Instructions to complete the Self Certification Form

US Status

Is the Account Holder a US Resident? Enter ‘Yes’ if the Account Holder is a US Resident. Otherwise enter ‘No’.  
Is the Account Holder a US Citizen? Enter ‘Yes’ if the Account Holder is a US Citizen. Otherwise enter ‘No’.
Is the Account Holder holding a US Permanent Resident Card (Green Card)? Enter ‘Yes’ if the Account Holder has a right of lawful permanent residence / holds a US Permanent Resident Card (“Green Card”) issued by the US Government. Otherwise enter ‘No’.

Tax Residence Information

Tax Residence / Citizenship Information Please complete the table indicating (i) where the Account Holder is resident for tax purposes and (ii) the Account Holder’s Taxpayer Identification Number or functional equivalent (hereafter referred to as ‘TIN’) for each country indicated.


The requirement to pay tax in a particular country does not necessarily signify tax residence in that country; it is possible to have to pay tax in a country in which one is not tax resident, and not to have to pay tax in a country in which one is tax resident. Whether a person is tax resident in a particular country depends on whether that person meets the definition of a tax resident under the tax laws of that country. For more information on tax residence, please consult your tax advisor or refer to the information at OECD automatic exchange of information portal at:

https://www.oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/tax-residency/#d.en.347760


If the Account Holder is a dual citizen, enter the country where the Account Holder is both a citizen and a resident at the time this Form is completed. If the Account Holder is not a resident in any country in which the Account Holder has citizenship, enter the country where the Account Holder was most recently a resident. If the Account Holder is a US citizen, a Form W-9 must be provided.


Where the Account Holder’s country of tax residence is Hong Kong, the Account Holder’s TIN is the Account Holder’s Hong Kong Identity Card (HKID) number.


If a TIN is unavailable, please provide the appropriate reason A, B or C.
  • Reason A should be selected by an Account Holder where the country concerned does not, under any circumstances, issue TINs to individual tax residents. Where the country concerned does issue TINs to individual tax residents, but the Account Holder has not been issued with a TIN because of particular circumstances, Reason B should be selected instead.
  • If you have selected Reason B, please explain why the Account Holder is unable to obtain a TIN, even though the country concerned does issue TINs to individual tax residents.
  • Reason C should be selected if the country that issued the TINs does not require TINs of individual tax residents to be collected or reported.

Remarks: If there is any inconsistency or conflict between the English and the Chinese versions of these instructions, the English version shall prevail.