Common Reporting Standards

FATCA

Tax Residency Self-Certification Form for Common Reporting Standards

Please read these instructions before completing the applicable form.

The Mutual Administrative Assistance in Tax Matters Act based on the OECD Common Reporting Standard (“CRS”)” requires Atlantic International Bank Limited (AIBL) to collect and report certain information about an account holder’s tax residency. If the account holder’s tax residence is located outside Belize, AIBL may be legally obliged to pass on the information in this form and other financial information with respect to your financial accounts to the Income Tax Department of Belize.  They may exchange this information with tax authorities of another jurisdiction or jurisdictions pursuant to intergovernmental agreements to exchange financial account information.

This form will remain valid unless there is a change in circumstances relating to information. If your circumstances change and any of the information provided in this form becomes incorrect, please let us know immediately and provide an updated self-certification.

Please fill in Form CRS-I “Individual Tax Residency Self-Certification Form” if you are an individual account holder, sole trader or sole proprietor. For joint or multiple account holders, use a separate form for each individual person.

Please fill in Form CRS-E “Entity Tax Residency Self-Certification Form” where you need to self-certify on behalf of an entity account holder.

Please fill in Form CRS-CP “Controlling Person Tax Residency Self-Certification Form,” if you are a controlling person of an entity.

If you are completing this form on behalf of a controlling person, please indicate what capacity you are signing in Part 3. For example, you may be a representative of the entity, or completing the form under a power of attorney.

As a financial institution, we are not allowed to give tax advice.

Your tax adviser may be able to assist you in answering specific questions on this form. You can also find out more, including a list of jurisdictions that have signed agreements to automatically exchange information, along with details about the information being requested, on the OECD automatic exchange of information website: http://www.oecd.org/tax/automatic-exchange/

Personal Account Holder Form:

Corporate Account Holder Form: