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Kiri

Rahandusministeerium · 28. mai 2024
Viit
7-1.1/2494-1
Registreeritud
28. mai 2024
Dokumendi liik
Sissetulev kiri
Adressaat
State Street Bank and Trust CO
Saabumis/saatmisviis
Lihtkiri
Funktsioon
7 RIIGI FINANTSVARADE JA -KOHUSTUSTE HALDAMINE
Sari
7-1.1 Raha- ja kapitalituru dokumendid (tehingukinnitused, maksekorraldused jne) ja kirjavahetus
Toimik
7-1.1/2024
Vastutaja
Kaja Kannerma (Rahandusministeerium, Kantsleri vastutusvaldkond, Eelarvepoliitika valdkond, Riigikassa osakond)

Failid

  • 📎240528_14_33_13_originaal.pdf541 KB

Sisu (failidest)

SEINE & CD STATE STREET BANK AND TRUST CC P0 BOX 5010 B0STON, MA 02206-5010 Rahanaus, fl(nlsteerium 28 -O5 ?U2t 001692 90045769522 90301 0 0000 0 000 0139 fr -1 MINISTRY 0F FINANCE 0F THE REPUBLIC 0F ESTON SUUR AMEERIKA 1 TALLINN, 10122 ESTONIA 1 042—S 1 Foreign Person’s U.S. Source Income Subject To Wlthholding irs.govIFormIO42S for klsbntctiona and the lateat information. Go to www ©23 OMBNo 1545-0096 Copy B Department of the Treasury Internal Revenue Service 1 01 0 1 0 1 8 1 3 1 2 4 1 0 2 UNIQUE FORM IDENTIFIER AMENDED P.MENDMENT NO. for Recipient 1 lncome 2 Gross income 3 Chapter indicator Enter ‘3’ or «4» 3 13e Recipient’s U.S. TIN, if any 13f Ch.3 status code 36 code 3a Exemption code 05 4a Exemption code 15 13g Ch.4 status code 27 01 $82516.00 3b Tax rate 00 00 4b Tax rata 00 00 13h Recipients GIIN 131 Recipient’s foreign tax identification 13J L0B code number, if any 5 Wthholding allowance 6 Net income 7a Federal tax withheld $0.00 13k Recipionts account number 0139 7b Check it federal tax withheld was not deposited with the IRS because escrow procedures were applied (saa instructions) 131 Recipients date of birth (YYYYMMDD) 7c Check if withholding occurred in subsequent year with respect (0 a partnership interest . 8 Tax withheld by other agents $0.00 14a Primary Withholding Agent’s Name (it applicable) 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions) ($0.00) 14b Primary Withholding Agents EIN 10 Total withholding credit (combine boxes 7a, 8, and 9) 15 Check if pro-rata basis reporting EI $0.00 15a Intemiediary orflow-through entitys EIN, if any 15b Ch.3 status code 15c Ch.4 status code 11 Tax paid by withholding agent (amounts not withheld)(see instructions) 15d Intermediary or flow-through entity’s name 12a Withholding agent’s EIN 12b Ch.3 status code 12c Ch.4 status code 04-6258081 15 01 15e Intermediary orflow-through entitys GIIN 12d Withholding agent’s name 1Sf Country code 15g Foreign tax identification number, ifany SEINE & C0 STATE STREET BANK AND TRUST C0 12e \Mthholding agent’s Giobal Intermediary Identification Number (GIIN) 15h Address (number and street) 12f Country code 12g Foreign tax 1 entification number, if any 151 City or town, state or province, country, ZIP or foreign postal code 12h Address (number and street) 16a Payeis name 16b Payers TIN P0 BOX 5010 121 City or town, State or province, country, ZIP or foreign postal code 16c Payer’s GIIN 16d Ch 3 status code 16e Ch. 4 status code - BOSTON MA 02206-5010 13a Recipient’s name 13b Recipient’s country code 17a State income tax withheld 17b Payer’s state tax no. 17c Name of state MINISTRY 0F FINANCE OF THE REPUBLIC OF EST0N EN 13c Address (number and street) SLJURAMEERIKA1 9c,a: 13d City or town state or province Country ZIP or foreign postal code L TALLINN EN 10122 - (keep for your records) Form 1042—3 (2023) Page 1 of 5 0016929004576952290301 000000000 Explanation of Godes U.S. Income Tax Filing Requlrements Box 1. tncome Code. Generally, every nonresident alien individual, nonresident alien fiduciary, and foreign Code Typesoflncome corporation with U.S. income, including income Ihat is effeclively connecled wilh the hterest conduct of a Irade or business in the United States, must file a U.S. income lex retum. 