Attachment 4 - W-14.pdf

This is Form W-14, the Certificate of Foreign Contracting Party Receiving Federal Procurement Payments, issued by the Department of the Treasury in August 2016 (OMB No. 1545-2263).

The form serves as a certification document for foreign contracting parties receiving federal payments and consists of five main parts. Part I requires identification information including the foreign contracting party's name, country of incorporation, permanent residence address, mailing address, U.S. taxpayer identification number (if applicable), contract/reference number, and acquiring agency details. Part II addresses exemptions based on international agreements, specifically allowing claims for relief from taxes under section 5000C pursuant to 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 specification of exempt and nonexempt contract amounts and calculation of the contract ratio. Part IV provides space for explanations if Parts II or III are applicable, including detailed instructions for identifying countries of manufacture or production and allocation methods for mixed contracts. Part V contains the certificate declaration, wherein the foreign person or authorized representative certifies under penalties of perjury that they have examined the information provided and that it is true, correct, and complete. The signatory must acknowledge understanding of regulations relating to procedural obligations under section 5000C and confirm no transactions designed to avoid section 5000C taxation. The form requires signature, date, and capacity to act from an authorized representative.