or am using this form to document myself as an individual that is an owner or account holder of a foreign financial institution,
The person named on line 1 of this form is not a U.S. person,
The income to which this form relates is: (a) not effectively connected with the conduct of a trade or business in the United States, (b) effectively connected but is not subject to tax under an applicable income tax treaty, or (c) the partner's share of a partnership's effectively connected income,
The person named on line 1 of this form is a resident of the treaty country listed on line 9 of the form (if any) within the meaning of the income tax treaty between the United States and that country,
For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions, and
I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.