R. IRS Form W-14 - Sample_W912PB26RA011.pdf

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

The form is a tax certification document required when foreign contracting parties receive federal procurement payments. It serves to establish exemptions from U.S. federal income tax withholding under Section 5000C. Part I requires identification information for the foreign contracting party, including name, country of incorporation, permanent residence address, and the acquiring agency details. Part II addresses exemptions based on international agreements, specifically allowing foreign contractors to claim relief under Section 5000C pursuant to qualified income tax treaties with the United States. Part III covers exemptions when goods or services are produced or performed in the United States, requiring documentation of the total contract price, nonexempt amounts, and the contract ratio. Part IV requires detailed explanations when claiming exemptions, including identification of relevant countries where goods are manufactured or services are provided, and the specific international procurement agreements relied upon. Part V contains certification statements under penalty of perjury, in which the foreign person certifies their identity, non-agency status, agreement to pay applicable taxes, understanding of procedural rules under Regulations Section 1.5000C-4, and confirmation of no transactions designed to avoid Section 5000C taxation. The form concludes with signature, date, and capacity-to-act fields for the foreign person or authorized representative.