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Request on another basis (Belgian internal law) - Documents to join

  • A credit advice mentioning the amount of dividends received (gross amount, rate of withholding tax, date and withheld amount of tax).
  • A bank statement of the beneficiary of the income mentioning the net amount of dividends received.
  • The attestation required by the concerned provisions of the Income Tax Code 92 or the Royal Decree enforcing the Income Tax Code. For instance, the certificate provided for in Article 117 § 6 or Article 117 § 4 of the Royal Decree enforcing the Income Tax Code 92.
  • A certificate of residence mentioning:
    • The status of the beneficiary of the income.
    • The tax identification number in this country.
  • The bank account number on which the reimbursement could possibly be paid.
  • If your request concerns dividends and if the amount to be reimbursed is higher than 100,000 €: the statement of transactions. This document must be signed by the last financial intermediary (custodian) and mention in detail every transaction carried out during the year preceding the date of payment of dividends as well as during the month following this date of payment of dividends. This document must clearly mention the identity (name, address and No. of the securities account) of the owner of the shares and include at least the following data:
    • The type of the transaction: purchase, sale or loan.
    • The date of the transaction.
    • The amount of the transaction.
    • The number of shares.
    • The name of the share and the ISIN code.
    • The name of the other party if the shares have been sold via an agreement between parties.
    • The current position per transaction. It means that, per transaction the current position must be displayed at this specific moment.
  • If you are an authorised representative: the line of proxies allowing you to submit a claim on behalf of your client (when the request is not signed by the beneficiary of the income).