8. Completing the form US-Company
Part A: Details of the company or concern and tax adviser
Please give all the details asked for. If the company or concern has a tax adviser, include the tax adviser's details.
All the information that you provide to HM Revenue & Customs is confidential. We can therefore only discuss the tax
affairs of the company or concern with
• an officer of the company
• any tax adviser or agent who is nominated by the company or concern.
We cannot disclose to the UK payer of the income or their tax adviser any information relating to the claimant company or
Part B: Questions
• For all claimants – please answer the questions in Part B1
• If you answered ‘Yes’, to either B1.2(a) or B1.2 (b), go to Part B2.
• If you answered ‘No’ to B1.2(a) and B1.2(b), go to
- Part B3 for a Mutual Fund, or
- Part B4 for a Pension Scheme, etc., or
- Part B5 for a Charitable Organisation, or
- Part B6 for a Trust.
Part B2, question B2.2
This note applies only if you answer ‘Yes’ to question B2.2
Relief from UK tax is available under the Double Taxation Convention only to residents of the United States.
If you answer ‘Yes’ to question B2.2, you are saying that the claimant company or concern is liable to United States tax in
respect only of income from sources in the United States or profits attributable to a permanent establishment in the
United States, and this will mean that the company does not meet the definition of ‘resident of a Contracting State’ found
at Article 4(1) of the Double Taxation Convention (most typically, where the claimant is a branch of a non-US enterprise).
If answering “Yes” please therefore detail on a separate sheet why you believe that the claimant is entitled to relief from
UK tax, notwithstanding that it is not to be considered as a resident of the United States.
Article 23 of the Double Taxation Convention and the questions in Part B of the form
In order to be able to benefit from the Double Taxation Convention the claimant is required to be a ‘qualified person’,
(as defined in Article 23 of the Double Taxation Convention) or if not a ‘qualified person’, then fulfil certain other tests in
respect of an item of income whose source is in the UK. The questions in Part B of the form seek to establish whether
the claimant is a qualified person or otherwise entitled to the benefits of the Double Taxation Convention.
If you are claiming that relief from UK tax should be allowed under the terms of Article 23(6) of the DTC you should
complete this claim form and send it in the normal way to the United States Internal Revenue Service (See Note 5).
At the same time, you should write to HM Revenue & Customs, Business International Tax Treaty Team,
100 Parliament Street, Westminster, London, England SW1A 2BQ. Your letter should clearly state that you are asking
the "competent authority" of the United Kingdom to deal with your claim under the terms of Article 23(6) of this treaty.
A copy of your letter to the competent authority should be attached to the claim form US-Company.
Question B1.3 on form US-Company asks whether any income to which the claim refers is paid under a
‘conduit arrangement’. The definition in Article 3(1)(n) of the Double Taxation Convention is as follows:
“(n) the term “conduit arrangement” means a transaction or series of transactions:
(i) which is structured in such a way that a resident of a Contracting State entitled to the benefits of this Convention
receives an item of income arising in the other Contracting State but that resident pays, directly or indirectly, all or
substantially all of that income (at any time or in any form) to another person who is not a resident of either Contracting
State and who, if it received that item of income direct from the other Contracting State, would not be entitled under a
convention for the avoidance of double taxation between the state in which that other person is resident and the
Contracting State in which the income arises, or otherwise, to benefits with respect to that item of income which are
equivalent to, or more favourable than, those available under this Convention to a resident of a Contracting State; and
(ii) which has as its main purpose, or one of its main purposes, obtaining such increased benefits as are available under