Rahandusministeerium · 9. aprill 2025
Sisu (failidest)
SEINE & Cl
STATE STREET BANK AND TRUST Cl
P0 BOX 5010
BOSTON, MA 02206-5010
002014 90065373432 7 0301 0 0000 0 000
0139
MINISTRY 0F FINANCE OF THE REPUBLIC OF
SUUR AMEERIKA 1
- TALLINN, 10122
ESTONIA
iiIIIIiiIIiIIIIIiIiIiiiII,IIiIiI,III,IIIIIiIIIIIiiIIIiIIiIiiIiIiI
1 042S 1 F0rejn Peison’s U.S. Source Income SubJect To Withholding
©24 OMB No 1545-0096
Departn,ent of the Treasury
Internat Revenue Service
1 tnme 2 Grosa income
I
Go to www.trs.govlFom,1042S for instructlons and the tateat Infoiniation.
•
0 1 0 1 0 1 1 1 1 1 01 1 21 UNIQUE FORM IDENTIFIER
0 9 4 0
3 Chapterindicator. Enter 3” or
0
3
[•] AMENDED Ei AMENDMENT NO.
13e Recipients U.S. TIN. 4 any 131 Ch.3 statua code
Copy B
for Recpient
36
code
3a Exemption code 24 4a Exemption code 15 13g Ch.4 status code 27
01 $82618 00
3b Tax rate 00.00 4b Tax rate 0000 13h Recipient’s GIIN 131 Recipients foreign las iderititicatiori 1 LOB code
number, if any
5 Withhotding allowance
6 Net income
7a Federal tax withheld $0.00 13k Recipient’s account number
0139
7b Check 4 federal tax withheld was not deposited with the tRS because
escrow procedures were applied (see instructions) 131 Recipient’a date of birth (YYYYMMDD)
7c Checl 4 withholdirlg occurred in aubsequent year with respect 10 a
partnorship interest
8 Tax withheld by other agents $0.00 14a Primary Withholding Agents Name (4 applicable)
9 Overwithhetd tax repaid to recipient pursuant to adjustment procedures (see inatructions)
($0.00) 14b Primary Withhotding Agents EtN
10 Total withhotding credit (combine boxes 7a. 8, and 9) 15 Check 4 pro-rata basis reporting EI
$0 00 15a tntermedtary or ftow-through entitys EtN, 1 any 15b Ch.3 status code ISo Ch.4 status code
11 Tax paid by withholding ageflt (amounts fbI withheld)(see instructions)
15d tntermediary or ftow-through entitys name
12a Wthholding agents EIN 12b Ch.3 status code 12c Ch.4 status code
04-6288081 15 01 .
15e Intermediary ortlow-through entitys GItN
12d Withhotding agents name 1Sf Country code ISg Foreign las identification number, if any
SEINE & C0
STATE STREET BANK AND TRUST CO
12e Wthhotding agents Giobat tntermediary tdentitication Number (GttN) 15h Addresa (number and street)
12f Country code 129 Foreign tax dentitication number, 4 any 151 City or town. state or province, country, ZtP or foreign postat code
12h Address (number and street) 16a Payejs name 18b Payers TtN
P0 BOX 5010
121 City or town, state or province, country, ZIP or foreign postal code ISo Payers GttN 16d Ch. 3 atatua codo 16e Ch. 4 status code
BOSTON MA 02206-5010
13a Recipients name 13b Recipient’s country code 17a State income tax withheld 17b Payers state tax no. 17c Name of state
MINtSTRY OF FtNANCE OF THE REPUBLIC OF
EN
13c Addreas (number and atreet)
SUUR AMEERIKA 1
13d City or town, state or province, country, ZIP or foreign postat code
TALLtNN, EN 10122
(keep for your records) Form 1 042-S (2024)
Page 1 of 5
002014 90065373432 703 01 0 0000 0 000
_____________________
1
Explanation of Godes U.S. Income Tax FiIing Requirements
Box 1. Income Code. Generelty, every nonresident elien individuel, nonresident elien fiduciery, and foreign
Code Types of Inconie corporation mith U.S. inoome, inoluding inoome thet ix eifeotively oonneoted mith the
Interest oonduct of e iredo or buxinexs in the United Stetes, muxt file x U.S. income tex retum.
