Case File
efta-01449827DOJ Data Set 10OtherEFTA01449827
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01449827
Pages
1
Persons
0
Integrity
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DRAFT
Convention between the United States and Germany with respect to any payment described in such
provisions and received or to be received by it in connection with this Agreement.
(b) Payee Tax Representations.
For purposes of Section 3(f) of this Agreement, Party B makes the following representations:
(1) In relation to Darren K. Indyke acting as trustee for and on behalf of The Haze Trust (and
Southern Financial LLC and Southern Trust Company Inc.):
[It is a U.S. person, and it is a corporation that is the beneficial owner of all payments to be made to it
under this Agreement, or it is a [corporation/partnershipitrust/other
1, organized under the
State of Tennessee, and its taxpayer identification number is [
].
Or
(1) In relation to Southern Financial LLC and Southern Trust Company Inc.:
It is (A) a "foreign person" within the meaning of the applicable U.S. Treasury Regulations
concerning information reporting and backup withholding tax, (B) organized under the laws of
and (C) treated as a [corporation/partnership/trust/other
] for U.S. federal
income tax purposes. No payment received or to be received by it in connection with this Agreement
is effectively connected with the conduct of a trade or business conducted in the United States.]
Please confirm which of the above reps would be appropriare in irlalion to Southern Financial I.,IX
and Southern TRIM Company Inc
(2)
It is fully eligible for the benefits of the "Business Profits" or Industrial and Commercial Profits"
provision, as the case may be, the "Interest" provision, "Dividends" provision or the "Other
Income" provision (if any) of the Specified Treaty with respect to any payment described in such
provisions and received or to be received by it in connection with this Agreement and no such
payment is attributable to a trade or business carried on by it through a permanent establishment
in the Specified Jurisdiction.
"Specified Treaty" means the income tax treaty, if any, between United States and United
Kingdom, France, Singapore, Belgium, Australia, Netherlands. Austria, Canada. New Zealand.
Switzerland or Germany.
"Specified Jurisdiction" means the jurisdiction of Party A's branch office from which pa inent is
made.
Part 3. Agreement to Deliver Documents.
(a)
For the purpose of Section 4(a)(i), the documents to be delivered are:
Party required to deliver
document
Party A
Form/Document/
Certificate
A properly executed:
United
States
Internal
Revenue Service Form W-9
(or any successor thereto). a
Date by which to be
delivered
(i) Upon execution of this
Agreement. (ii) promptly
upon reasonable demand by
Party B and (iii) promptly
32
Confidential
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0 105299
SONY GM_00251483
EFTA01449827
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