IMPORTANT For UPDATING ONLY previously submitted info

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Part I Identification of Beneficial Owner

Without either of these numbers, unless your country has a Tax Treaty with the USA, 30% will be withheld from your royalty payment and paid to the US Internal Revenue Service per IRS regulations.

If you DO NOT have a U.S. Social Security Number (SSN) you will need to obtain a ITIN (if you do not already have one). You can get it and assistance if you live outside the USA in most countries. Copy and past link below to see if your country is listed with Agents or see local CPA Firms listed at top of page. https://www.irs.gov/individuals/acceptance-agent-program

Enter as Month/Day/Year

If you DO NOT have one, leave this field blank

Part II Claim of Tax Treaty Benefits

Part III Certification

Signature of beneficial owner (or individual authorized to sign for beneficial owner)

Explain the capacity in which acting (if form is not signed by beneficial owner)

Enter as Month/Day/Year