Late W-8 affidavit of unchanged status

Template from tincompliance.com. Under Treas. Reg. 1.1441-1(e)(4)(ii)(D) and as applied by IRS examiners (IRM 4.10.21.9.7.3, May 12, 2026), a Form W-8 obtained after a payment can be relied on for that payment if it is accompanied by a signed, dated affidavit under penalties of perjury that the information on it was accurate at the time of the payment. No affidavit is needed if the form is received within 30 days of the payment. If it is received more than one year after the payment, the affidavit must be accompanied by documentary evidence (a government-issued ID without a U.S. address, or a certificate of incorporation; for a treaty claim, photo identification issued within three years, otherwise a bank statement or utility bill). The payee signs this; the payer keeps it with the W-8. Not legal or tax advice.

Affidavit of unchanged status accompanying Form [W-8BEN / W-8BEN-E / W-8ECI / W-8EXP / W-8IMY]

Payee (beneficial owner) name: [name exactly as on line 1 of the Form W-8]

Country of residence: [country]

Foreign TIN / U.S. TIN (if any): [number]

Withholding agent (payer): [Company legal name], EIN [00-0000000]

Payment(s) covered: [description, e.g., royalty payments under agreement dated ___ ] made on [date(s)] in the amount(s) of $[amount]

I, [name of individual], [title, if signing for an entity], declare as follows:

1. I am [the beneficial owner named above / an individual authorized to sign for the beneficial owner named above].
2. The Form [W-8BEN / W-8BEN-E / W-8ECI / W-8EXP / W-8IMY] dated [date signed] and furnished to the withholding agent on [date received] is attached to this affidavit.
3. All of the information on the attached form, including [the beneficial owner's foreign status / the chapter 3 status / the chapter 4 status / the claim of treaty benefits under Article [__] of the income tax treaty between the United States and [country]] was true, correct and complete on the date(s) of the payment(s) identified above.
4. No change in circumstances occurred between the date(s) of the payment(s) and the date the form was signed that would make any information on the form incorrect for those payments.
5. [W-8ECI only:] The income identified above was, or will be, included in gross income on a United States federal income tax return for the taxable year in which it was received.
6. [If more than one year after the payment:] The following documentary evidence is attached: [government-issued identification without a U.S. address / certificate of incorporation or organization / photo identification issued within the last three years / bank statement or utility bill dated ___].

Under penalties of perjury, I declare that I have examined this affidavit and the attached form, and to the best of my knowledge and belief they are true, correct and complete.

______________________________

[Signature]

[Printed name]

[Title and capacity, if signing for an entity]

[Date]

For the payer: file this with the W-8 it accompanies. Note the received date on the form. If the affidavit is not obtained, the payment is treated under the presumption rules as of the payment date: an undocumented individual or unknown entity paid inside the United States is a U.S. nonexempt recipient (24% backup withholding and a Form 1099); an undocumented entity receiving a withholdable payment is a nonparticipating FFI (30%). Guide: tincompliance.com/guides/foreign-vendor-exam-as-the-irs-runs-it/