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Individual Self-Certification for FATCA and CRS

Important Notice (Please read before completion)

In line with the Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS), financial institutions like Permanent TSB plc (PTSB/Us) are obliged to collect and review information to identify the tax residence or multiple tax residences (if any) of our Account Holders.

The obligation is outlined under Section 891E, Section 891F, and Section 891G of the Taxes Consolidation Act 1997 (as amended), and regulations made pursuant to those sections, to collect certain information about each Account Holder’s tax status.

Determining your tax residency

There are country-specific rules that determine whether you qualify as tax resident of such jurisdiction. If you are unsure of your status, please seek advice from a qualified tax specialist and/or review the information provided on the OECD website for guidance.

A Specified US Person for FATCA is any U.S. person (citizen or resident) defined under tax law. They are individuals with U.S. tax obligations, subject to reporting to foreign financial institutions to prevent tax evasion.


Providing your Tax Identification Number (TIN) where you are tax resident

The TIN or its functional equivalent is a unique number assigned to individuals or entities for tax-related purposes. It is used to track and identify taxpayers for various administrative, regulatory, and reporting purposes. If you are not sure of your TIN or its equivalent, further details on acceptable TINs can be found on the OECD website.

If you, the Account Holder, have a tax residency/or multiple tax residencies outside Ireland, we are required to obtain your TIN as part of our onboarding process. Further information can be found on the Revenue website.

As a financial institution, we are not able to provide tax advice to you. If you have any questions about this form or defining your tax residency status, please contact your tax advisor or domestic tax authority.

Please note that if you are looking to open/update status on a joint or multiple Account - each Account Holder is required to complete a separate Self- Certification form.

If you have any further questions about FATCA or CRS you can find more information here.

Account Holder Details

Are you completing this form in your capacity as a Substantial Owner (for FATCA) or Controlling Person (for CRS)?

FATCA Declaration

A “Specified U.S. Person” under FATCA is someone who is treated as a U.S. taxpayer. This usually means a person who is a U.S. citizen, holds a U.S. Green Card, or lives in the U.S. for tax purposes, even if they live or bank outside the U.S. If a customer is born in the US, they are considered a Specified U.S Person and need to provide their TIN.

Please tick either (a) or (b) and complete as appropriate:

CRS Declaration

CRS Declaration of Tax Residency* (Multiple Tax Residencies is possible (other than US and Ireland))

Please complete below detailing each country where you are tax resident

Do you have further tax residencies
Do you have further tax residences

Declaration and Undertakings

I declare that the information provided in this form is, to the best of my knowledge and belief, accurate and complete.

I acknowledge that the information contained in this form may be reported to the Irish tax authorities and exchanged with tax authorities of another country or countries in which I am tax resident where those countries (or tax authorities in those countries) have entered into Inter-governmental Agreements to exchange financial account information.

I/the Account Holder undertake to advise PTSB of any change in circumstances in the above-mentioned information and provide an updated Self-Certification form which causes any of the information contained in this form to be incorrect within 30 days of such occurrence.

I agree
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