Please note, by providing these details, you have confirmed the information provided is accurate and complete. Should this information become invalid, you agree to advise DBS Bank (Hong Kong) Limited ("DBS") of such a change. If, in any event, the information provided is misleading, false or incorrect, this shall be deemed an offence and you will be liable to pay a Level 3 fine of HKD10,000.

Please note you can only proceed with the application if you are a Hong Kong tax resident.

1. Important Note - Self Certification:

Declarations for Individual Tax Residency Self Certification

I acknowledge and agree that (a) the information contained in this self-certification is collected and may be kept by DBS Bank (Hong Kong) Limited ("DBS") for the purposes of automatic exchange of financial account information and US federal income tax, and (b) such information and information regarding the account holder and any reportable account(s) (including information on DBS record) may be reported by DBS to the Inland Revenue Department of the Government of the Hong Kong Special Administrative Region and exchanged with the tax authorities of another jurisdiction or jurisdictions in which the account holder may be resident for tax purposes, pursuant to the legal provisions for exchange of financial account information provided under the Inland Revenue Ordinance (Cap.112), or to the US Internal Revenue Service pursuant to the Foreign Account Tax Compliance Act (FATCA) or to any third party including any Hong Kong or overseas government authority for the purposes of confirming or investigating the content of this self-certification , as appropriate.

I certify that the information in this self-certification is true, accurate and complete. I undertake to advise DBS of any change in circumstances which affects the tax residency status of the individual identified or causes the information contained herein to become incorrect, and to provide DBS with a suitably updated self-certification form and supporting documents if required within 30 days of such change in circumstances.

I certify that I am the account holder of all the account(s) to which this self-certification relates, and have consented to such collection, use, disclosure and processing of my personal data by DBS for the purposes of this Individual Tax Residency Self Certification.

I declare that the information given and statements made in this self-certification are, to the best of my knowledge and belief, true, correct and complete.

Important Notes for Individual Tax Residency Self Certification

This is a self-certification provided by you to DBS Bank (Hong Kong) Limited ("DBS") for the purposes of (1) automatic exchange of financial account information; and (2) US federal income tax.

The information on DBS record and data collected in this self-certification may be transmitted by DBS (i) for the purpose of (1) above, to the Inland Revenue Department for transfer to the tax authority of another jurisdiction; and (ii) for the purpose of (2) above, to the US Internal Revenue Service in the case of US persons.

The data collected in this self-certification will remain valid unless there is a change in circumstances relating to your tax status, (e.g. a change in your residence country) or other mandatory fields included on this self-certification. You must notify DBS within 30 calendar days of the change if there is a change in circumstance that makes any of the information provided in this self-certification incorrect or incomplete and provide an updated self-certification form.

As a financial institution, DBS is not allowed to give tax or legal advice regarding your tax residence. If you have any questions about your tax residency status, please speak to your tax adviser or domestic tax authority.

WARNING: For the purpose of (1) above, it is an offence under section 80(2E) of the Inland Revenue Ordinance if any person, in making a self-certification, makes a statement that is misleading, false or incorrect in a material particular AND knows, or is reckless as to whether, the statement is misleading, false or incorrect in a material particular. A person who commits of the offence is liable on conviction to a fine at level 3 (i.e. $10,000).

If there is any discrepancy between the English and Chinese versions, the English version shall prevail.

2. FATCA

a) For FATCA, please refer to:
https://www.irs.gov/businesses/corporations/foreign-account-tax-compliance-act-fatca

b) Definition of "US person":

  1. A citizen or permanent resident of the United States (e.g. US Green Card holder or someone who meets the requirements to be considered a resident under the 'substantial presence test');
  2. US corporations, partnerships, estates and trusts
  3. Any other person that is not a foreign (i.e. non-US) person (as defined under U.S. federal tax law).

3. Common Reporting Standard

a) Resident for Tax Purpose

In general, whether or not an individual or entity is a tax resident of a jurisdiction is determined by having regard to the person's physical presence or stay in a place (say, whether over 183 days within a tax year). That a person has paid taxes charged by a jurisdiction (say, value-added tax, withholding tax or capital gains tax) does not automatically render that person a tax resident of that jurisdiction. Special circumstances may cause the person to be resident elsewhere or resident in more than one jurisdiction at the same time (dual residency). Each jurisdiction has its own rules for defining tax residence. These jurisdictions have provided information on how to determine if you are resident in the jurisdiction on the following website: http://www.oecd.org/tax/automaticexchange/crs-implementation-and-assistance/tax-residency/#d.en.347760\. Please consult your lawyers or tax advisors on your tax residence(s) related matters.

b) Tax Identification Number (TIN)

"Tax Identification Number (TIN)" (including "functional equivalent") - TIN is a unique combination of letters or numbers assigned by a jurisdiction to an individual (or an entity) and is used to identify the individual (or entity) for the purpose of administering tax laws of such jurisdiction. Further details of acceptable TINs can be found at the OECD Automatic Exchange Portal at the following link: http://www.oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/

Some jurisdictions do not issue a TIN. However, these jurisdictions often utilise some other high integrity number with an equivalent level of identification (a "functional equivalent"). Examples of that type of number include (a) (for individuals) a social security/insurance number, citizen/personal identification/service code/number, and resident registration number; and (b) (for entities) a Business/company registration code/number.