2024年1月19日发(作者：)

Form W-8BEN (Rev. February 2006) Department of the Treasury Internal Revenue

Service

W-8BEN税表(最后更新时间2006-02) 美国财政部 国家税务管理局

Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding

在美预扣税受益人的外籍身份证明

OMB No. 1545-1621 地址：OMB No. 1545-1621

Section references are to the Internal Revenue Code. See separate instructions. Give

this form to the withholding agent or payer. Do not send to the IRS.

参见国税法。参见独立的说明。将此表交给预扣税机构或支付方，不要交给国税局。

Instead, use

Form:

代替的，应该对应使用如下表格。

Do not use this form for:

不要将本表用作以下用途：

U.S. citizen or other U.S. person, including a resident

alien individual W-9

美国公民或其他美国境内居民,包括居住在美国的外国人

A person claiming an exemption from U.S. withholding on

income effectively connected with the conduct

of a trade or business in the United States . W-8ECI

在美国的贸易或业务行为所得是免于在美国缴纳预扣税的个人

A foreign partnership, a foreign simple trust, or a

foreign grantor trust (see instructions for exceptions).

W-8ECI or W-8IMY

国外的合伙制公司,国外的简单信托,或国外的授予人信托

(参见说明中给出的例外).

A foreign government, international organization,

foreign central bank of issue, foreign tax-exempt

organization,

foreign private foundation, or government of a U.S.

possession that received effectively connected income or

that is

W-8ECI or W-8EXP

Claiming the applicability of section(s) 115(2), 501(c),

892, 895, or 1443(b) (see instructions).

外国政府,国际机构,外国指定银行,外国的免税机构,

外国的私人基金会,或者是美国的所属政府,

该政府获得相关的收入或宣称适用于第115(2),501(c),892,895或1443(b)条的规定 (参见说明)。

Note: These entities should use Form W-8BEN if they are claiming treaty benefits

or are providing the form only to claim they are a foreign person exempt from backup

withholding.

备注:如果以上这些实体希望获得税收协定优惠待遇,或只是提供表格来要求作为不受预扣税限制的外国居民,则应该使用表格W-8BEN

A person acting as an intermediary.

作为一个中间人的个人

W-8IMY

Note: See instructions for additional exceptions.

备注: 参见说明中给出的其它例外情况。

Part I Identification of Beneficial Owner (See instructions.) 受益方身份(参见说明)

1 Name of individual or organization that is the beneficial owner 作为受益方的个人或机构的名称:(填写你的名字)

2 Country of incorporation or organization 成立或组织的所在国家 (填写China)

3 Type of beneficial owner:受益方类型:(一般我们选择第一个即可，个人)

Individual 个人 Corporation 股份公司 Disregarded entity 非独立实体

Partnership合伙制公司 Simple trust简单信托 Grantor trust授予人信托 Complex

Trust复合信托 Estate房地产 Government政府 International organization国际组织

Central bank of issue国外指定银行 Tax-exempt organization免税机构 Private

Foundation私人基金

4 Permanent residence address (street, apt. or suite no., or rural route). Do not

use P.O. box or in-care-of address.

永久居住地址 (街道,室号,或邮道). 不要填写邮政信箱或转交地址，用英文填写。参照：英文地址写法和翻译原则

City or town, state or province. Include postal code where appropriate. 城市或乡镇,省,包括邮政编码

Country (do not abbreviate) 国家 (不要使用缩写)

5 Mailing address (if different from above) 邮寄地址(如果和上述地址不同填写)

City or town, state or province. Include postal code where appropriate.城市或乡

镇,省,包括邮政编码.

Country (do not abbreviate) 国家 (不要使用缩写)

6 U.S. taxpayer identification number (if required, see instructions)

美国的缴税身份编号(根据要求提供,参见说明)

7 Foreign tax identifying number, if any (optional) （SSN or ITIN 和 EIN可选）外国的缴税身份编号 (选择填写)

8 Reference number(s) (see instructions) 参考编号 (参见说明)

Part II Claim of Tax Treaty Benefits (if applicable) 税收协定优惠待遇(如果适用)

9 I certify that (check all that apply):我在此做出以下声明(选择所有的适用项):

a The beneficial owner is a resident of_________within the meaning of the income

tax treaty between the United States and that country 受益方居住在_________属于美国和该国家之间的达成的税收协定的作用范围以内。这里是我们需要填写的，填China即可。

b If required, the U.S. taxpayer identification number is stated on line 6 (see

instructions).