01 Interest paid by U.S obligors-general However, no return is required 10 be iiled by a nonresidenl alien individual, nonresident 02 lnterest paid on real property mortgages alien fiduciary, or foreign corporalion if such person wae not engaged in a trade or business 03 Interest paid 10 controlling foreign corporations in the United States at any time during the lex year and if the lex liabilily of such person 04 Interest paid by foreign corporations was fuily satisfied by the withhoiding of U.S lex at the source. Corporalions tie Form 05 lnterest on tax-free covenant bonds 1120-1; ali olhers fiie Form 1 040-NR. You may get the return forme and inslruclions eI 22 Interesl paid on deposit with a foreign branch of a domestic corporation or 1RS.gov, at any liS. Embassy or consuiale, or by wriling 10: lnlernai Revenue Service, partnership 1201 N. Milsubiehi Molorway, Bioominglon, IL 61705-6613 29 Deposit interest 30 Original issue discounl (OlD) En rgie gnraIe, tout tranger non-rsident, toul organisme fidrticommissaire lranger 31 Short-term OlD non-r6sidenl eI loute soci6l lrangre percevanl un revenu aux Etats-Unis, y compris loul 33 Substitute paymenl-interest revenu driv, en feit, du fonctionnement d’un commerce ou d’une affaire aux Etats-Unis, 51 Interest paid on certain actively lraded or publicly offered securities[1j doit produire une d4ciaration d’impöl sur te revenu auprs des services tiscaux des 54 Substitute payments-interest from certain actively lraded or publicly offered ElaIs-Unis Cependanl aucune d&iaration d’impöt sur te revenu n’eet exig4e d’un 6tranger securities(1] non-rsident, dun organisme lidicommissaire rtlranger non-utsidenl, ou d’une socit4 DMdend lrangre siis n’onl pris parI å aucun commerce ou affaire aux Etate-Unis aucun momenl 06 Dividends paid by liS. corporations-general pendant I’anne fiscale et ei lee impåts donl Is sont redevabies, ont 6l enlirement 07 Dividends qualifying for direcl dividend rale acquitls per une retenue å la source sur leur selaire. Lee soci6t6s doivenl faire leur 08 Dividends paid by foreign corporatons odclaralion d’impöt en remphssanl le formulaire 1 120-F; lous lee autree redevabies doivent 34 Substilule payment-dividends rempiir te forniuiaire 1040-NR. On paul se procurer lee formuiaires de dcIeralions d’impöls 40 Olher dividend equivalenls under RC seclion 871(m) eI las instruclions y affrentes ä IRS.gov et dans toutes les smbassedes eI lous tee 52 Dividends paid on certain activeiy traded or pubiicly offered securilies[1] coneulels des Etals-Unis. Lon peul geiemenl sedreseer pour tout renseignement 53 Substilule paymenls-dividends from cerlain acliveiy traded or pubiiciy offered Internal Revenue Service, 1201 N. Milsubishi Molorway, Bioominglon, IL 61705-6613. securites[1 56 Dividend equivaients under RC seclion 871(m) as a resuil 01 appiying the Por regia general, todo extranjero no residenle, todo organismo fideicomisario extranjero no combined transaction rules residenle y loda sociedad enönima exlranjera que recibe ingresos en los Estados Unidos, Oer incluyendo