个人税务居民身份自我证明表格（香港）.PDF

INDIVIDUAL TAX RESIDENCY SELF CERTIFICATION FORM (HONG KONG) Please complete in BLOCK LETTERS, tick (√) the applicable box and delete as appropriate and cross out any of the unused spaces. √ Please read these instructions before completing the form. Important Notes 1. This is a self-certification form provided by you to DBS Bank (Hong Kong) Limited (“DBS”) for the purposes of (i) automatic exchange of financial account information; and (ii) US federal income tax. ()() (i) (ii) 2. The data collected may be transmitted by DBS (i) for the purpose of paragraph 1(i) above, to the Inland Revenue Department for transfer to the tax authority of another jurisdiction; and (ii) for the purpose of paragraph 1(ii) above, to the US Internal Revenue Service in the case of US persons. (i) 1(i) (ii) 1(ii) 3. This form will remain valid unless there is a change in circumstances relating to your tax status, (e.g. a change in your residence country) or other mandatory fields included on this form. You must notify DBS within 30 calendar days of the change if there is a change in circumstance that makes any of the information provided in this form incorrect or incomplete and provide an updated self‐certification form. 30 4. All sections of the form must be completed (unless not applicable or otherwise specified). If space provided is insufficient, please continue on additional sheet(s). Information in fields / sections marked with an asterisk (*) are required to be reported by DBS to the Inland Revenue Department. / * If you are filing an updated self-certification form to DBS, you must fill in again all information relating to your tax residence(s), as this updated self-certificati