海外帐户税收合规法案及共同汇报标准.PDF

Account No. : 帳戶號碼: Account Name : 帳戶名稱: In order to comform with the Foreign Account Tax Compliance Act (“FATCA”) and the Common Reporting Standards (“CRS”), CIS Securities Asset Management Limited (“CIS”) is required to collect certain information (including U.S. tax status or tax residency) from its clients to determine if reporting of their personal and financial information to the relevant governmental authorities is required annually. 為了符合海外帳戶稅收合規法案及共同匯報標準，順安證券資產管理有限公司 ( 『順安』) 須向其客戶們收集若干資料 (美國稅務狀況和稅務 居住身份包括在內) ，而決定是否需要每年向有關政府部門申報他們的個人及財務資料。 As a financial institution, CIS is not allowed to give you any legal or tax advice. Any information provided in this form sha ll not be construed as any legal or tax advice. 作為一家金融機構，順安不允許向閣下提供任何法律或稅務意見。本表格所載的任何資料將不可以被解釋為任何法律或稅務意見。 If you have any questions about this form or how to determine your U.S. tax status or tax residency, please contact your legal/tax advisor or jurisdictional tax authority, or seek further information from the Internal Revenue Ser vice of the United States () or the Organisation for Economic Co-operation and Development (). 若 閣下對本表格或如何監定 閣下的美國稅務狀況或稅務居住身份有任何疑問，請與 閣下的法律/稅務顧問或管轄稅務當局查詢、或向美國 國家稅務局() 或經濟合作與發展組織() 索取進一步資料。 Entity Self-Certification Form (FATCA and CRS) 實體自我證明表格 (海外帳戶稅收合規法案及共同匯報標準) Section 1 - IDENTIFICATION OF ENTITY ACCOUNT HOLDER 第一部份 – 實體帳戶持有人身份識辨 Legal Name of Entity 實體的法律名稱 Certificate of Incorporation No. 公司註冊號碼 Business Registration No. 商業登記號碼 Current Business Address 現時營業地址 Line 1 第一行 Line 2 第二行 Country 國家