ingresoe reiacionedoe con ia conducciön de un negocio o comercio dentro de los 09 Capilal gains Estados Unidos, deberå presenler una deciaraciön esladounidense de impuestos sobre ei 10 Industrial royaities ingreso. Sin embargo, no se requiere deciareciön aigune a un individuo extranjero, una 11 Motion picture or television copyright royaities sociedad enönirna extranjera u organismo fideicomisario extranjero no residente, si tai 12 Other royalties (for example, copyrighl, software, broadcasting, endorsement persona no ha efectuado comercio o negocio en los Estados Unidos duranle ei arto fiscai y payments) eila responsabiiidad con los impueslos de lal persone he sido satisfectra ptenamenle 13 Royallies paid on certain publiciy offered securities[1] mediante retenciön del impuesto de los Estados Unidos en la fuenle. Las sociededes 14 Real property ineome and natural resourees royalties anönimas envian ei Formuierio 1120-F; todos los dems contribuyentee envian ei 15 Pens,ons, annuitres, alimony, andlor insurance premiums Formulerio 1 040-NR. Se podut oblener formularios e inslrucciones en 1RS.gov y en 16 Scholarship or fellowship grants cueiquier Embejada 0 Consuledo de los Eslados Unidos 0 escribiendo directamente a: 17 Compensation for independent personal services[2j lnlernai Revenue Service, 1201 N. Miteubishi Motorway, Bioominglon, IL 61705-6613. 18 Compensalion for dependenl personal servrces[2] 19 Compensation for teaching[2J Im atgemeinen muss jede eusländische Einzelperson, jeder ausltndieche Bevolimächligle 20 Compensation during sludying and lraining[2j und jede ausländisohe Gesellscheft mit Einkommen in den Vereinigten Steelen, 23 Olher income einschhesshch des Einkommene, welches direkt mit der Aueubung von Handel oder 24 Qualified investment entity (OlE) distributions of capital gains Gewerbe innerhalb der Staelen verbunden ist, eine Einkommensteuererkiarung der 25 Twst distributions subject 10 IRC seetion 1445 Vereinigten Slaaten ebgeben. Eine Erkiärung, mues jedoch nicht von Ausländem, 26 Unsevered growing crops and limber dislribulrons by a trusl subject to ausländischen Bevotmäctrtigten oder ausi8ndischen Geselischaften in den Vereinigten IRC section 1445 Staaten eingereichl werden, falls eine soiche Person wahrend des Steuerjshres kein 27 Publicly lraded parlriership distributions subject 10 IRC section 1446(a) Gewerbe oder Handel in den Vereiniglen Slaaten auegeubl heI und die Sleuerschuld durch 28 Gambling winnings[3] Einbehaltung der Sleuern der Vereinigten Steaten durch die Einkommensquelie abgegollen 32 Notional principal conlracl income[4) ist. Geseliechaften reichen den Vordruck 1120-F ein; alle anderen reichen das Formblett 35 Subetitute payment-other 1040-NR ein. 36 Capilal gains dislribulions Einkommensteuererklärungen und lnslruklionen können unler IRS.gov und bei den 37 Retum of capilal Botschatten und Koneulaten der Vereiniglen Slaelen eingehoit werden. Um weilere 38 Eligible deferred compensation items subject 10 IRC section 877A(d)(1) informalionen wende man sieh bitle en: Internel Revenue Servine, 1201 N. Milsubiehi 39 Dislribulions from a nongrantor lrusl subject 10 1RC section 877A(f)(1) Motorway, Bloomington, IL 61705-6613. 