STG Certification of Non-Foreign Status (FIRPTA) (Individual)

CERTIFICATION OF NON-FOREIGN STATUS

FIRPTA Certification

INDIVIDUAL TRANSFEROR(S)

Section 1445 of the Internal Revenue Code [26 USCS § 1445] provides that a transferee (buyer) of a U.S. real property interest must withhold tax if the transferor (seller) is a foreign person. To inform the transferee (buyer) that withholding of tax is not required upon my/our disposition of a U.S. real property interest, I /we hereby certify the following:

  1. I/we am/are not a nonresident alien for purposes of U.S. income taxation;
  2. My/our U.S. taxpayer identifying number [Social Security number] is/are
    __________________________ and __________________________; and
  3. My/our home address is:
    _____________________________________________________________
    _____________________________________________________________

I/we understand that this certification may be disclosed to the Internal Revenue Service by the transferee and that any false statement I/we have made here could be punished by fine, imprisonment, or both.

Under penalties of perjury I/we declare that I/we have examined this certification and to the best of my/our knowledge and belief it is true, correct, and complete.


_______________________________________
[Signature]
Print Name: ___________________________

______________________________________
[Date]


_______________________________________
[Signature]
Print Name: ___________________________

______________________________________
[Date]

The Buyer must retain the FIRPTA Certification until the end of the fifth taxable year following the taxable year of transfer and must file the Certification with the Internal Revenue Service if required by regulation or otherwise.

For issuing guidelines on this form, see Guidelines