01 Interest paid by U.S. obligors-generel l-lowever, no return ix required lo be filed by e nonresident elien individuel, nonresident
02 lnterest peid on reel property mortgeges elien tiduoiery, or foreign oorporetion if suoh person wes not engeged in e trede or business
03 lnterest peid to controlling foreign corporatioes in the United Stetes xl eny time during the tex yeer and if the lex liebitity of such person
04 lnterest peict by foreign corporetions wes fully safixfied by the withholding of U.S. lex eI the xouroe Corporationx lue Form
05 lnterest on tex-free covenent bonds 1 120-F; eli others fite Form 1040-NE. You mey get the retum formx and inxtruotionx eI
22 Interest peid on deposit with e foreign branch ota clomestic corporetion or tRS.gov, eI any U 5. Embessy or conxulete, or by mriting to: Inlernal Revenue Service,
partnership 1201 N. Mitxubixhi Motorwey, Bloomington, IL 61705-6613.
29 Deposit interest
30 Originel issue discount (OlD) En rrtgle gönörele, tout dtrenger non-räsident, tout orgenisme fiddioommisseire dtrxnger
31 Short-term OlD non-rdsident eI toute sooiötd dtrengdre peroevent un revenu eus Etetx-Unix, y oompris tout
33 Substitute payment-interest revenu ddried, en feit, du fonolionnement d’un oommerce ou d’une effeire eux Etetx-Unis,
51 lnterest peid on certain ectively treded or publicly offered secorities)1) doit produire une ddoIaretion d’impöt sur le rexenu euprrts des servioes fisoaux des
54 Substitute peyments-ieterest frore certain actively traded or poblicly otterect Etets-Unis. Copendent euoune ddoieretion d’impöt sur le revenu n’est exigde d’un dlrenger
securities[1] non-rdsident, d’un orgenisme fidrtioommissxire ötrenger non-räsident, ou d’une sooirttä
Dividend dtrangöre siis n’ont pris perI ä euoun oommeroe ou effeire eux Eteis-Unis 4 euoun moment
06 Dividends paid by It.S. corporations-generat pendxnt l’annde fisoale eI si lex impåts dont ilx sont redesebies, onl dtrt entirtremenl
07 Dividends quelifying for direot dividend rate eoquittdx per une retenue 4 le souroe sur leur saleire. Lex xooidlds doiveni feire leur
08 Dividends paid by foreign corporations döolerxtion d’impöt en remplixsent le formuieire 1 120-F, fous lex eutres redesebles doixent
34 Substitute payment-dividends remplir le formuleire 1040-NE. On peut se proourer iex formulsires de ddoleretions d’imp8tx
40 Oiher dividend equivalents under IRC section 871(m) ei lex insfruolions y effdrentes 4 IRS.gox eI dens toutes lex embessedes eI tous lex
52 Dividends paid on certein aotively treded or publicly offered securities[1j oonxuletx des Etetx-Unix. Von peut ögeiement x’edrexxer poer toul renxeignement 4:
53 Substitute peyments-dividends from oertain ectively freded or pubhoIy offered tnternei Revenue Servioe, 1201 N. Mitxubixhi Motorwey, Oloominglon, tL 61705-6813.
