Form descriptions - Japan: A-C

27.09.2017

Information is provided here about the forms and their use in relation to the holding of Japanese securities or relief and reclaim procedures with regard to withholding tax on income from them.

Appendix A - For Exempt Pension funds residents in Netherlands, Switzerland, United Kingdom and U.S.A.

A per-payment certification issued by the exempt pension fund, stating that it qualifies for the exemption.

How many are provided?One per Clearstream Banking account and per dividend payment.
Who completes it?The exempt pension fund. The depository bank to be entered will be communicated to customers via the tax notification.
How often is it provided?Per payment.
When is it provided?Communicated per-payment via the Clearstream Banking tax notification.
Copy or original?Original required.

Appendix B - Power of Attorney

The power of attorney is executed by the beneficial owner (the pension fund) granting Clearstream Banking's depository the right to request tax exemption at source from the issuer.

The form must be printed under the pension fund’s letterhead, signed and completed by the exempt pension fund.

How many are provided?One per Clearstream Banking account and per dividend payment.
Who completes it?The exempt pension fund. The depository bank to be entered will be communicated to customers via the tax notification.
How often is it provided?Per payment.
When is it provided?Communicated per-payment via the Clearstream Banking tax notification.
Copy or original?Original required.

Application Form

The form provides details regarding the beneficial owner and its Qualified Financial Intermediary (QFI) and is valid for five years.

The applicant in the form should always be the ultimate beneficial owner of the securities and the applicable QFI to be mentioned in the form must be the last financial institution in the custody chain with which the beneficial owner has the account.

The QFI of the applicant is to complete the QFI part and sign this on behalf of the beneficial owner.

Copies must be sent by email to tax@clearstream.com according to whether the customer holds the securities for itself or for a third party, as follows:

  • For customers holding proprietary assets, an electronic copy;
  • For customers holding client assets, a scanned copy. The original form must be sent by registered post upon verification of Clearstream Banking.
How many are provided?One per beneficial owner.
Who completes it?Beneficial owner and the QFI of the beneficial owner.
How often is it provided?Every five years.
When is it provided?Before the first investment.
Copy or original?Original required.

Application Form for Amendment concerning Withholding Tax Exemption

The form must be provided where there is any change of address, registered address or name of the beneficial owner or its QFI and is valid for five years.

The applicant in the form should always be the ultimate beneficial owner of the securities and the applicable QFI to be mentioned in the form must be the last financial institution in the custody chain with which the beneficial owner has the account.

The QFI of the applicant is to complete the QFI part and sign this on behalf of the beneficial owner.

Copies must be sent by email to tax@clearstream.com according to whether the customer holds the securities for itself or for a third party, as follows:

  • For customers holding proprietary assets, an electronic copy;
  • For customers holding client assets, a scanned copy. The original form must be sent by registered post upon verification of Clearstream Banking.
How many are provided?One per beneficial owner.
Who completes it?Beneficial owner and the QFI of the beneficial owner.
How often is it provided?Every five years.
When is it provided?As soon as a change in the beneficial owner or QFI details occurs.
Copy or original?Original required.

Beneficial Owner Details List

A Beneficial Owner Details List that provides information regarding the beneficial owner(s), the payment(s) and the respective DTT rate(s). The Beneficial Owner Details List must be submitted via Clearstream Banking’s Upload Beneficial Owner List facility for reclaim on Japanese Listed Equities, ETFs and REITs and/or Japanese Convertible bonds.

How many are provided?

One per Clearstream Banking account.

Who completes it?

Customer.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, three months before the statutory deadline.

Copy or original?

Original required.

Certificate of Residence

A certificate proving the residency of the beneficial owner, issued by the beneficial owner’s local tax authorities.

How many are provided?One per beneficial owner.
Who completes it?Beneficial owner’s local tax authorities.
How often is it provided?Convertible bonds - Relief at source: valid for one year from the date of issuance and to be renewed annually, except for Chilean and Qatari eligible beneficial owners for whom the form is valid until revoked (unless there is a change in the beneficial owner’s details).

Convertible bonds - Standard refund: valid for one year following the date on which it was stamped by the local tax authorities, this period covering the date on which the reclaim application is submitted to the Japanese Tax Authorities.

Listed Equities, ETFs and REITs - Relief at source: in general valid for three years from the date of submission of the Form 17 to the Japanese Tax Office but, for U.S. investment vehicles and German eligible beneficial owners under DTT with Limitation On Benefits Article, for one year only as from the date of submission of the Form 17 to the Japanese Tax Office.

For Chilean and Zambian eligible beneficial owners, the form is valid for one year as from the date of issuance.


Listed Equities, ETFs and REITs - Standard refund: valid for one year following the date on which it was stamped by the local tax authorities, this period covering the date on which the reclaim application is submitted to the Japanese Tax Authorities.
When is it provided?Convertible bonds - Relief at source: at the latest, ten business days before the income payment date by 10:00 CET.

Convertible bonds - Standard refund: original certificate to be provided with the reclaim.

Listed Equities - Relief at source: at the latest, five business days after each relevant income record date by 10:00 CET.

Listed ETFs and REITs - Relief at source: at the latest, three business days after each relevant income record date by 10:00 CET.

Listed Equities, ETFs and REITs - Standard refund: original certificate to be provided with the reclaim.
Copy or original?Original required.

N.B: upon request, an additional Certificate of Residence issued by the competent authority covering the interest payment date (in the original) may be submitted by all customers.

Consent Letter for JGB Book-entry System operated by Bank of Japan

One-time certification that provides information regarding Clearstream Banking's customer, stating that, in its role as a foreign indirect participant (the “FIP”) of the JGB Book-entry System operated by the Bank of Japan, the customer complies with the law concerning the Book-entry Transfer of Corporate Debt Securities.

Note: Clearstream Banking S.A. customers must use the template named “Consent Letter for JGB Book-entry System operated by Bank of Japan (CBL)" and Clearstream Banking AG customers must use the template named “Consent Letter for JGB Book-entry System operated by Bank of Japan (CBF)".

How many are provided?One per Clearstream Banking account.
Who completes it?Customer.
How often is it provided?Once. Valid until revoked.
When is it provided?Before the first investment.
Copy or original?Original required.

Consent Letter for Securities managed under Business Regulations on the Book-Entry System for Stocks and Corporate bonds

One-time certification that provides information regarding Clearstream Banking's customer, stating that the customer agrees to comply with the requirements under Article 25 of the “Business Regulations on the Book- Entry Transfer of Stocks etc.” and under Article 26 of the “Business Regulations on the Book-Entry Transfer of Corporate Bonds etc.” as prescribed by the Japan Securities Depository Center, Inc. (JASDEC).

How many are provided?One per Clearstream Banking account.
Who completes it?Customer.
How often is it provided?Once. Valid until revoked.
When is it provided?Before the first investment.
Copy or original?Original required.

Credit Advice

The credit advice identifies income payment details including the security type, gross amount of payment, date of payment and amount of tax withheld and must reconcile with the information in the refund form.

If the income is not paid to the final beneficial owner by Clearstream Banking directly, credit advices of the payment are required from all parties involved, up to the final beneficial owner.

How many are provided?One per beneficial owner.
Who completes it?The financial institution with whom the beneficial owner holds the securities.
How often is it provided?Per reclaim application.
When is it provided?At the latest, three months before the statutory deadline.
Copy or original?Original required.