Completing tax forms in the Portuguese market - Clearstream · Completing tax forms in the Portuguese market 7 Completing the Mod. 21-RFI Part III. Certification by the competent

Completing tax forms in the Portuguese market

Mod.21-RFI

July 2015

Completing tax forms in the Portuguese market - Mod.21-RFI

July 2015

Document number: 6827

Information in this document is valid at the time of its publication. Its content does not represent legal or tax advice or anycommitment on the part of Clearstream Banking S.A.

© Copyright Clearstream Banking S.A. (2014). All rights reserved.

Clearstream Banking S.A. is a Deutsche Börse Group company.

Foreword

The purpose of this document is to provide assistance to customers in completing Modulario 21-RFI(Mod.21-RFI) required by local tax authorities and/or regulators in connection with applications forrelief or quick reclaim of tax on dividend from holdings in equities in the Portuguese market.

How this document is organised

First, some introductory information is provided:

"In what circumstances should I submit these forms?" on page 1;

"How do I get hold of these forms?" on page 2.

This is followed by detailed guidance for completing the forms:

"Completing the Mod. 21-RFI" on page 5;

Contact details

For further information or if you have specific questions regarding this report, please contact us [email protected].

Disclaimer

The content in this document is prepared for general information purposes only. It is not intended toprovide professional legal advice and should not be relied upon in that regard. Readers should seekappropriate professional advice where necessary before taking any action based on the informationcontained in the document.

Clearstream Banking makes no guarantees, representations or warranties and accepts no responsibilityor liability as to the accuracy or completeness of the presentation, and under no circumstances will itbe liable for any loss or damage caused by reliance on any opinion, advice or statement made in thisdocument. Information in this document is subject to change without notice.

Clearstream Banking S.A. July 2015Completing tax forms in the Portuguese market i

mailto:[email protected]

Foreword

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July 2015 Clearstream Banking S.A.ii Completing tax forms in the Portuguese market

In what circumstances should I submit these forms?

If you hold Portuguese equities or certain Eurobonds and want to:

• obtain relief at source or apply for a quick refund on tax withheld on dividends; or

• renew your Mod.21-RFI (valid for a year only from the date of signature by your local taxauthorities);

then a Mod.21-RFI must be provided to Clearstream Banking along with a Position Breakdown report.

Clearstream Banking S.A. July 2015Completing tax forms in the Portuguese market 1

How do I get hold of these forms?


Follow these four steps to retrieve the Mod.21-RFI.

Step 1. Go to the Financial Portal of the Portuguese government website

In your web browser, enter the URL:

http://info.portaldasfinancas.gov.pt/pt/apoio_contribuinte/modelos_formularios/double_tax_conventions

Click on the respective icon to download the Mod.21-RFI.

July 2015 Clearstream Banking S.A.2 Completing tax forms in the Portuguese market

http://info.portaldasfinancas.gov.pt/pt/apoio_contribuinte/modelos_formularios/double_tax_conventions


Step 2. Select the document to download

Click on the respective icon to download the form you are looking for.

IMPORTANT!This document must be printed double-sided with page 4 on the reverse side of each page. That is 1/4,2/4 and 3/4.





Completing the Mod. 21-RFI

Part I. Identification of the beneficial owner

Add the country of residence of the beneficial owner.

Mandatory fields:

• Name/Business Name;

• Tax residence (street, number and floor);

• Tax Identification Number in country of residence;

• Postcode;

• City;

• Country; and

• Portuguese TIN, if any (if none, leave in blank, to be completed by the depository).



Part II. Identification of the Income

This part must be left blank; To be completed by Clearstream Banking’s depository.



Part III. Certification by the competent tax authorities

May be left blank if accompanied by a specific certificate of residence* (COR), otherwise to be completed, signedand stamped by domestic tax authorities.

* The COR has to be issued by the tax authorities of the other Contracting State and should contain a specificwording:

a) Confirming the residency of the beneficial owner for tax purposes during the period when the withholding took place; and

b) That the beneficial owner is subject to tax in the country of residence.

Part IV. Questions to be answered by the beneficial owner

Mandatory: To be completed by the beneficial owner - part A and/or B depending on legal status.



Part V. Identification of the financial intermediary

This part must be left bank. To be completed by Clearstream Banking.

Part VI. Identification of the entity resident in Portugal

This part must be left blank. To be completed by Clearstream Banking’s depository.

VII. Identification of the beneficial owner’s legal representative

To be completed by the beneficial owner’s legal representative (if the legal representative is the one completingthe below BOX VIII).

If the beneficial owner completes the BOX VIII, then BOX VII shall be left in blank.



Part VIII. Statement by the beneficial owner or the legal representative

Mandatory: To be completed by the beneficial owner or the Legal representative:

• City;

• Date of signature;

• Signature;

• Name; and

• Title/Position.



Address details

Contactwww.clearstream.com

Published byClearstream Banking S.A.

Registered addressClearstream Banking S.A.42 Avenue J.F. KennedyL-1855 Luxembourg

Postal addressClearstream BankingL-2967 Luxembourg

July 2015

Document number: 6827

http://www.clearstream.com

Completing tax forms in the Portuguese market - Clearstream · Completing tax forms in the Portuguese market 7 Completing the Mod. 21-RFI Part III. Certification by the competent

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