International Wire Option Form
IWIF
International Wire Option Form
Use this form to link an international bank account to your Vanguard? account for wire redemptions. Print clearly, preferably in capital letters and black ink. Most forms can be downloaded from our website at serviceforms. To get assistance in filling out this form, call us at 800-662-2739 (U.S.) or 610-669-1000 (international collect). Return this form to Vanguard, P.O. Box 1110, Valley Forge, PA 19482-1110. For overnight delivery, mail to Vanguard, 455 Devon Park Drive, Wayne, PA 19087-1815.
1. Account Owner Information
Account Number
Name (first, middle initial, last)
Citizenship
U.S. Citizen
Resident Alien
Nonresident Alien
Tax Residency
U.S.
Other
Country of Tax Residence, if Not U.S.
?
?
OR
Social Security Number or Individual Taxpayer ID Number
?
Employer ID Number
Country of Citizenship, if Not U.S.
Street Address
City, State, Zip
?
?
?
Daytime Telephone Number
Country, if Not U.S.
?
?
?
Evening Telephone Number
Name of Joint Owner (if applicable)
2. Bank Information--ALL FIELDS REQUIRED
U.S. Correspondent Bank Information
Bank Name
Foreign Bank Information
Bank Name
SWIFT Code SWIFT Code
Account Number
Account Registration at Foreign Bank
Street Address
City, State, Zip
Country, if Not U.S.
Foreign Bank's Telephone Number 1
IWIF-page 2 of 2
3. Additional Instructions--IF APPLICABLE Complete the information below to include "further credit" instructions with your wire requests.
Beneficiary Name
Street Address
City, State, Zip
Country, if Not U.S.
Bank or Special Reference (for example, account number, sort code, branch code, or IBAN number, if provided by your bank)
4. Signature of Account Owner (Sign exactly as your account is registered and in the presence of the guarantor.)
If I am a U.S. citizen, a U.S. resident alien, or a representative of a U.S. entity, I certify under penalty of perjury that: 1. The taxpayer ID number I have given on this form is correct (or I am waiting for a number to be issued to me). 2. I am not subject to backup withholding because (a) I am exempt from backup withholding, (b) I have not been notified
by the Internal Revenue Service that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. Important: Cross out item "2" if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest or dividends on your tax return. 3. I am a U.S. person (including a U.S. resident alien). If I am a nonresident alien, I certify that the information that I provided on the previously filed Form W-8 is still accurate for purposes of foreign status and treaty claim (if applicable). If the information has changed, I may be required to complete a new Form W-8 or provide additional documentation to recertify my foreign status or claim for treaty benefits. I understand that I am not under penalty of perjury by certifying the above information.
The IRS does not require your consent to any provision of this document other than the certification required to avoid backup withholding.
I agree that Vanguard will not incur any loss, liability, cost, or expense for acting upon my instructions. I understand that this authorization may be terminated by me at any time by written notification to Vanguard. The termination request will be effective as soon as Vanguard has had a reasonable amount of time to act upon it.
S I G N A T U R E
Signature of Account Owner
?
?
Date (month, day, year)
S I G N A T U R E
Signature of Joint Account Owner (if applicable)
?
?
Date (month, day, year)
5. Signature Guarantee
If the name on the bank account to receive wire requests is not identical to the name on your Vanguard account, you must obtain a signature guarantee.
You can get a signature guarantee from an authorized officer of a bank, broker, and many other financial institutions. A notary public CANNOT provide a signature guarantee.
S I G N A T U R E
Authorized Officer to Place Stamp Here
Signature of Authorized Officer or Guarantor
Officer's Title / Name of Institution
?
?
Date (month, day, year)
? 2007 The Vanguard Group, Inc. All rights reserved.
Applies to all signatures in Section 4.
IWIF 022007 2
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