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Get SG DBS Self Certification On USA Citizenship/Tax Residency Status 2019-2024

Y of Issue: (India Residents can provide alternate ID proof in the absence of Passport) Date of Birth: Place of Birth: Country of Birth: Father's Name: (in case PAN number is not provided) PAN Number: Residential Address: State: Country: Postal code: TAX RESIDENCY STATUS USA (PLEASE TICK ONE OF THE BOXES ONLY) For the purpose of US Federal income tax, I represent and warrant that: I am not a US Person1 / Tax Resident2 / Green Card Holder. Please provide one of the following doc.

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