Entity Form - Tax Information by BVCA
The BVCA Entity Tax Information Form is used to declare an entity’s tax residency details in compliance with the OECD Common Reporting Standard (CRS) and Foreign Account Tax Compliance Act (FATCA) regulations. It is part of BVCA’s widely trusted library of open, lawyer-vetted compliance forms.
PLEASE READ BEFORE COMPLETING THIS FORM: Tax authorities require us to collect and report certain information about the tax residency status of certain Account Holders in order to comply with legal requirements based on the OECD Common Reporting Standard for Automatic Exchange of Financial Account Information "CRS". If you have any questions regarding how to complete this form, please consult your tax adviser.
To enable us to comply with our obligation to report to the relevant tax authorities, you are required to state the residency for tax purposes of the entity which is the Account Holder for the relevant account(s).
When completing this form, please refer to the separate Key Definitions section.
Entity Tax Information Form
Part 1 - Account Holder Information
Account Holder - The person listed or identified as the holder of a Financial Account. The name of the Account Holder should be provided. If the person opening the account is not a Financial Institution and is acting as an intermediary, agent, custodian, nominee, signatory, investment advisor or legal guardian on behalf of another entity that is the account holder, this form must be completed by or on behalf of that other entity which is referred to as the Account Holder.
Entity Name: [entity name]
Address: [entity street address]
City/Town: [entity city]
State/Province/County: [entity state province county]
GIIN (if any): [entity giin]
Country of Incorporation or Organisation: [country of incorporation]
Postal Code/Zip Code: [entity postal code]
Country (do not abbreviate): [entity country]
Part 2 - Tax Residence
Please provide details for all jurisdictions in which the Account Holder is resident for tax purposes*. If the entity has no residence for tax purposes, enter the country in which its principal office is located.
Taxpayer Identification Number (TIN) – A TIN or functional equivalent should be provided for each country of residence for tax purposes identified. A TIN is a unique combination of letters and/or numbers assigned to the entity by a government, or its tax authorities, which is used to identify the account holder for the purposes of administering taxes. In some countries this may be a number that is specifically referred to as a TIN, while other countries may use other numbers (such as a social insurance number) to identify their residents for tax purposes. In the UK, an entity's TIN is their Unique Taxpayer Reference (UTR).
Country of Tax Residence 1: [tax residence country 1]
Taxpayer Identification Number 1: [tin 1]
TIN Unavailable - [ ]
Country of Tax Residence 2: [tax residence country 2]
Taxpayer Identification Number 2: [tin 2]
TIN Unavailable - [ ]
Country of Tax Residence 3: [tax residence country 3]
Taxpayer Identification Number 3: [tin 3]
TIN Unavailable - [ ]
[ ] I certify the countries listed above (and in any attached statement) represent any and all countries in which the Account Holder is considered a tax resident.
*If Account Holder is tax resident in additional countries please attach a statement to this form containing the country and TIN for each.
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