Guide on completing the Application Form for Withholding Tax Exemption
Please start to fill in the Excel Application Form for Withholding Tax Exemption as from line 6.
Safekeeping account number at HSBC
- Please enter 1 line with the safekeeping account “009-027939-314” if the applicant invests in Japanese Government Bonds (JGBs) only.
- Please enter 1 line with the safekeeping account “009-027939-317” if the applicant invests in Japanese Corporate and Municipal Bonds only.
- Please enter 2 lines: 1 line with the safekeeping account “009-027939-314” for JGBs and 1 line with the safekeeping account “009-027939-317” for Japanese Corporate and Municipal Bonds if the applicant invests in both JGBs and Japanese Corporate and Municipal Bonds.
Unique reference number
- New application: this column should be left blank for a new application.
- Renewal of application form: please enter the applicant’s TIN number for a renewal of application form.
Action for the Account (New/ Renewal)
- New application: please enter “New”.
- Renewal of application form: please enter “Renewal”.
Procedure type *Fixed
Please do not delete or modify the content of this column.
1. Date
Please fill in the date from when the tax exemption is applied before submitting the form to the Specified Book-entry Transfer Institution, etc. or the Qualified Foreign Intermediary (QFI).
Year: format must be YYYY.
Month: format must be MM.
Day: format must be DD.
2. Type of the applicant
Please select the number corresponding to the “Type of the Applicant” from the pull-down menu.
3. Name of the applicant
Please fill in the name of the applicant.
4. Individual Number or Corporate Number, Japan residents only, do not input for non-resident
Please fill in the Individual Number or Corporate Number if the applicant is an Individual Number or Corporate Number holder, for Japan residents only.
5. Address of the applicant
Please fill in the domicile or residence (outside Japan). If the applicant is a non-resident individual with residence or permanent establishment in Japan, the address of the residence or permanent establishment is to be filled in.
6. Other items required to be filled in depending on the type of the applicant
Please fill in this column:
- In case of a non-resident with a residence or PE (permanent establishment) in Japan: domicile or residence (outside Japan).
- In case of a foreign corporation with PE (permanent establishment) in Japan: address of the head office or the main office (outside Japan).
- In case of a trustee of a Qualified Foreign Securities Investment Trust (QFSIT): name and an established place of the QFSIT as well as the countries and territories where offerings were made.
- In case of a trustee of a foreign pension trust: name of the foreign pension trust and name of the foreign law or ordinance that was used as the base of its establishment.
- When receiving interest etc. on book-entry JGBs etc. that belong to the partnership assets of the partnership to which special treatment is applied or belong to the trust assets of the trust to which special treatment is applied: name and address of the main office in Japan of the partnership to which special treatment is applied or the trust to which special treatment is applied (if it has a main office outside Japan, address of the main office outside Japan), as well as name or trade name and domicile of the operating officer, etc.
7. Type of bond (JGB, etc.)
- Japanese Government Bonds: Please choose the number “1” (i.e. YES) from the pull-down menu if the applicant invests in JGBs. Please choose the number “2” (i.e. NO) from the pull-down menu if the applicant does not invest in JGBs.
- Japanese Local Government Bonds and Japanese Corporate Bonds, etc.: Please choose the number “1” (i.e. YES) from the pull-down menu if the applicant invests in Japanese Local Government Bonds and Japanese Corporate Bonds, etc. Please choose the number “2” (i.e. NO) from the pull-down menu if the applicant does not invest in Japanese Local Government Bonds and Japanese Corporate Bonds, etc.
- In the case of Book-entry transfer Discount Japanese Government Bonds (DJGBs), Discount Japanese Local Government Bonds (DJLGBs) and Discount Japanese Corporate Bonds, etc. (DJCBs): Please choose the number “1” (i.e. YES) from the pull-down menu if the applicant invests in Japanese Government Bonds (JGBs) and/or in Japanese Local Government Bonds and Japanese Corporate Bonds, etc.
QFI, etc.
8-1. Address
For clients who are holding client assets, please fill in the address of the qualified foreign Intermediary (QFI).
For clients who are holding proprietary assets, this column should be left blank.
Name
For clients who are holding client assets, please fill in the name of the qualified foreign Intermediary (QFI).
For clients who are holding proprietary assets, this column should be left blank.
8-2. Date of receipt by the qualified person at the QFI's specified foreign branch
For clients who are holding client assets, please fill in the date of receipt of the application form by the QFI.
For clients who are holding proprietary assets, this column should be left blank.
9. Name of the ID Document by which the QFI's specified foreign branch identified the applicant
For clients who are holding client assets, please fill in the name of the document used for confirmation and validation of the applicant details by the QFI.
For clients who are holding proprietary assets, this column should be left blank.
10. Remarks
In case where the applicant appoints a tax agent, please fill in the name and address of the entity appointed as the applicant's “Tax agent”.
11-1. Specified Book Entry Transfer Institution, etc.
Address and Name: These columns should be left blank by the applicant. It will be filled in by our depository.
11-2. Date application accepted *To be filled in by HSBC
Year, Month, Day: These columns should be left blank by the applicant. It will be filled in by our depository.
Important note:
Cells protection
The cells must be protected by the applicant before sending the application form to Clearstream Banking.
To protect the necessary cells, please follow the steps below:
1) Go to “Review” tab;
2) Select “Protect Sheet”;
3) Input the “Password to unprotect sheet”;
4) Press “OK”;
5) Re-enter password to proceed;
6) Press “OK”;
7) Save the file.
Password protection
The Excel application form must be password-protected and sent by email to tax@clearstream.com. The original is not required.
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1. Clearstream Banking refers collectively to Clearstream Banking S.A., registered office at 42, avenue John F. Kennedy, L-1855 Luxembourg, and registered with the Luxembourg Trade and Companies Register under number B-9248, and Clearstream Banking AG (for Clearstream Banking AG clients using Creation Accounts), registered office at 61, Mergenthalerallee, 65760 Eschborn, Germany and registered in Register B of the Amtsgericht Frankfurt am Main, Germany under number HRB 7500.