Form TypeIdentify form type: Individual Self-Certification,...
Account Holder TypeIdentify account holder type: Individual, Entity, ...
Account Holder NameExtract the account holder or entity name....
Date of Birth/IncorporationExtract date of birth (individual) or incorporatio...
Place of BirthExtract place/country of birth for individuals. Re...
Current Residence AddressExtract the current residence or registered addres...
Mailing AddressExtract mailing address if different. Return Same ...
Tax Residency CountriesList all countries of tax residency declared....
TIN Country 1Extract the first country of tax residency....
TIN 1Extract the TIN for the first country....
TIN Country 2Extract second country of tax residency if applica...
TIN 2Extract the TIN for the second country. Return N/A...
TIN Country 3Extract third country of tax residency if applicab...
TIN 3Extract the TIN for the third country. Return N/A ...
No TIN ReasonIf TIN not provided, extract the reason (e.g., Cou...
US Person StatusIs the account holder a US person for FATCA purpos...
US Indicia PresentList any US indicia present (US birthplace, US add...
Entity CRS ClassificationFor entities, identify CRS classification: Financi...
Controlling Persons DeclaredFor Passive NFE, are controlling persons declared?...
Controlling Person NamesList names of controlling persons if declared. Ret...
Declaration SignatureIs the declaration signed? Yes or No...
Signature DateExtract the signature date. Return in YYYY-MM-DD f...
Financial InstitutionExtract the name of the financial institution rece...