CRS and FATCA ‒ Entity Self-Certification

Please consult your professional tax advisor with respect to the entity's tax residency and any related guidance on the Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS).

NOTES FOR COMPLETING THIS FORM – the form does not save details entered and information will be lost if it is not completed and submitted in one go.  To assist you to do this, you will need the following information before starting:

  • Nedbank CIS number(s) – this can be found on the communication we sent to you
  • Entity registration number
  • Registration number of entity for which you are a controlling person
  • Name, email address and SA ID or foreign passport number of your controlling person(s) that have foreign tax obligations
  • Both SA and foreign tax identification number(s) for the entity as applicable

Completing the form takes 10 - 12 minutes.

Please note that, for the purposes of this document, a number of the technical terms used in the self-certification form are defined in the attached glossary of terms; which can be accessed through the following link:

Glossary of terms for entity self-certification

If you do not want to click on a link, please type the following address in your browser:

https://www.nedbank.co.za/content/nedbank/desktop/gt/en/supplimentary/fatca_crs-glossary.html

Part 1 ‒ Identification of entity

If you have more than one entity with accounts at Nedbank, please complete a self-certification form for each entity.

 

Physical Address

If your address has changed and / or is different to the information on our records, we will ask you to bring proof into the branch to enable us to re FICA (Financial Intelligence Centre Act) you.

South African or Foreign address?

Postal Address

South African or Foreign address?

Part 2 ‒ Certify country of residence for tax purposes

Please select appropriate options that describe the entity:

2.1 Is the entity incorporated or organised or has a place of effective management outside of South Africa (SA)?

2.2 Does the entity have tax obligations, tax liabilities or tax residences outside of South Africa?

2.3   Does any of the controlling persons of the entity:

        (a)    have tax obligations, tax liabilities or tax residences outside of South Africa, or

        (b)    hold US citizenship, or are they a US person or a US national? 

Please complete a Nedbank Individual and Controlling Person Self-certification form for every controlling person to whom the above applies.

Is the entity a financial institution?

Part 3 ‒ Certify financial institution entity type

Please indicate your entity's type by selecting one of the following options:

FATCA - Sponsoring Entity GIIN

If 3.4 is selected, Please complete an IRS W-8BEN-E form.

If 3.1 is selected and 2.3 has been answered 'Yes', then complete Part 7 for every controlling person who:

(a) has tax obligations, tax liabilities or tax residencies outside of SA; or

(b) holds US citizenship, or is a US person or a US national?

In addition a Nedbank Individual and Controlling Person Self-certification form must be completed and submitted for each controlling person listed in Part 7 by the relevant controlling person.

Part 4 ‒ Certify United States tax residency

Please tick if yes

If any of the options under Part 4 have been selected, please complete IRS W-9 form for the entity.

 

Part 5 ‒ Entity tax residency

Please complete fields below in relation to the entity, indicating:

5.1 all countries (including US) where the entity is tax resident, has a tax obligation or has a tax liability; and

5.2 the tax payer identification number (TIN) for each country.

Note: If the entity takes the form of a partnership or similar legal arrangement and has no residence for tax purposes, it will be treated as having its tax residence in the jurisdiction in which its place of effective management is situated.

Part 6 - Entity classification

This section applies only for entities that are NOT financial institutions. If 'No' has been selected for all questions under Part 2 (2.1, 2.2 and 2.3), this section does not have to be completed.

The entity must select only ONE of the options below. Part 7 is applicable only if 6.8 is selected.

Entity's shares are traded on an established stock exchange

Entity is related to another entity whose shares are regularly traded on established stock exchange

If 6.8 is selected and 2.3 has been answered 'Yes', then complete Part 7 for every controlling person who:

(a) has tax obligations, tax liabilities or tax residencies outside of SA; or

(b) holds US citizenship, or is a US person or a US national?

In addition a Nedbank Individual and Controlling Person Self-certification form must be completed and submitted for each controlling person listed in Part 7 by the relevant controlling person.

Part 7 ‒ Controlling person identification

Name

Surname

ID type

Identification Number

Foreign identification number

Passport number

Email

Part 8 ‒ Declaration and acceptance of terms and conditions

I, the undersigned

(i) am authorised to sign this document on behalf of the entity and declare that all statements made in this declaration are, to the best of my knowledge and belief, correct and complete;

(ii) undertake to advise Nedbank within 30 days of any circumstances that affects the entity's tax residency status or causes the information contained herein to become incorrect, including any changes to the information on controlling persons of the entity, and to provide Nedbank with updated self-certification forms within 90 days of such change in circumstances;

(iii) understand that the information contained in this form and the information regarding any portable accounts may  be provided to SARS, and exchanged with tax authorities of another/other country/countries in which the entity or any controlling persons may be a tax resident(s) in terms of South African tax legislation; and

(iv) understand that, by selecting 'Yes' below, it is deemed that I, the duly authorised representative of the entity, have attached my signature to this document.

 

If signing under a power of attorney, please provide a copy of the power of attorney by scanning and sending it via e-mail to the following e-mail address: FATCACRS@Nedbank.co.za

Do you understand and accept the abovementioned terms?

Please note that you cannot continue if you have not accept the terms and conditions. Return to homepage