FATCA and CRS Self-Certification form (Republic of Ireland)

The Governor and Company of the Bank of Ireland (‘the Bank’) and its subsidiaries are obliged to collect certain information about account holders who are United States (‘US’) citizens and/or tax resident in any country or territory other than the Republic of Ireland under the Foreign Account Tax Compliance Act (‘FATCA’) and the Common Reporting Standard (‘CRS’) - specifically the following legislation:

- Section 891E and Section 891F of the Taxes Consolidation Act 1997 (as amended) and tax regulations made pursuant to those sections.

Please complete the sections below and provide any extra information that is needed. In certain circumstances, we may be obliged to share your account information with the Revenue Commissioners. They may in turn share it with the relevant tax authorities in other jurisdictions.
The information which we may be obliged to share includes the name, address, tax identification number (‘TIN’), date of birth, place of birth (in certain circumstances), account number, account balance or value at the end of the reporting period and the gross amount of income (interest, dividends etc.) paid or credited to the account during the reporting period.
This form is intended to request information only where such request is not prohibited by Irish law.

Bank of Ireland cannot legally provide taxation advice. For tax-related questions or further information, please contact Revenue (https://www.revenue.ie/en/companies-and-charities/internationaltax/ aeoi/index.aspx) or your professional tax advisor.
If you need assistance please refer to our Frequently Asked Questions on FATCA or CRS which can be found at www.BankofIreland.com or alternatively you can contact the Bank of Ireland FATCA/CRS Helpline on 0818 200360 from the Republic of Ireland and +353 1 2500360 from abroad. Operating hours will be 9-5 Monday to Friday

If you have a place of birth in the United States but answered 'No' to the above question (stating that you are not a United States citizen), we will need documentation that verifies this.

You must provide a copy of valid ID confirming your citizenship or nationality in a country other than the United States. This could be, for example, a non-US passport or other government issued ID. You must submit this together with either a Certificate of Loss of Nationality or one of the explanations listed below.

Option 1:

Copy of valid ID confirming your citizenship or nationality in a country other than the United States PLUS a copy of your Certificate of Loss of Nationality of the United States

Option 2

Copy of valid ID confirming your citizenship or nationality in a country other than the United States PLUS a reasonable explanation for why you do not have a Certificate of Loss of Nationality of the United States

Option 3

Copy of valid ID confirming your citizenship or nationality in a country other than the United States PLUS a reasonable explanation as to why you did not obtain US citizenship at birth

If you have previously given us a foreign (non-Republic of Ireland) address, but answered No to the question above (stating that you are not resident for tax purposes in any country or territory other than the Republic of Ireland), you must provide one of the following forms of documentary evidence of your tax residence status.

Option 1:

Copy of a certificate of residence issued by an authorised government body of the jurisdiction where you are resident.

Option 2

Copy of any valid Irish ID that includes your name and is issued by an authorised government body, for example a passport, national identity card or driving licence.

Option 3

Copy of any audited financial statement third-party credit report, bankruptcy filing or securities regulator’s report.