Please provide answers below and click Submit information.

Required fields are marked with *

Click here to open Form W-8 ECI instructions from the IRS web site in a new window.

Note: Persons submitting this form must file an annual U.S. income tax return to report income claimed to be effectively connected with a U.S. trade or business (see instructions).

Part 1: Identification of Beneficial Owner (See instructions.)

1 User Name * : (Account that log in AVOP)

2 Name of individual or organization that is the beneficial owner * :

3 Country of incorporation or organization * :

4 Type of entity:

5 Permanent residence address. Do not use a P.O. Box.

Street Address * :
City * :
State, province or region:
Zip or postal code, if appropriate:
Country * :

6 Business address in the United States. Do not use a P.O. Box.

Street Address * :
City * :
State * :
Zip Code * :

7 U.S. Taxpayer Identification Number (required - see instructions) *

SSN or ITIN EIN

8 Foreign Tax Identifying Number, if any (optional)

9 Reference number(s) (see instructions)

10 Specify each item of income that is, or is expected to be, received from the payer that is effectively connected with the conduct of a trade or business in the United States * .

Part 2: Certification

Under penalties of perjury I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct and complete. I further certify under penalties of perjury that:

I am the beneficial owner (or I am authorized to sign for the beneficial owner) of all the income to which this form relates,

The amounts for which this certification is provided are effectively connected with the conduct of a trade or business in the United States and are includible in my gross income (or the beneficial owner's gross income) for the taxable year, and

The beneficial owner is not a U.S. person.

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner.

Signature of beneficial owner (or individual authorized to sign for the beneficial owner) (Typing in your name acts as your signature) * :	Capacity in which acting * :

The date and time of submission and your computer's IP address will be recorded when you click Submit information.