CERTIFICATION - INDIVIDUAL TRANSFEROR
Re: Transfer by ______________________ to _____________________ ; Legal
Section 1445 of the Internal Revenue Code 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 disposition of a U.S. real property interest, I, _____ (name of transferor) _____ , hereby certify the following:
1. I am not a nonresident alien for purposes of U.S. income taxation;
2. My U.S. tax identifying number (Social Security number) is ______________ ; and
3. My home address is: _________________________________________________
I understand that this certificate may be disclosed to the Internal Revenue Service by the transferee and that any false statement I have made here could be punished by fine, imprisonment, or both.
Under penalties of perjury, I declare that I have examined this certification and to the best of my knowledge and belief it is true, correct, and complete.
NOTE: The transferee must retain this certification until the end of the fifth taxable year following the taxable year in which the transfer takes place. The Internal Revenue Service may require this certificate to be filed with it. This certificate is furnished for the information of the transferee; the transferee should seek legal advice as to the effect of same.
No guidelines are available for this form at this time.