Tax Treaty-Based Return Position Disclosure Form
Please use this form to clearly and completely disclose your tax treaty-based return position. All fields are required for proper documentation.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Country of Residence
*
Country of Source (where income/item arises)
*
Tax Year Covered
*
Treaty Article(s) Relied On
*
Type of Income or Item (e.g., dividends, royalties, capital gains)
*
Description of the Return Position Taken
*
Explanation of How the Treaty Applies to This Position
*
Certification: I certify that the above information is true and complete to the best of my knowledge.
*
I certify
Submit Disclosure
Should be Empty: