Form descriptions - Standard refund - Luxembourg equities

19.04.2022

Information is provided here about the forms and their use in relation to the procedure for standard refund of withholding tax on income from Luxembourg equities, as follows:

  • Form 901bis - Claim for reduction or partial refund of withholding tax;
  • Power of Attorney (PoA) for tax reclaim processes follow-up;
  • PoA;
  • Full chain of Credit Advices;
  • Bank statement of the final beneficial owner;
  • Letter of request to Clearstream Banking for reclaim of Luxembourg withholding tax.

Important note: Corrections or strike-throughs on any documents being submitted are not allowed and are grounds for immediate rejection.

Form 901bis - Claim for reduction or partial refund of withholding tax

Form 901bis - Claim for reduction or partial refund of withholding tax, available from the Luxembourg Tax Authorities’ (LTA) website is, in general, to be used for all reclaim applications.

Each claim form consists of four copies that have to be completed and signed by the beneficial owner or his legal representative. These copies are designated as follows:

  • One for the tax administration of the State of residence of the beneficial owner;
  • One for the Luxembourg Tax Administration;
  • One for the payer of the dividends;
  • One for the beneficial owner of the dividends.

Clearstream Banking only needs to receive the “2e exemplaire/2nd sheet” for the Luxembourg Tax Administration. The other copies must be kept by the entity mentioned on the upper right-hand side of the form.

Under box III of the form, customers must complete Clearstream Banking’s payment details as follows:

  • Account holder: Clearstream Banking SA
  • IBAN: DE44500700100938225000
  • BIC: DEUTDEFF
  • Name and address of bank: DEUTSCHE BANK AG, FRANKFURT AM MAIN, GERMANY

Under box V of the form, the stamp and signature of the local tax authorities are mandatory. Stand-alone certificates of residence will be rejected by the LTA.

Who completes it?

Beneficial owner or its legal representative.

How often is it provided?

Per reclaim application .

When is it provided?

At the latest, two months before the statutory deadline.

Copy or original?

Original required.

PoA for tax reclaim processes follow-up

This PoA gives the necessary powers to Clearstream Banking to act on behalf of the beneficial owner to present the tax reclaim, process any necessary follow-up and receive the amount refunded. It must be signed, stamped or provided on the company’s letterhead (if a legal entity), and dated the year of the distribution of the dividend or year of the claim, by the final beneficial owner reclaiming the tax or by its representative. If signed by a representative, a PoA between the beneficial owner and its representative must also be provided.

Who completes it?

Beneficial owner or its representative under a PoA.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two months before the statutory deadline.

Copy or original?

Original required.

PoA

If the customer or a third party is completing the form on behalf of the beneficial owner, a PoA must be provided. When a custody chain exists, the full chain of PoAs must be provided. All PoAs must be signed, stamped or provided on company’s letterhead (if legal entity), and dated the year of the distribution of the dividend or year of the claim.

Who completes it?

Beneficial owner.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two months before the statutory deadline.

Copy or original?

Original required.

Credit Advice (full chain)

This identifies dividend payment details including the security type, gross amount of payment, date of payment and amount of tax withheld. The information in the Credit Advice must correspond to that in the refund form. When a custody chain exists, the full chain of Credit Advices must be provided. You can request the Clearstream Credit Advice in the “Letter of Request to Clearstream Banking for Reclaim of Luxembourg Withholding Tax" when sending a reclaim.

Who completes it?

Financial institution paying the beneficial owner.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two months before the statutory deadline.

Copy or original?

Original required.

Bank statement

This document proves payment of the dividend on the date of distribution to the bank account of the final beneficial owner claiming the tax refund. The bank statement must contain the name of the bank, the account number including BIC, identification of the payer of the dividend (company name/ISIN code), date of payment and amount paid.

Who completes it?

Financial institution paying the beneficial owner.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two months before the statutory deadline.

Copy or original?

Original required.

Letter of request to Clearstream Banking for reclaim of Luxembourg withholding tax

This authorises Clearstream Banking to reclaim withholding tax from the LTA on the customer's behalf.

Who completes it?

Customer.

How often is it provided?

Per reclaim application.

When is it provided?

At the latest, two months before the statutory deadline.

Copy or original?

Original required.