Fillable Certificate Of Non Foreign Status (Firpta) printable pdf download

Certificate Of Non Foreign Status (Firpta)

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CERTIFICATE OF NON FOREIGN STATUS

Section 1445 of the Internal Revenue Code provides that a transferee (buyer) of a U.S.

real property interest must withhold tax if the transferor (seller) is a foreign person. To

inform _______________________________________________________________

(the “Transferee”) that withholding of tax is not required upon the disposition of a U.S.

real property interest by __________________________________________________

(the “Transferor”), the undersigned hereby certifies the following on behalf of the

Transferor:

1. That the Transferor is the owner of the following described property, to wit:

Block: ________________

Lot: ________

County: ___________________

Premises: ________________________________________________________

2. The Transferor is not a non-resident alien for purposes of the U.S. income taxation (as

such term is defined in the Internal Revenue Code and Income Tax Regulations).

3. The Transferor’s U.S. taxpayer identification number (Social Security Number) is

__________________

4. The Transferor’s address is

________________________________________________________________________

5. The Transferor understands that this certification be disclosed to the Internal Revenue

Service by the Transferee and that any false statement contained herein could be

punished by fine, imprisonment or both.

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS

CERTIFICATION AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS

TRUE, CORRECT AND COMPLETE, AND I FURTHER DECLARE THAT I HAVE

AUTHORITY TO SIGN THIS DOCUMENT ON BEHALF OF THE TRANSFEROR.

DATED: __________________________

BY:_______________________________

Certificate Of Non Foreign Status (Firpta)

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