Individual Self-Certification Form

Summary

This document is a template Individual Self-Certification form published by Cayman Islands DITC for use under FATCA and the Common Reporting Standard (CRS), collectively referred to as AEOI (Automatic Exchange of Information). Cayman Islands Financial Institutions use this form to collect tax residency and taxpayer identification information from individual account holders, as required under the Tax Information Authority Law, related Regulations, Guidance Notes, and international AEOI agreements.

• Identification: The individual must identify themselves.
• U.S. status: Declare whether they are a U.S. citizen or U.S. tax resident, and provide a U.S. TIN if so.
• Other tax residency: Declare any other countries of tax residency along with tax reference numbers.
• Declaration: Sign a declaration confirming the accuracy of the information.
• Joint accounts: Joint account holders must each complete a separate form.
• Information sharing: The information collected may be shared with relevant tax authorities.

While the form itself is not legislation, completing it correctly creates obligations for the individual signing it, including promptly updating the information if circumstances change, and acknowledges that providing false information is an offence.

Key obligations

• Individual account holders must complete Section 1 identifying information (name, date/place of birth, residence address).
• Individual account holders must declare U.S. citizenship or U.S. tax residency status in Section 2, providing a U.S. TIN if applicable.
• Individual account holders must declare all non-U.S. countries of tax residency and corresponding tax reference numbers in Section 3, or explain why a tax reference number is unavailable.
• Where there are joint account holders, each individual must complete a separate Self-Certification form.
• The individual must advise the recipient promptly and provide an updated Self-Certification form within 30 days if any change in circumstances causes the information in the form to become inaccurate or incomplete.
• The individual consents to the recipient sharing the information with relevant tax information authorities where legally obliged to do so.
• The individual must sign and date the declaration confirming the information is accurate and complete to the best of their knowledge.

Applies to

individual account holders, Financial Institutions (as recipients/users of the form)

Deadlines

• within 30 days: The individual must provide an updated Self-Certification form within 30 days of any change in circumstances that causes the information in the form to become inaccurate or incomplete.