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Testing Fatca


    Please complete the following questions:

    Name of Company
    Jurisdiction e.g. DIFC, ADGM
    Commercial License/Registration Number

    Section 1 – Financial Institution

    1. Is the company licensed by the Central Bank, Securities and Commodities Authority or Insurance Authority to provide financial services?

    1.a If the answer to question 1 above is yes, please specify the following which regulator and the license type(i.e. what financial services)

    2.a Is the company (or any part of its financial assets*) managed by another entity that is licensed (whether by a UAE regulator or another regulator outside of UAE) to provide the following financial services?
    1. Trading in money market instruments (such as checks, bills, certificates of deposit and derivatives), foreign exchange, interest rate and index instruments, securities or commodity futures trading

    2. Portfolio management

    3. Other forms of managing funds or money on behalf of other persons

    2.b Is the company (or any part of its financial assets) managed by another entity that is licensed (whether by a UAE regulator or another regulator outside of UAE) to provide the following financial services?
    1. Deposit taking e.g. banking services

    2. Custodial services e.g.(i.e. main business is to hold financial assets* for others along with related financial services)

    3. Cash value insurance policies and/or annuities

    3. In the last 3 years (or shorter period if the company has been in existence for less than 3 years) -
    a. Did 50% or more of the company’s gross income come from investing, reinvesting, or trading in financial assets*?

    b. Was the company, or any part of its financial assets* during that time being professionally managed by:
    1. A bank or similar deposit-taking institution

    2. A custodial institution (i.e. main business is to hold financial assets* for others along with related financial services),

    3. A Specified Insurance Company (e.g. one that provides cash value and annuity contracts) or

    4. Aprofessional investment entity?

    4. Does the company operate as, or hold itself out to be, any of the following?
      1. Collective investment vehicle

      2. Mutual fund - Exchange-traded fund

      3. Private equity fund

      4. Hedge fund

      5. Venture capital fund

      6. Leveraged buyout fund

      7. Any similar type of investment vehicle established with an investment strategy of investing, reinvesting, or trading in financial assets*.

      * Financial Assets include a security, partnership interest, commodity, swap, insurance contract or annuity contract, or any interest (including a futures, forward contract or option).

      [group section-2]

      Section 2: NFFE/NFE

      1a. In the last calendar year did the company earn less than 50% of its gross income from passive income*** (including dividends, interest, annuities and rent)?

      1b. In the last calendar year was less than 50% of its assets held for the purpose of producing passive*** income?

      2. Is the company’s stock regularly traded on an established securities market or is it part of a group in which a related entity** has stock that is regularly traded on an established securities market?

      3. Is the company a holding company of a non-financial group (i.e. substantially all of its activities consist of holding (in whole or in part) the outstanding stock of, or providing financing and services to, one or more subsidiaries that engage in trades or businesses other than financial services business.

      4. Is the company a start-up i.e. it is not yet operating a business and has no prior operating history, but is investing capital into assets with the intent to operate a business other than as a Financial Institution.

      NB: this exception does not apply after 24 months from the date of the initial organisation of the company.

      5. Is the company a treasury centre for members of its group, i.e. does it primarily engage in financing and hedging transactions with, or for, related entities that are not financial service providers and does not provide financing or hedging services to any entity that is not a related Entity.

      NB: The group of any such related entities** must be primarily engaged in a business other than that of providing financial services as a business.

      6. Non-profits: i.e. established or operated exclusively for religious, charitable, scientific, artistic, cultural, athletic, or educational purposes; or it is operated in UAE as a professional organisation, business league, chamber of commerce, labour organisation, agricultural or horticultural organisation, civic league or an organisation operated exclusively for the promotion of social welfare.

      7. Does the company file FATCA reports directly with the IRS?

      **Related Entity of another Entity means: if either Entity controls the other Entity, or the two Entities are under common control. For this purpose control includes direct or indirect ownership of more than 50 percent of the vote or value in an Entity.
      *** Income in respect of which, broadly speaking, the recipient does not participate in the business activity giving rise to the income, e.g. dividends, interest, rental income, royalties, etc. www.oecd.org/ctp/glossaryoftaxterms.htm#P

      [group section-3]

      Section 3 - FATCA

      1. Has the company supplied W8 forms to a US withholding agent to certify that it is deemed compliant with FATCA requirements because of an exemption under US tax laws?

      2. Is the company registered with the IRS to confirm that it meets certain requirements for exemption from FATCA reporting in the UAE?

      3. Has any other entity, whether in the UAE or elsewhere, registered the company with the IRS for the purpose of filing FATCA reports on its behalf?

      4. Has the company registered with the IRS for a Global Intermediary Identification Number (GINN)?

      5. If the answer to question 3 of this section is yes, please provide GIIN number.


      [group section-4]

      Section 4 – Please Provide A Brief Description Of The Company’s Purpose, Actual Activities & Its Income Sources


    Submitted by:


    Email Address:

    Contact Phone No.:

    Digital Signature [signature* digital-sign color:#a02b87 backcolor:#dddddd width:300 height:200]

    Required documents

    Certificate of incorporation [multifile* upload-1 limit:2097152 filetypes:jpg|jpeg|pdf|png]

    Most recent Commercial License [multifile* upload-2 limit:2097152 filetypes:jpg|jpeg|pdf|png]

    Change of Name certificate if the company’s name has been changed since incorporation [multifile upload-3 limit:2097152 filetypes:jpg|jpeg|pdf|png]

    An organizational chart of the group structure where any referred entity is a member of a group [multifile* upload-4 limit:2097152 filetypes:jpg|jpeg|pdf|png]

    Most recent 3 years financial statements/accounts [multifile* upload-5 limit:2097152 filetypes:jpg|jpeg|pdf|png]

    Statement of income for the year 2021 [multifile* upload-6 limit:2097152 filetypes:jpg|jpeg|pdf|png]

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      63739 street lorem ipsum City, Country


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