如果需要,在第6行中给出了美国缴税身份编号(参见说明)

c The beneficial owner is not an individual, derives the item (or items) of income

for which the treaty benefits are claimed, and, if applicable, meets the requirements

of the treaty provision dealing with limitation on benefits (see instructions).

受益方并非一个个人,拥有可以享受税收协定优惠的一项或多项所得,且如果适用的话,还满足了税收协定中限制性条款的要求(参见说明)

d The beneficial owner is not an individual, is claiming treaty benefits for

dividends received from a foreign corporation or interest from a U.S. trade or

business of a foreign corporation, and meets qualified resident status (see

instructions).

受益方并非一个个人,对其从外国公司获得的红利和外国公司在美业务中获得的利息收入,要求享受税收协定优惠待遇,

并且符合有关居民身份的规定.(参见说明)

e The beneficial owner is related to the person obligated to pay the income within

the meaning of section 267(b) or 707(b), and will file Form 8833 if the amount subject

to withholding received during a calendar year exceeds, in the aggregate, $500,000.

受益方和按照267(b)或707(b)条有义务支付的个人是相关的.如果在一个公历年度中收到的应缴纳预扣税的收入累计超过了$500,000,就会填写8833表

10 Special rates and conditions (if applicable—see instructions): The beneficial

owner is claiming the provisions of Article . . . . . . . . . . . of the treaty

identified on line 9a above to claim a . . . . . . . .% rate of withholding on (specify

type of income): Explain the reasons the beneficial owner meets the terms of the

treaty article:

特别的比例和条件(如果适用—参见说明): 受益方根据以上9a中所述的税收协定中的第………条要求退回对其………..(指出收入种类)所征收的. . . . . . . .%预扣税.

解释受益方符合税收协定中的优惠条款的具体原因

Part III Notional Principal Contracts 名义本金合同

11 I have provided or will provide a statement that identifies those notional

principal contracts from which the income is not effectively connected with the

conduct of a trade or business in the United States. I agree to update this statement

as required.

我已经提供了或将会提供一份声明,其中列出的名义本金合同所产生的收入和在美的贸易或商业活动无关.我同意按照要求对这个声明进行更新.(这个是可选的)

Part VIII Certification 证明

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:

我在此声明我已经详细检查了本表的信息,而且在我所知所能的范围内证明这些信息是真实,正确和完整的,并愿意承担作伪证的惩罚:

● I am the beneficial owner (or am authorized to sign for the beneficial owner)

of all the income to which this form relates,我是和本表格涉及的全部收入相关的受益方(或被授权代表受益方进行签署).

● The beneficial owner is not a U.S. person,受益方不是美国境内居民.

● The income to which this form relates is not effectively connected with the conduct

of a trade or business in the United States or is effectively connected but is not

subject to tax under an income tax treaty, and

本表涉及的收入不是来自在美国的业务或贸易行为,或虽然有联系但根据所得税协定不应缴税,以及

● For broker transactions or barter exchanges, the beneficial owner is an exempt

foreign person as defined in the instructions.对于中间交易或实物交易,受益方根据说明中的定义是免税的外国人.

Furthermore, I authorize this form to be provided to any withholding agent that has

control, receipt, or custody of the income for which I am providing this form or

any withholding agent that can disburse or make payments of the income for which

I am the beneficial owner.

此外,我授权可以将本表提供给任何对所涉及收入有控制,接收和监管功能的税务机构或向我这个受益方进行减退税实际支付的机构.

Sign Here

此处签名

Signature of beneficial owner (or individual authorized to sign for beneficial owner)

受益方签署(或授权代表受益方签署的个人)