Attachment 3 Form W-14.pdf

Form W-14 is a Certificate of Foreign Contracting Party Receiving Federal Procurement Payments issued by the Department of the Treasury. This form is used to document the identification and tax status of foreign contractors receiving payments from the U.S. federal government.

Part I requires identification information for the foreign contracting party and acquiring agency, including the contractor's name, country of incorporation, permanent residence address, mailing address, U.S. taxpayer identification number (TIN), contract/reference number, and the name and address of the acquiring federal agency. Part II addresses exemptions based on international agreements, such as qualified income tax treaties. Part III covers exemptions based on international procurement agreements or because goods/services are produced or performed in the United States, requiring disclosure of the total contract price and contract ratio calculations. Part IV requires detailed explanations if claiming exemptions under Parts II or III, including identification of relevant countries where goods are manufactured or services are provided, and the allocation method between exempt and nonexempt amounts. Part V contains the certificate statement where the foreign person or authorized representative certifies under penalties of perjury that the information is true and complete, including specific representations regarding tax withholding obligations under Section 5000C and understanding of applicable regulations. The form requires signature, date, and capacity to act from the authorized signatory.