reporting NFFE, complete lines 1 through 4d as follows:

If an account is closed or transferred in its entirety

Line 1. Do not enter any information on line 1.

by an account holder during a calendar year,

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report the amounts paid or credited to the

Line 2. If the amounts reported in lines 3a and 4a through

account for the calendar year until the date of transfer or

4d are not reported in U.S. dollars, enter the code for the

closure on lines 4a through 4d. See Regulations section

currency in which the amounts are reported. The currency

1.1471-4(d)(4)(iv)(D).

code must be a valid three-character ISO 4217 currency

code. If the amounts are reported in U.S. dollars, enter

Withholding Agents

“USD.”

A withholding agent that is not an FFI should enter the

Line 3a. Enter the value of equity interest in the NFFE of

following information on lines 1 through 4d in connection

the substantial U.S. owner identified in Part III.

with withholdable payments made to:

Line 3b. Do not check the box on line 3b.

An account maintained by the withholding agent and

held by a passive NFFE with a substantial U.S. owner or

Lines 4a through 4d. Enter the total of all payments

an ODFFI with a specified U.S. person owning certain

made by the NFFE during the calendar year to the

equity or debt interests in the ODFFI.

substantial U.S. owner identified in Part III (either divided

A payment on an obligation made to a payee that the

by type of payment or as one amount on line 4d),

withholding agent treats as a passive NFFE with

including the gross amounts paid or credited to the

substantial U.S. owner(s) or an ODFFI with a specified

substantial U.S. owner with respect to such owner’s equity

U.S. person owning certain equity or debt interests in the

interest in the NFFE during the calendar year, which

ODFFI.

include payments in redemption or liquidation (in whole or

part) of the substantial U.S. owner’s equity interest in the

Line 1. If the payment is made to an account, enter the

NFFE.

account number on line 1. If the payment is not made to

an account maintained by the payor, enter NANUM for no

Part V – Pooled Reporting Type

account number.

See the chart at Specific Instructions and Special

Line 2. If the amounts reported in lines 3a and 4a through

instructions for filers not specifically listed in chart, earlier,

4d are not reported in U.S. dollars, enter the code for the

before you begin this part to determine whether you are

currency in which the amounts are reported. The currency

required to complete Part V.

code must be a valid three-character ISO 4217 currency

If you are a PFFI, use Part V to report information about

code. If the amounts are reported in U.S. dollars, enter

the accounts held by recalcitrant account holders (or, for

“USD.”

Reporting Model 2 FFIs, non-consenting U.S. accounts)

Line 3a. With respect to an account held by an ODFFI,

and amounts paid to nonparticipating FFIs you are

enter the average calendar year account balance or value

reporting on a pooled basis. If you are required to report

if that amount is reported to the account holder.

more than one type of pooled reporting account, file a

Otherwise, report the account balance or value as of the

separate Form 8966 for each type.

end of the calendar year. See Regulations section

Direct Reporting NFFEs and Sponsored

1.1471-5(b)(4) for detailed rules for determining an

Direct Reporting NFFEs. Do not complete Part

account’s balance or value. If the account holder is a

passive NFFE, do not enter any information on this line.

CAUTION

Line 3b. Do not check the box on line 3b.

Lines 1 through 5. Complete lines 1 through 5 as

follows to report information about accounts for which

-12-

Instructions for Form 8966 (2015)

Instructions For Form 8966 (2015) Page 12

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