41 Guaranlee of indebtedness 42 Earnings as en artist or athlete-no central withholding agreement[5j 43 Earnings as an artist or alhiete-cenlral wilhholding agreemenl[5] 44 Specified federal procurement paymenls 50 lncome previously reported under escrow procedure[6] 55 Taxable death benefils on iife insurance conlracts 57 Amount reaiized under IRC seetion 1446(f) 58 Pubiiciy lraded partnership distributions-undeterminect Boxes 3a and 4a. Exemption Code (applies Wthe tax rata enterad in box 3b or 4b ts 00.00). Code AuyforExamptio4l Chapter3 01 Effectiveiy connecled income 02 Exempl under 1RC[7] 03 income is not from U.S. 04 Exempl under tax lreaty 05 Portfoiio interest exempt under IRC 06 01 Ihal assumes primary wilhholding responsibility 07 WFP0rWFT 08 US. branch treated as U.S. Person 10 01 represenls ihal income is exempl 11 QSL that assumes primary withholding responsibility 12 Payee subjecled 10 chapler 4 wilhhoiding 22 QDD that essumes primary wilhholding responsibility 23 Exempt under section 897(i) 24 Exempt under section 892 See back of Copy C for sdditionai codes [1) This code ehould only be used if the income paid is described in Regulatione seolion 1.1441 -6(c)(2) and the wilhholding agenl has reduced the rale of wilhhoiding under an income lex treely withoul the recipienl providing a liS. or foreign TIN. [2) lf nompeneation that otherwise wouid be covered under ineome Codes 17 lhrough 205 directly allributabie 10 Ihe recipienl’s occupalion as an ertist or athlele, usa ineome Code 42 or 43 instead. Page 2 of 5 1 042—S 1 Foreign Person’s U.S. Source Income Subject To Withholding ©23 OMB No. Deparlmenl of the Treasury Inlernal Revenue Servce 1 Income 2 Gross income I 0 for o to ww rs.gov/FormIo42S ndcalor. Enler ‘3” - Insfrudlons end the Ietest Information. 1 o 1 1 o 1 8 1 3 1 2 1 4 1 0 1 2 1 UNIQUE FORM IDENTIFIER 3 L1 AMENDED 13e Recpient’s U.S. TIN, if any AMENDMENT NO. Copy C for Recipienl Allach 10 any Federal lex return you file 13! Ch3 slatus code 36 code 01 3a Exemplion code 05 4a Exemption code 15 13g Ch.4 slalus code 27 $82516 00 3b Tee rata 00 00 4b Tax rale 00.00 13tt Recipients GIIN 131 Recipienls loreign lex idenhEcalion 13j LOB code number, 4 any 5 V1lhholding allowance 6 HeI income 7a Federal lex withheld $0.00 13k RecipienFs account number 0139 7b Check 4 federal lex wilhheld was fbI deposiled with the IRS because escrow procedures were applied (see iflSlruCtiOflS) 131 Recpient’s dale 0! birth (YYYYMMDD) 7c Check 4 wllhhotcling occurred in subsequenl year wilh respect 10 a parlnershlp interesl 8 Tax wdhhetd by other agenls $0.00 14a Primary Wtlhholding Agenls Name (if applicable) 9 Overwilhhetd lex repaid 10 recipient pursuant 10 adjustment procedures (see nstwclions) ($0.00) 14b Primary Viiilhholding Agenls EIN 10 Tolal withholdirig credil (combine boxes 7a, 8, and 9) 15 Check 4 pro-rata basis reporling $0 00 15a Intermediary or llow-lhrough entily’s EIN, 4 any 15b Ch.3 slalus code 5c Ch.4 slatus code 11 Tax paid by wilhhotding agenl (arrrounls fbI withheld)(see instruclions) 15d Intermediary or flow-lhrough enlity’s name 12a V1lhholding agenls EIN 12b Ch.3 slatus code 12c Ch.4 slalus code 04-6288081 15 01 ISe Inlermediary orflow-lhrough enlilys GIIN 12d V1thholding agerils narrte 151 Country code 15g Foreign lex dentificalion number, if any SEINE & CO STATE STREET BANK AND TRUST CO 12e V4thholding agents Giobal Intermediary ldenlihcalion Number (GIIN) 1511 Address (nuinber and street) 12! Country code 12g Foreign lex identifioalion number, 4 any 151 City or lown, slale or province, counlry, ZIP or foreign poslal code 12h Address (number and slreel) 16a Payer”s name 18b Payer’s TIN P0 BOX 5010 121 Cily or town, sIale or province, counlry. ZIP orforeign poslal code 16c Payer’s OlIN 16d Ch. 3 Slalus code 16e Ch. 4 elatus code BOSTON MA 02206-5010 13a Recipienls name 13b Recipienl’s eounlry code 17a SIale income tax wilhheld 17b Payer’s slate lex no. 17c Name 0! sIale MINISTRY OF FINANCE OF THE REPUBLIC OF ESTON EN 13c Address (number and sIteet) SUURAMEERIKA1 . 