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,
TIP
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
!
V.
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
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Instructions for Form 8966 (2015)