securitiesf 11
56 Dividend equivelents under IRC section 871(m) ase resuit of spplying the Por regix general, lodo extrenjero no residenle, lodo orgenixmo fideioomixerio extrxn)ero no
oombined transeolion rules residente y tode xooieded xnönime extrenjere que reoibe ingrexox en los Extxdox Unidox,
Ofher inoiuyendo ingrexox releoionedox oon lx oonduooiön de un negooio 0 oomeroio dentro de los
09 Capitel gains Estedox Unidos, deberå presentar une deoixreoiön extedounidense de impuestox xobre ei
10 lndustriel royelties ingrexo Sin embergo, no se requiere deolereoiån elgune e un indixiduo exiren)ero, ene
11 Motion pioture or television oopyright royalties xooieded anönima extran)era u orgenixmo fideioomixerio extrenjero no residente, xi tel
12 Other royelties (for essmple, oopynght, softwere, brosdcesting, endorsement perxone no he efeoiuedo oomeroio o negooio en los Exfedox Unidox durente ei arto fixcal y
peyments) eila rexponxebiiided oon los impueslos de tel persone he xido setixfeohe plenemente
13 Royelties peid on oertsin publioly olfered securities[1j mediente retenoiön del impuesto de los Extadox Unidox en ix fuente. Las xooiadedex
14 Reel property inoome sed neturel resouroes royelties anönimex envian ei Formulerio 1120-F; todos los demåx oontribuyentex enxien ei
15 Pensions, ennuities, elimony, end/or insurenoe premiums Formuixrio 1040-NE. Se podrä obtener formularios e inxlruooionex en IES.gov y en
16 Soholership or fellomship grents ouxlquier Embajeda o Oonxuiado de lox Exiadox Unidox 0 exoribiando direotamente e:
17 Compensetion for independent personel servioes[2] Inlernel Revenue Servioe, 1201 N. Mitxubixhi Motorwey, Bloominglon, IL 61705-6613.
18 Compensetion for dependent personel services[21
19 Compensstion for teeohing[2j Im aligemeinen muxs )ede xuxiendixohe Einzelperxon, )eder auxlendixohe Bevolimeohtigte
20 Compenxxtion during xtudying and treining[2j ued lede auxlandixohe Gexeluxohxft mit Einkommen in den Vereinigten SIssIen,
23 Other inoome einxohliexxlioh des Einkommenx, melohes direkt mit der Auxöbung von Nendal oder
24 Ouelified invextment entity (OlE) distributionx of cxpitel geins Gxmerbe innerhxlb der Stxaten verbunden ixt, eine Einkommanxteuererklärung der
25 Truxt dixtribufionx xubject to IRC seotion 1445 Vereinigten SIssIen ebgeben. Eine Erkierung, muxx jedooh nioht von Ausiändem,
26 Unxevered groming oropx and timber dixtributionx by e truxt xubject to axxlendixohen Bexoilmäohtigten oder euxländixohen Gexelixoheflen in den Vereinigten
IRC xection 1445 Staelen eingereioht merden, felix eine xolohe Perxon mährend des Sleuer)ahrex kein
27 Publicly treded pertnerxhip dixtribulionx xub)eot to lEO seotion 1446(e) Gemerbe oder 1-landel in den Vereinigten Staeten auxgeuibt heI und die Steuerxohuld duroh
28 Gembling minningx[3J Einbeheitung der Steuern der Vereinigten Staaten duroh die Einkommenxquelie abgegoiten
32 Notionei prinoipal oontrxot inoome[4] xl. Geseilsoheften reiohen den Vordruok 11 20-F ein; alle anderen reiohen dxx Formbixlt
35 Subxtitute peyment-ofher 1040-NE ein.
36 Cepitei geinx dixtribulionx Einkommenxteuererklerungen und Instruktionen können unter IRS.gox und bei den
37 Return of oepitel Botxohxften und Konxulxlen der Vereinigfen Steeten eingehoit werden. Um weitere
38 Eligible deferred compeexetion itemx xubject to lEO xeotion 877A(dfll) Informationen mende man xioh bitte en lnternxi Eevenue Servioe, 1201 N Milxubixhi
39 Dixtributionx from e nongrentor truxt xubject to lEO seofion 877A(f))1) Motorwey, Eloomington, IL 6170S-661 3.
41 Guerentee of indebtednexx
42 Eerningx es en ertiet or ethlete-no centrel wilhholding egreement[5]
43 Eerningx es en ertist or ethlete-centrei withholding egreement[5)
44 Specitied federel procurement paymenlx
50 tnoome previouxly reported under escrow prooedure[6j
55 Texeble deeth benefitx on life inxurence oontrects
57 Amount reelized under lEO seotion 1446(f)
58 Publioly treded pertnerxhip dixtributions-undetermined
Boxes 3a and 4a. Exernpt)on Code (applles if the tsx rate entared in box 3b or 4b ts
00.00).