13d Cily or lown slate or province Country ZIP or foreign poslal code TALLINN EN 10122 r Form 1042-8 (2023) Page3of5 00169290045769522903020 0000 0000 Explanation of Codes continuad 09 Ragistarad Daamad-Compliant FFI-Othar 10 Cartitiad Daemad-Compliant FFt-Qthar Chapter4 11 Cartifiad Deamad-Compliant FFt-FFI with Low Valua Accounta 13 Grandfatharad payment 12 Cartitiad Daamad-Compliant FFI-Nonragiatering Local Bank 14 Effeclivaly connactad incoma 13 Cartitiad Daamad-Compliant FFI-Sponaorad Entity 15 Payee not aubjact 10 chaptar 4 withholding 14 Cartitiad Daamad-Compliant FFI-Invaatmant Errtity that doaa not maintain 16 ExcIudad nontinancial paymant tinancial accounts 17 Foraign Entity ttiat aasumas primary w4hholding raaponsibility 15 Nonpanicipating FF1 16 11.8. Payaas-of participating FF1 or ragisterad daamad-compliant FF1 16 Ownar-Documantad FF1 19 Exampt kom withholding undar tGA(8j 17 11 5 Brench-traatad aa 11.5. paraon 20 Dormarit accouril[9] 16 liS. Branch-not traatad aa 11.5. paraon (raporting unctar saction 1471) 21 Other-paymant not subjact 10 chaptar 4 withhotding 19 Pasaiva NFFE idantitying Subalantial U.S. Ownara 20 Passiaa NFFE with no Subatantial 11.5. Ownars Boxea 12b, 12c, 13f 13g, 15D, ISo, 18d, and 16e. WthholdktgAgent, 21 Publicly Tradad NFFE or Aifilieta ot Publicly Tradad NFFE Reciplent Intaanadiaty, and Payer Chapter 3 and Ghapter 4 Statua Godaa. 22 Activa NFFE 23 tndividual Gode Type of Reciplent, Wthholdfrig Agant Payer, or Intermediaiy 24 Seelion 501(c) Entitiaa Chapter 3 Statua Codea 25 Eecaptad Tarritory NFFE 05 11.5. branch-traatad as 11 8. Parson(10j 26 Excapted NEFE-Othar 06 11.5. branch-not traatad aa 11.5 Parson[1 1] 27 Exampt Banaficial Owner 07 11.5. branch-ECI prasumption appliad 28 Entily 1AhoIIy Ownad by Exampt Banaticial Ownare 08 Partnarship othar than Withhotding Foraigri Partnarship 29 Unknown Racipiant or Publicly Tradad Partnarahip 30 Racalcitrant Account Holdar 09 Wthholding Foraign Partnarahip 31 Nonraporting IGA FFt 10 Trust othar than Withholding Foraign Truat 32 oireet raporting NFFE II Wthholding Foraign Trust 33 11.5. raportabia eccount 12 Qualifiad Intarmadiary 34 Nonconeanting 11.8 account 13 Qualifiad Sacuritiaa Landar-Qualitiact Intarmadiary 35 Sponsorad diract raporting NFFE 14 Qualitiad Sacuritias Landar-Othar 36 Eacaptad Intar-attiliate FF1 15 Corporation 37 Undocumantad Praaxisting Obiigation 16 Individual 38 11.8. Branch-ECt praaumption appliad 17 Estata 39 Account Holdar of Excludact Financial Account(13] 16 Privata Foundation 40 Pasaiva NFFE reportad by FFI(14] 19 International Organization 41 NFFE aub)act to 1472 withholding 20 Tax Exempt Organization (Saction 501(c) entities) 50 11.5. Withholding Agant-Eoraign branch of FI 21 Unknown Recipient Pooted Repo.Itng Godes 22 Artiat or Athlata 42 Racalcitranl Pool-No U.S. tndicia 23 Pension 43 Racalcitrent PooI-1l.5. Indicia 24 Foraign Central Bank ot lasue 44 Racalcitrent PooI-Dorment Account 25 Nonqualitied tntarmediary 45 Racalcitrant PooI-U.S. Paraona 26 Hybrid arttity making Traaty Ctaim 48 Racalcitrant Pool-Paasiva NFFEa 35 Qualifiad Derivativea Daalar 47 Nonperticipatirrg FFt Pool 38 Foraign Govarnment-Intagral ParI 48 liS. Payaas Pool 37 Foraign Govarnmant-Controllad Entity 49 Qt-Racalcitrant PooI-Ganaral[1 5] 38 Publicly Tradad Partnarahip 39 Diaclosing Qualitiad Intarmediary Box 13]. LOS Gode (antar Itte code IlmI best desoribes the appllcebla limitatton on benefits Pooled Reportlrtg Codes[12) (LOS) cetegoty thst qual Sas the taxpeyer for the requested treaty benefits). 