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

pooled reporting is permitted. A PFFI is not required to

Line 5. If the amounts reported in lines 3 and 4 (to the

complete line 3 for accounts held by recalcitrant account

extent applicable) are not reported in U.S. dollars, enter

holders (or for Reporting Model 2 FFIs, non-consenting

the code for the currency in which the amounts are

U.S. accounts).

reported. The currency code must be a valid

three-character ISO 4217 currency code. If the amounts

Line 1. Check the appropriate box for the applicable

are reported in U.S. dollars, enter “USD.”

pooled reporting type. See Accounts and Withholdable

Payments Required To Be Reported: Accounts for which

Paperwork Reduction Act Notice. We ask for the

pooled reporting is permitted for the categories of pooled

information on this form to carry out the Internal Revenue

reporting accounts.

laws of the United States. Chapter 4 of the Code requires

For calendar years 2015 and 2016, if a PFFI is

certain withholding agents and foreign financial

prohibited under domestic law from reporting a

institutions to report information with respect to certain

TIP

nonparticipating FFI on a specific payee basis

U.S. accounts, substantial U.S. owners of passive NFFEs,

without consent from the nonparticipating FFI account

U.S. accounts held by owner-documented FFIs, and

holder and the PFFI has not been able to obtain such

certain other accounts as applicable based on the filer’s

consent, the PFFI may report such accounts in a pool.

chapter 4 status. Form 8966 is used to comply with this

See Regulations section 1.1471-4(d)(2)(ii)(F).

reporting requirement.

You are not required to provide the information

For pooled reporting of non-consenting U.S.

requested on a form that is subject to the Paperwork

accounts, report the type substituting

TIP

Reduction Act unless the form displays a valid OMB

“non-consenting U.S. account” for “recalcitrant

control number. Books or records relating to a form or its

account.”

instructions must be retained as long as their contents

Line 2. Enter the total number of accounts reported in

may become material in the administration of any Internal

Part V.

Revenue law. Generally, tax returns and return

information are confidential, as required by section 6103.

Line 3. Only complete line 3 if you are reporting accounts

held by nonparticipating FFIs.

The time needed to complete and file this form will vary

depending on individual circumstances. The estimated

For calendar years 2015 and 2016, if you are

average time is 25 minutes.

reporting accounts held by nonparticipating FFIs,

TIP

enter the aggregate amount of foreign reportable

If you have comments concerning the accuracy of this

amounts paid to the accounts reported in Part V. See the

time estimate or suggestions for making this form simpler,

definition of foreign reportable amount, earlier. Instead of

we would be happy to hear from you. You can send us

reporting foreign reportable amounts, you may report all

comments from Click on “More

income, gross proceeds, and redemptions (irrespective of

Information” and then on “Give us feedback.” Or you can

source) paid to the accounts reported in Part V during the

write to Internal Revenue Service, Tax Forms and

calendar year.

Publications, SE:W:CAR:MP:TFP, 1111 Constitution Ave.

NW, IR-6526, Washington, DC 20224. Do not send the

Line 4. Enter the aggregate balance or value of the

form to this address. Instead, see When, How, and Where

accounts held by recalcitrant account holders (or, for

to File, earlier.

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

at the end of the year. Do not complete line 4 if you are

reporting accounts held by nonparticipating FFIs.

-13-

Instructions for Form 8966 (2015)

Instructions For Form 8966 (2015) Page 13

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