Gode Authority for Exentpt)on
Ghapter 3
01 Effeotiveiy conneoted inoome
02 Exempt under 1110)7)
03 lncome ix not from U.S. xourcex
04 Exempt under tee treety
05 Portfolio interest exempt ender lEO
06 01 thet essumes primery withhoiding responsibility
07 WFP or WFT
08 U.S. brench treeted ex U.S. Perxon
10 01 reprexents thxt inoome ix exempt
11 OSL Ihat esxumes primery mifhholding responsibility
12 Peyee xubjected to ohepter 4 withholding
22 ODD ihet essumes primary mithhoiding rexponxibilify
23 Esempt under seotion 897(i)
24 Exempt under seotion 892
See beck of Copy C for additionel oodes
)1) Thix oode xhould oniy be uxed 8 the unoome peid ix dexoribed in Reguletionx seotion 1.1441 -6(o)(2) and the withhoiding egenl hes reduoed the rete of mithhoiding under en inoome lex
Ireety mithout the reoipient proxiding e U 5 or foreign TIN.
)2) lf oompenxetion thxt otherwixe mould be ooxered under Inoome Oodex 17 through 20 ix direoily altributebie to the reoipient’x oooupetion xx en artixt or ethiele, use Inoome lode 42 or
43 inxtead.
Page 2 of 5
1 042—S 1 Foreign Person’s U.S. Source Income SubJect To Wlthholding 1 OMB No. 1545-0096
Department of the Treasury
Internal Revenue Service
1 Income 2 Gross income
I! Go 10 w*w.irs.govIFormlO42S for iflatnJCtionS and the tatest flfOfmatlOn.
n 1 o 0 1 0 9 1 4
3Chapterindicator.Enter
1 1 1
“
o 1
or “4”
2 1 UNIQUE FORM IDENTIFIER
3
11 AMENDED
13e Recipent’s U.S. TIN, if any
AMENDMENT NO.
Gopy C for Recipient
Attach to any Fecteral tax return you file
13f Ch.3 status code 36
code
3a Exemption code 24 4a Exemption code 15 13g Ch.4 status code 27
01 $82618.00
3b Tax rate 00 00 4b Tax rate 00 00 13h Recipient’s GIIN 131 Recipient’s foreign tax identification 13J LOB code
number, 4 any
5 V6thhotding allowance
6 Net incon,e
7a Federat las withheld $000 13I Recipient’s account number
0139
7b Check 4 federal tee withheld was rtot depositecl with the IRS because
escrow procedures were applied (see iflStructiofls) 131 Recipient’s date of birth (YYYYMMDD)
7c Check if withholding occurred jo subsequent year with respect to a
partnership interest
8 Tax withhetct by other agents $0.00 14a Primary Wthholding Agent’s Name (if appticable)
9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
($0.00) 14b Primary Wthholding Agent’s EIN
10 Total withholding credit (combine boxes 7a, 8, and 9) 15 Check 4 pro-rata basis reporting jj
$0.00 15a Intermediary or tlow-through entitys EIN, if any 15b Ch.3 status code 5c Ch.4 status code
11 Tax paid by withholding agent (amounts not withheld)(see instructions)
15d Intermediary or flow-through entitys name
12a Wthholding agent’s EIN 12b Ch.3 status code 12c Ch.4 status code
04-6288081 15 01
1 Se Intermediary or flow-through entity s GIIN
12d Wthholding agent’s name 1Sf Country code 15g Foreign las identification number, 4 any
SEINE & CO
STATE STREET BANK AND TRUST CO
12e Withholding agent’s Gtobal Interrnediary Identification Number (GIIN) 151t Address (number and street)
12f Country code 12g Foreign tax identification number, 4 any 151 City or town, state or provlnce. country, ZIP or foreign postal code
12h Address (number and street) 16a Payefs name 16b Payers TIN
P0 BOX 5010
121 City or town, state or province, country, ZIP orforeign postal code 16c Payers GIIN 16d Ch 3 status code 16e Ch. 4 status code
BOSTON MA 02206-5010
13a Recipient’s name 13b Recipient’s country code 17a State income las withheld 17b Payers state las no. 17c Name of state
MINISTRY OF FINANCE OF THE REPUBLIC 0F
EN
13c Address (number and street)
SUUR AMEERIKA 1
