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Self-Certification Form – Entity (Sample form for ...

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To: (Name of Financial Institution) (Address of Financial Institution) Ref. No.: (Reference Number with the Financial Institution) Self-Certification Form Entity (Sample form for reference and adoption by financial institutions) Important Notes: This is a Self-Certification form provided by an account holder to a reporting financial institution for the purpose ofautomatic exchange of financial account information. The data collected may be transmitted by the reporting financial institution to the Inland Revenue Department for transfer to the tax authority of another jurisdiction. An account holder should report all changes in its tax residency status to the reporting financial institution.

This is a self-certification form provided by an account holder to a reporting financial institution for the purpose of automatic exchange of financial account information.

  Self, Certifications

Download Self-Certification Form – Entity (Sample form for ...


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