CERTIFICATION OF NON-FOREIGN STATUS
Section 1445 of the Internal Revenue Code [26 USCS § 1445] provides that a transferee of a U.S. real property interest must withhold tax if the transferor is a foreign person. For U.S. tax purposes (including section 1445 [26 USCS § 1445]), the owner of a disregarded entity (which has legal title to a U.S. real property interest under local law) will be the transferor of the property and not the disregarded entity. To inform the transferee that withholding of tax is not required upon the disposition of a U.S. real property interest by ___________________________________________________ [insert name of transferor] (hereinafter, the "Transferor"), the undersigned hereby certifies the following on behalf of the Transferor:
The Transferor understands that this certification may be disclosed to the Internal Revenue Service by the transferee and that any false statement contained herein 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, and I further declare that I have authority to sign this document on behalf of the Transferor.
Print Name: ___________________________
Print Title: ___________________________
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.
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For issuing guidelines on this form, see Guidelines.