27 Wthholding Rata Pool-Ganaral LOS Code LOS Treaty Gategoty 28 Withholding Rata PooI-Exampl Organination 02 Govarnmant contracting atata!political aubdiviaionllocal authority - 29 PAI Withholding Rata Pool-Ganaral 03 Tax asampt pansion truatlPanaion (und 30 PAI Vdthholding Rata PooI-Exampt Organization 04 Tee asamptlCharitabla organization 31 Agancy Wtthholding Rata Pool-Ganaral 05 Publicly tradad corporalion 32 Agancy Wthholding Rata PooI-Exampt Organiaalion 08 Subaidiary ot publicly tradad corporation 07 Company that maata tha ownamhip and baaa aroaion taat Chapter 4 Statua Godes 08 Company that maata tha darivaliva banatita taat 01 U.5. Wthholding Agant-FI 09 Company with an itam ot incoma that maata tha activa trada or buainaaa taat 02 11.5 Wthtrolding Agant-Othar 10 Diacretionary datarmination 03 Tarritory Ft-not traatad es 11.8 Paraon 11 Othar 04 Tamtory Ft-traatad ea 11.5. Parson 12 No LOS articla in traaty 05 Participating FFt-Othar 08 Participating FFt-Raporting Modal 2 FF1 07 Ragiatarad Daamad-Compliant FFI-Raporting Modal 1 FFt 08 Ragiaterad Daamad-Cornpliant FFI-Sponaorad Entity [31 Subject lo 30% wilhholding rata unleaa the recipient ia kom one of the treety countriea liated under Gambling winninge (Inccma Code 28) in Pub, 515. (4] Usa appropriate tntereat Income Code for embedded intereat in a notional principal contract [5] tncome Code 43 ahoutd only be uaed 4 Letter 4492, Venua Notification, haa been iaaued by the tnternal Revenue Semice )otherwiae, uae Income Code 42 for eaminga aa en ertiat or ethlete). tf Income Code 42 or 43 ia uaed, Recipient Code 22 (ertiat or ethlete) ehould be ueed ineteed ot Recipient Code 16 (individual), 15 (corporation(, cr08 (partnerahip other then withholding foreign pertnerehip or publicly treded pertrrerehip). [6) Usa only te report groaa income the tee for which ia baing depoaited in the current yeer becauae auch tee wea praviouely eecrowed for cheptare 3 and 4 and the withhotding agant previoualy raported the grosa incoma in e prior yaar and checked the box to raport the lex ee not dapoaited under the eacrow procedure, Saa the inatructione te thia form for further explanetion. [7] Thia code should only ba uaed if no olher apecific chepter 3 exemption code appliea. [8] Uaa only te report e 11 5. reponable account or nonconaenting U.5. eccount thet ia receiving e payment eub)ect to chepter 3 withholding. [9] Usa only 4 epptying the aacrow procedure for dorment accounta under Regulationa eeclion 11471 -4(b)(6) tf tex waa withheld and depoaited under chepter 3, do not check box 7b (“tax not depoaited with IRS purauent te aacrow procedure”). You muat inetaad entar “3” in box 3 and complete box 3b. [10] Thia code een be uaed by e Territory EI thet ia treeted aa a 11.5. peraon. [11] Thie code een be uaed by e Territory EI Ihet ia not treated ea e U.S peraon [12] Codee 27 through 32 ahould only he uaad by e 01, QSL, WP, or wr. AlI acting ase 000 may usa only code 27 or 28 [13] Thie code ehould only be ueed if income ia peid te en eccount thet ie eecluded from the detinition ot