13d City or town, state or province, country, ZtP or foreign postal code
TALLINN, EN 10122
Form 1042-3 (2024)
Page 3 of 5
002014 90065373432 703 02 00000 0000
Explanatiori of Codes (conlinued) 09 Regiatered Deemed-Compl’ant FFI-Olher
10 Certitied Deemed-Complianl FFI-Olher
Chapter 4 11 Certified Deemed-Compliant FFI-FFI with Low Value Accounts
13 Grandfalhered payment 12 Cerlified Deemed-Complianl FFI-Nonregislering Local Bank
14 Effeclively connected income 13 Certified Dnemed-Complianl FFI-Sponnored Entity
15 Payee nol subjecl to chapler 4 wilhholding 14 Certitied Deemed-Complianl FFI-Inveslmenl Entily Ihat doen not maintain
16 Excluded nonhinancial payment financial accounls
17 Foreign Enlily Ihal assumes primary wilhholding responsibilily 15 Nonpartic’paling FF1
18 U.5• Payees-of participaling FF1 or reg’slered deemed-compliant FF1 16 Owner-Documented FF1
19 Exempt kom wilhholdirig under IGA[8J 17 lis. Branch-Ireated as liS. person
20 Dormant accounI[9 18 lis. Branch-not trealed as lis. person (reporting under aection 1471)
21 Other-paymenl nol subjecl lo chapler 4 wilhholding 19 Passive NFFE idenlifying Subslanlial lis. Owners
20 Fansive NFFE wilh no Subslanlial U.5 Owners
Boxes 12b, 12c, 13t, 13g, 151,, 15c, ISd, and 16e. WthholdingAgant, 21 Publicly Traded NFFE or Aifiliale of Pubticly Traded NFFE
Racipient, Intermadiy, and Payer Chapter 3 and Chapter 4 Statua Godea. 22 Aclive NFFE
23 Indiaidual
Code Type of Raciplent, WtflioIdIng Agent, Payer, or Intermediaiy 24 Snction 501(c) Entilies
Chapter 3 Statu8 Codes 25 Escepted Terrilory NFFE
05 li 5 branch-treated asU 5. Person(10( 26 Escepted NFFE-Other
06 U 5. branch-not lrealed as U & Person[1 ii 27 Exempt Beneficial Ownnr
07 115. branchECI presumptiori applied 28 Enlily Wtrolly Owned by Enempl Bennficial Owners
08 Partnership olher Ihan Wlhholding Fcreign Parlnership 29 Unknown Recipinnl
or Publicly Traded Partnerah’p 30 Recalcilranl Account Holder
09 Wilhholding Foreign Parlnerahip 31 Nonreporting IGA FF1
10 Trusl olher Ihan WlhhoIdng Foreign Tnisl 32 Direct reporting NFFE
11 Wilhholding Foreign Trual 33 liS. reportahle accounl
12 Qualilied Inlermediary 34 Nonconnenting liS. accounl
13 Oualilied Securilies Lender-Qualilied Inlermediary 35 5ponnored direct reporting NFFE
14 Qualilied Securilies Lender-Olher 36 Excnplnd Inler-atfilialn FF1
15 Corporation 37 lindocumenled Preexisling Ohligation
16 Individual 38 liS. Branch-ECI presumplion applind
17 Estate 39 Account Holder of Excluded Financial Account[13[
18 Privale Foundalion 40 Pannive NFFE reported by FFI[14[
19 International Organizalion 41 NFFE nubject to 1472 wilhholding
20 Tas Exempl Organization (Seclion 501(c) enliliea) 50 liS. Withholding Agent-Foreign branch of FI
21 Unknown Recipienl Pooted Reponting Codes
22 Artist or Athlete 42 Recalcilranl Pool-No liS. lndicia
23 Pension 43 Recalcilrant PooI-li.S Indicia
24 Foreign Cenlral Bank of lasue 44 Recalcilrant Pool-Dormanl Accounl
25 Nonqualitied Inlermediary 45 Recalcitranl PooI-li.S Pernonn
26 Hybrid enlity niaking Treaty Claim 46 Recalcilrant Pool-Pannive NFFEn
35 Oualitied Derivalives Dealer 47 Nonparticipating FF1 Pool
36 Foreign Governmenl-Integral Part 48 li 5. Payees Pool
37 Foreign Government-Conlrolled Enlily 49 0t-Recalcilrant Pool-General[15[
38 Publicly Traded Partnership
39 Diaclosing lualified Inlermediary Box 13]. LOS Gode (enter the code that best desatbes the applicable Iimttation on benefita
Pooled Reporting Codes(12 (LOS) categoiy that quattftes the taxpayer for the requested treaty benetlte).
