7/9/2020 Tax Information Interview
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Reference Id: A10050392XDCL03EBB71V
Certificate of Foreign Status of Beneficial
Owner for United
States Tax Withholding and Reporting SUBSTITUTE
Form W-8BEN (Individuals) (July 2017)
Do NOT use this form if: Instead, use Form:
You are NOT an individual W-8BEN-E
You are a U.S. citizen or other U.S. person, including a resident alien individual W-9
You are a beneficial owner claiming that income is effectively connected with the conduct of trade or business W-8ECI
within the U.S. (other than personal services)
You are a beneficial owner who is receiving compensation for personal services performed in the United States 8233 or W-4
A person acting as an intermediary W-8IMY
Part I Identification of Beneficial Owner
1 Name of individual who is the beneficial owner 2 Country of citizenship
Muhammad Asad Nazeer Pakistan
3 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
House# 1064/A3 Bilal Street Adra
City or town, state or province. Include postal code where appropriate.
Rawalpindi Punjab 46000
Country
Pakistan
4 Mailing address (if different from above)
City or town, state or province. Include postal code where appropriate.
Country
5 U.S. taxpayer identification number (SSN or ITIN), if required (see 6 Foreign tax identifying number (see instructions)
instructions)
Part II Claim of Tax Treaty Benefits
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7/9/2020 Tax Information Interview
9 I certify that the beneficial owner is a resident of within the meaning of the income tax treaty between the United States and that
country.
10 Special rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of of the treaty
identified on line 9 above to claim a % rate of withholding on (specify type of income):
Explain the additional conditions in the Article and paragraph the beneficial owner meets to be eligible for the rate of withholding:
Part III Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true,
correct, and complete. I further certify under penalties of perjury that:
1. I am the individual that is the beneficial owner (or am authorized to sign for the individual that is the beneficial owner) of all the income to
which this form relates or am using this form to document myself for chapter 4 purposes,
2. The person named on line 1 of this form is not a U.S. person,
3. The income to which this form relates is (a) not effectively connected with the conduct of a trade or business in the United States, (b)
effectively connected but is not subject to tax under an income tax treaty, or (c) the partner's share of a partnership's effectively connected
income,
4. The person named on line 1 of this form is a resident of the treaty country listed on line 9 of the form (if any) within the meaning of the
income tax treaty between the United States and that country, and
5. For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the
beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. I agree that I
will submit a new form within 30 days if any certification made on this form becomes incorrect.
The Internal Revenue Service does not require your consent to any provisions of this document other than the certifications required to
establish your status as a non-U.S. individual and, if applicable, obtain a reduced rate of withholding.
Muhammad Asad Nazeer 07-09-2020
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY) Capacity in which acting
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