Streamlined Foreign Offshore Procedures Checklist
Completion Date
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Day
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Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Marital Status
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Single
Married
Civil Partnership
Separated
Other
Name
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First Name
Last Name
Risk questions:
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Rows
Yes
No
N/A
Short Notes (if required)
At any time during the catch-up period, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located outside of the US?
If the answer to the above question is “yes”, did the aggregate value of such non‐US financial accounts described above exceed $10,000 at any time during the period?
Did the aggregate value of your foreign financial assets (including pensions) exceed $50,000 on 31 December or $75,000 at any time during the catch-up period?
Were you the owner or beneficiary of a non‐US life insurance policy (not including a term life insurance policy)?
Do you participate in any deferred compensation plans offered by a non‐US employer (e.g. employer sponsored pension plan, Stock Appreciation Rights (SARs) plan, restricted stock, etc.)? If so, please provide details of the plan.
Are you the owner or beneficiary of a s.529 plan?
During the catch-up period did you make contributions to a s.529 plan?
During the catch-up period, did you make a gift to anyone (either cash or non‐cash) in excess of $15,000?
Did you receive a gift from a non‐US person or entity (including a bequest from an estate of a non‐US person) in excess of $100,000?
During the catch-up period, did you own shares of a non‐US corporation, or were you an officer or director of a non‐US corporation, which is not listed on a public stock exchange?
Did you transfer cash or property to any non‐US entity (including UK Ltd, UK LLP) in excess of $100,000?
Did you hold a greater than 10% ownership interest in a non‐US partnership or contribute cash or property to a non‐US partnership?
Did you have any loans that you made outstanding to a non‐US entity (corporation, partnership etc) or to any individual?
Did you hold any non‐US investments which could be considered Passive Foreign Investment Companies (PFICs)? This can include Stocks and Shares ISAs, collective investment vehicles, unit trusts, non‐US mutual funds or non‐US Exchange Traded Funds (ETFs).
Were you a member of a UK or other non‐US pension plan including a UK Self‐Invested Personal Pension (SIPP)? Please describe the type of plan.
Are you a grantor, settlor, beneficiary or trustee of a non‐US trust or have you ever transferred or loaned property to a non‐US trust or received a distribution from a non‐US trust?
Do you have any tax shelter(s) such as reportable transaction(s) or IRS listed transaction(s) that would require reporting/disclosing on your tax return?
Did you sell a property including your main residence?
Did you refinance, redeem or make capital repayments in respect of a mortgage denominated in any currency other than US$?
Are there any State issues to consider for (e.g. you owned property in a state or had workdays in a state, such as California)?
Did you have a dependent child who earned more than USD $2,200 of unearned income?
Did you make or hold a qualified investment in a Qualified Opportunity Zone Fund at any time during the year?
Did you engage in any transactions involving a digital asset or hold any digital assets? (e.g. Crypto, NFTs, Blockchain derivatives)
During the catch up period, please confirm you had at least one full calendar year where you spent at least 330 full days outside of the United States.
Any additional comments?
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