tinanciel eccount undar Reguletiona aaclion 1.1471 -5)b)(2) or ender Annex II of the appticeble Modet 1 IGA or Modet 2 IGA. [14] Thie code ahould only he uaed when the withholding egent haa racaived a cartitication on the EEI withholding atatement ot e perticipeting FF1 or ragietared deemed-compliant EEI thet mainteina the eccount thet the FF1 hea reported the eccount held by the peasive NEEE ea e 11.8. eccount (or U.S. raporteble eccount) under te EATCA raquirementa. The wittrtrotding agent muet report the neme and GIIN of auch FF1 in boxea 15d and 15a. [15] Thie code ahould only he uaed by e withholding egent that ia reporting a peyment (or portion ote peyment) made tee ei with reepect te the Ola recalcitrent ecccunt hoidere. Pege4of5 1 042S 11 FeiWI Peon’s U.S. Source Income Subject To Withholding Go to www.Irs.govIFom1042S for Insbudlons and the test infofmatlon. ©23 l OMB No 1545-0096 Copy D for Recipient Department of the Treasury 1 1 1 Attach to any state tax retum you Se Internal Revenue Service 0 01 0 0 1 8 3 1 2 1 41 0 21 UNIQUE FORM IDENTIFIER AMENDED AMENDMENT NO. 1 tncome 2 Gross income 3 Chapter indicator Enter’ or 4 3 13e Recipienrs U S TIN, if any 13f Ch 3 status code 36 code 3a Exemption code 05 4a Exemphon code 15 13g Ch 4 status code 27 0-1 $82516 00 3b Tax rate 00 00 4b Tee rate 00 96 13tt Recipients OlIN 131 Recipients foregn tax ident4ication 13J LOS code number, 4 any 5 V1thholding allowarice 6 Net income 7a Federal lex withheld $0 00 13k Recipients account number 0139 7b Check 1 federal tax withheld was fbI deposited with the IRS because escrow procedures were applied (see Instructions) ......... 131 Recipient’s date of birth (YYYYMMDD) 7c Check if withholding occurred in subsequent year with respect 10 a partnership interest 8 Tax withhelct by other agents $0.00 14a Primary Withholding Agents Name (if applicable) 9 Overwithheld tax repaid 10 recipent pursuant 10 adjustment procedures (see instructions) ($0.00> 14b Primary Withholding Agents EIN 10 Total withhoIdng credit (combine boxes 7a, 8, and 9> 15 Check 1 pro-rata basis reporting soo 15a Intermediary or ftow-through entitys EIN, 4 any 15b Ch 3 status code 15c Ch.4 status code 11 Tax paid by withholding agent (amounts not withheld)(see instructions) 15d Intermediary orflow-through entitys narne 12a Wtthholding agents EIN 12b Ch.3 status code 12c Ch.4 status code 04-6288081 15 01 15e Intermediary or ftow-through entity s GIIN 12d Wthholding agents name 1Sf Country code 15g Foreign tax identification number, 4 any SEINE & Cl STATE STREET BANK AND TRUST Cl 12e Withholding agents GIobal Intermediary Identification Number (GIIN) 15tt Address (number and street) 12f Country code 12g Foreign tax identification nuriber, 4 any 151 City or town, state or province, country, ZIP or foreign postal code 12h Address (number and street> 16a Payeis name 16b Payes TIN P0 BOX 5010 121 City or town, state or province, country, ZIP or foreign postal code 16c Payer’s GIIN 16d Ch. 3 status code 16e Ch. 4 status code BOSTON MA 02206-5010 13a Recipient’s name 13b Recipients country code 17a State income tax withheld 17b Payer’s state tee no. 17c Name of state MtNtSTRY OF FINANCE OF THE REPUBLIC IF ESTIN EN 13c Address (number and street> . SUUR AMEERIKA 1 13d City or town state or province country ZIP or foreign postal code TALLINN EN 10122 Form 1042-8 (2023) Page 5 of 5 0016929004576952290303 1 0000 0000
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