France: 2022 version of Forms 5000 and 5001


Clearstream Banking1informs customers that the French Tax Authorities (FTA) have published new versions of Form 5000 (Affidavit of residence) and Form 5001 (Calculation of withholding tax on dividends), as well as the related explanatory notice; and that effective


customers must provide the latest 2022 versions of Form 5000, when claiming the benefit of the double taxation treaty through the simplified procedure, and Form 5001 for relief at source under the parent-subsidiary regime or for the normal procedure (standard refund).


The Forms 5000, 5001 and explanatory notice have been published on FTA’s website under “Millésime 2022”. 

Form 5000 – Affidavit of residence

The content of Form 5000 has not changed and still bears the reference number 12816*03. The FTA have created a new form in the Portuguese language with the reference number 12816*02. Customers are reminded that the FTA only accepts the French version of the form.

Notice 5000 – Affidavit of residence

The main changes to this “Millésime 2022” are in the explanatory notice, reference 51147#05:

  • The notice now confirms the acceptance of an electronic certificate of residence (COR) instead of certification by the foreign tax authorities in box IV of Form 5000 (point 4-). The Form 5000 duly completed, and signed by the beneficial owner has to be accompanied by this COR.

The certification  with a COR is accepted only if the foreign tax authority has officially informed the FTA that it will no longer certify box IV of the Form 5000.

  • the explicit reference to the domestic withholding tax rates has been removed and replaced (point 1-) by a reference to relevant articles of the French General Tax Code.

However, the updates of the notice have apparently not been fully performed as incorrect information remain in the notes:

  • Note 6 of the notice in foreign languages still incorrectly refers to pension funds.
  • Note 10 still states the old dividend withholding tax rates.

Form 5001 - Calculation of withholding tax on dividends

The FTA have published a new template of Form 5001 with reference number CERFA 12816*04.

Only minor changes were brought to this new version, as follows:

On page 1 (front page)

  • the box "Recipient's name" (top left) has been deleted;
  • the indication "Signature of beneficiary or his/her legal representative" has been replaced by "Name and signature of beneficiary or his/her legal representative" (bottom right);
  • the Ministry’s logo (bottom centre) has been deleted and moved to the top left of the form.

On page 2 (back page)

  • In column 8 “Total withholding tax under domestic legislation”, the indication into brackets “column 7 x 30%” has been replaced by “column 7 x rate applied”;
  • In column 9 “Withholding tax due under the applicable tax treaty” the indication into brackets “column 7 x treaty rate" has been replaced by “column 7 x applicable rate".

The 2022 versions of Forms 5000, 5001 and explanatory notice are now available in French, English, Spanish, German, Italian, Dutch, Chinese and Portuguese.

Impact on customers

When applying for tax treaty benefits on French-sourced dividends through the simplified procedure, quick refund or standard refund, beneficiaries must always use the most recent version of the Forms as published by the FTA. 

Further information

For further information, please refer to the Market Taxation Guide – France (securities held in CBF).
1. Clearstream Banking refers collectively to Clearstream Banking AG, registered office at 61, Mergenthalerallee, 65760 Eschborn, Germany and registered in Register B of the Amtsgericht Frankfurt am Main, Germany under number HRB 7500, and Clearstream Banking S.A., registered office at 42, avenue John F. Kennedy, L-1855 Luxembourg, and registered with the Luxembourg Trade and Companies Register under number B-9248.