27 Wlhholding Rale Pool-General LOS Code LOS Treaty Cetegoty
28 Withholding Rale Pool-Esempl Organization 02 Governmenl conlracling stalefpolilical nubdivisiorntlocal aulhority
-
29 PAI Wlhholding Rale Pool-General 03 Taa esempt pension lruntlFennion tund
30 PAI Wlhholding Rale PooI-Exempl Organizalion 04 Tee exemptlCharilable organiaalion
31 Agency Wilhholding Rale Pool-General 05 Publicly lraded corporalcon
32 Agency Wlhholding Rale Pool-Esempl Organiralion 06 Subnidiary ot publicly traded corporalion
07 Company Ihat meels the ownership and bane eronion teet
Chapter 4 Status Godes 08 Company Ihat menIn the derivalive benefitn teet
01 U.S Wlhholding Agenl-FI 09 Company wilh ao item ot ncome Ihat menIn the actine trade or buninenn tenI
02 lis. Wlhholding Agenl-Olher 10 Dincretionary determmnation
03 Terrilonj FI-not trealed as liS. Person 11 Other
04 Territory FI-lrealed as li 5. Person 12 No LOS artmcle in treaty
05 Participaling FFI-Olher
06 Participaling FFI-Reporting Model 2 FF1
07 Registered Deemed-Complianl FFI-Reporting Model 1 FF1
08 Regiatered Deemed-Complianl FFI-Sponsored Enlily
[3] Sub)ecl to 30% wmthholdmng rate untesn the recipient in kom one of the treaty countrien linted under Gambling winmngn (Income Code 28) in Puh 515
[4] Use approprmale Intereat Income Code tor embedded inlerent in a nolional prmncipal contract.
[5] Income Code 43 nhoutd only he uned if Leller 4492, Venue Notificalion, haa been innued by the tnlernal Renenue Servmce (olherwiae. une tncome Code 42 for eamingn en an arlint or alhlete).
lf tncome Code 42 or 43 me uned, Recmpienl Code 22 (artiat or athtete) nhould be uned inntead of Recipient Code 15 (mndmaidual). 15 (corporalion), or 08 (partnarnhmp olher Ihan withhotding foreign
parlnernhip or publicly lraded partnernhip)
[6] line only to report grosa income the las for whmch me being deponited in the current year hecause such las waa previounly encrowed for chaptern 3 and 4 and the withholding agent
previounly reported the gronn income in a prior year and checked the bos to report the tee an not deponited under Ihe escrow procedure See the inntructiona lo thin form for further espianalmon.
[7] Thin code nhould only he uned 4 no other specif mc chapter 3 exemplmon code applies.
