2024年2月6日发(作者：)

FormW-8BENᮣ(Rev. February 2006)Department of the TreasuryInternal Revenue ServiceCertificate of Foreign Status of Beneficial Ownerfor United States Tax WithholdingSection references are to the Internal Revenue Code.ᮣSee separate instructions.ᮣGive this form to the withholding agent or payer. Do not send to the No. 1545-1621Do not use this form for:●A U.S. citizen or other U.S. person, including a resident alien individual●A person claiming that income is effectively connected with the conductof a trade or business in the United States●A foreign partnership, a foreign simple trust, or a foreign grantor trust (see instructions for exceptions)●A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization,foreign private foundation, or government of a U.S. possession that received effectively connected income or that isclaiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) (see instructions)Note: These entities should use Form W-8BEN if they are claiming treaty benefits or are providing the form only toclaim they are a foreign person exempt from backup withholding.●A person acting as an intermediaryNote: See instructions for additional d, use Form:W-9W-8ECIW-8ECI or W-8IMYW-8ECI or W-8EXPW-8IMYPart I13Identification of Beneficial Owner

(See instructions.)2Disregarded entityGovernmentName of individual or organization that is the beneficial ownerType of beneficial owner:Grantor trustCentral bank of issueIndividualComplex trustTax-exempt organizationCorporationEstatePrivate foundationCountry of incorporation or organizationPartnershipSimple trustInternational organization4Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of or town, state or province. Include postal code where y (do not abbreviate)5Mailing address (if different from above)City or town, state or province. Include postal code where y (do not abbreviate)7EINForeign tax identifying number, if any (optional)68U.S. taxpayer identification number, if required (see instructions)SSN or ITINReference number(s) (see instructions)Part II9abcde10Claim of Tax Treaty Benefits (if applicable)The beneficial owner is a resident ofwithin the meaning of the income tax treaty between the United States and that country.I certify that (check all that apply):If required, the U.S. taxpayer identification number is stated on line 6 (see instructions).The beneficial owner is not an individual, derives the item (or items) of income for which the treaty benefits are claimed, and, ifapplicable, meets the requirements of the treaty provision dealing with limitation on benefits (see instructions).The beneficial owner is not an individual, is claiming treaty benefits for dividends received from a foreign corporation or interest from aU.S. trade or business of a foreign corporation, and meets qualified resident status (see instructions).The beneficial owner is related to the person obligated to pay the income within the meaning of section 267(b) or 707(b), and will fileForm 8833 if the amount subject to withholding received during a calendar year exceeds, in the aggregate, $500,l rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of Articletreaty identified on line 9a above to claim a% rate of withholding on (specify type of income):Explain the reasons the beneficial owner meets the terms of the treaty article:of III11Notional Principal ContractsI have provided or will provide a statement that identifies those notional principal contracts from which the income is not effectivelyconnected with the conduct of a trade or business in the United States. I agree to update this statement as IVCertificationUnder penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. Ifurther certify under penalties of perjury that:1 I am the beneficial owner (or am authorized to sign for the beneficial owner) of all the income to which this form relates,2 The beneficial owner is not a U.S. person,3 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 isnot subject to tax under an income tax treaty, or (c) the partner’s share of a partnership’s effectively connected income, and4 For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the rmore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner orany withholding agent that can disburse or make payments of the income of which I am the beneficial HereᮣSignature of beneficial owner (or individual authorized to sign for beneficial owner)Date (MM-DD-YYYY)FormCapacity in which actingFor Paperwork Reduction Act Notice, see separate . No. 25047ZPrinted on Recycled PaperW-8BEN(Rev. 2-2006)

表格用途：

W-8BEN 表格簡要中文説明

本表格適用於非美國居民向美國國稅局申報美國所得稅減免時使用。如果您所居住的國家為美國的稅務減免互惠國，您便可能符合減稅或免稅的資格。請到美國國稅局網站 做進一步了解。請將您的W8表格寄到史考特證券，不要送到美國國稅局。

表格不適用於：

應使用表格

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非美國居民本年度在美國居住超過183天(含183天)，但持有F，J，M，Q簽證者不在此限。

美國公民，永久居民或美國稅法所定義的外國居民………………………………………………………………W9

申報稅務減免的個人與美國有經貿往來………………………………………………………………………W-8ECI

如您持有上述種類簽證，請在此註明簽證類別：

詳細資料請查閲美國國稅局W-8BEN 英文版全文説明。

表格填寫簡單説明：

第一部分(Part I)：帐户持有人資料

第1點：姓名。

第2點：如果是公司，填入公司成立的國家，如果是其他實體，填入創建，組合或管轄的法律根據國家，

如果是個人，填入N/A(不適用)。

第4點：永久居住地址（請勿使用郵政信箱PO Box 或轉寄地址，還有國家名稱請勿簡寫。）

第5點：郵寄地址（如果不同於永久地址請另填寫，國家名稱請勿簡寫）。

第6點：美國稅號SSN，ITIN 或EIN 號碼（如果沒有，勿需填寫）。

第7點：外國稅號（如果有）。國際帳戶此欄可以不填。

第8點：扣繳單位使用的參照號碼。國際帳戶此欄可以不填。

第9點：確認以下勾選的均使用

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第三部分：國際帳戶此欄可以不填。

第四部分：申明

本人申明以上所填資料屬實而且完整。

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簽名欄（SIGN HERE）：帳戶持有人簽名/日期/（月日年）

注意：

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在交出W-8BEN表格後您的身份若有變更（變成美國公民或居民），請於30天内主動通知預扣稅款單位。

W-8BEN表格的有效期為簽署年起至第三年年底止。

W-8BEN的中文簡要説明僅為方便華人客戶提供。本公司客戶須以美國國稅局所提供之英文原本為準。您可到史考特證券表格中心下載W-8BEN英文版全文説明或到美國國稅局網站 做進一步暸解。

本人（或授權人）為本表格所提及的所有所得申報人。

所得個人不是美國稅法規定的美國申報人（US Person)。

本人的所得不屬美國的貿易或商業行爲。

本人確實符合美國的稅務減免互惠的資格。

勾選a項：如果所得申報人居住在____________（國家名稱），其為美國的稅務減免互惠國。

其它欄目不需要勾選。

第3點：持有人種類：個人請勾選Individual; 若為共同賬戶請分別填寫W-8BEN。

第二部分：稅務減免申報（若適用）

第10點：國際帳戶此欄可以不填。

除此之外，在此申明，預扣稅款單位有權預扣我的稅款。