FACTA Self Certification Declaration This certification must be completed by all investors to declare their FATCA status or U.S. tax status. U.S. IRS
Form W-8 or W-9 is accepted in place of this declaration. Please refer to section 8 for explanations of FATCA
terms before completing this form. We strongly encourage you to seek the advice of an experienced tax or
professional adviser in relation to completing this form.
PURPOSE OF THIS FORM
The Foreign Account Tax Compliance Act (FATCA), a United States regulatory requirement that aims to deter
tax evasion by U.S. taxpayers, was introduced in 2010. From 1 July 2014 financial institutions (being managed
investment funds) are required to identify investors that hold certain “financial accounts” and are U.S. persons
or that are entities with substantial U.S. owners. Information on accounts and investments held by these U.S.
investors must then be reported to the U.S. Internal Revenue Service (IRS) via the Australian Taxation Office
(ATO).
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FACTA Terms Glossary