[8] line only to report a li 5. reporlabte account or nonconnenting li.S account that in receining a payment nubject to chapler 3 wmlhholding
[9] line only it applymng the encrow procedure for dormanl accounts under Regulatmonn nection 1.1471-4(b)(6) If tas wan withheld and deposited under chapter 3, do not check box 7b
(“las not deponited wmth tRS purnuant to encrow Frocedure”(. You muet inntead enter “3” in hos 3 and complele bos 3b
[10] Thin code can he used by a Terrmtory FI thal is trealed an a liS. pernon.
[11] This code can he uned by a Territory Ft Ihat in nol treated an a liS. pernon.
[12] Codes 27 through 32 should only he uned hy a II, OSL, WP, or WT. Ali acting as a ODD may uno only code 27 or 28.
[13] Thin code nhouid only he uned if income in paid to an accounl thal in escluded from the defmnitron of tinancmal account under Regulationn nectmon 1.1471 -5(b))2) or under Annos II of the
applicable Modet 1 IGA or Model 2 IGA.
[14] Thin code nhouid only he uned when the wilhholdmng agent han receiaed a certitication on the FF1 withhoiding ntatement of a partmcipating FF1 or regintered dnnmed-complianl FF1 that
maintainn the account Ihat the FF1 han reported the accounl held by the pannmne NFFE an a li.S. accouot (o li.S reportahle account) under iln FATCA requirementn. The withholding agenl
munt report the name and GIIN of nuch FF1 in bonen 15d and iSo.
[15] Thin code nhould only he uned by a wmlhholdirl9 ageni Ihat in reportmng a payment (or porlmon ota payment) made to a II wmth renpect to the lI’n recatcitrant accouni holdern.
Page4of 5
1 042—S 11 Forei9n Person’s U.S. Source IncomeftteSubject To Vvithholding
Go 10 www.irs.gov/FormIO42S for lnstructions and lateat information. ©24 1 DM6 No. 1545-0096
Copy D for Recipient
Department ot the Treasury Allach 10 any stale tax return you tie
Internal Revenue Service 0 1 0 1 0 1 0 1 9 4 1 0 1 0 1 0 1 21 UNIQUE FORM IDENTIFIER AMENDED AMENDMENT NO.
1 inoome 2 Gross ineome 3 Chapterinditor. Enter “3 or
OO4O
3 13e Recipient’s U.S. TIN, if any 13f Ch.3 status code 36
code
3. Exemplion code 24 4. Exemplion coda 15 13g Ch.4 status code 27
01 $82618 00
3b Tax rata 00 00 4b Tax rate 0000 13tt Recipient’s GIIN 131 Recipienl’s foreign tax idenlification 13 LOB code
nuniber, 1 any
5 Withholding aliowance
6 Nel income
7. Federal tax withheid $0.00 13tt Recipienrs account number
0139
7b Check if federal tax withheld was fbI deposited with the IRS because
escrow procedures were appliecl (see instructions) 131 Recipienrs date of birlh (YYYYMMDD)
7c Check if withholding occurred in subsequent year wilh respeot 10 a
parlnership interest . . .
8 Tax withheld by other agenls $0.00 14. Primary iMthhotding Agenl’s Name (it applicable)
9 Overwithheid tax repaid 10 recipient pursuanl to adjuslmenl procedures (see instructions)
($0.00) 14b Primary tMlhholding Agenl’s EIN
10 Total wilhhotding credit (combine boxes 7a, 8, and 9) 15 Check if pro-rata basis reporting
$0.00 15a intermediary or flow-through entily’s EIN, if any 150 Ch.3 slalus code 150 Ch.4 status code
11 Tax paid by wilhholding agent (amounls fbI withheld)(see inslruClions)
15d Inlermediary or fiow-lhrough entity’s name
12a Wlhholding agenls EIN 12b Ch.3 slatus code 12c Ch.4 slatus code
04-6288081 15 01
___________________________________________________________________________ 15. Intermediary orflow-through enlitys GIIN
12d tMlhholding agent’s name 15f Country code 15g Foreign tax identificalion number, if any
SEINE & Cl
STATE STREET 8ANK AND TRUST Cl
12. Withhotding agenrs Giobal Inlermediary Idenlificalion Number (GIIN) 151i Address (number and slreel)
121 Country Code 12g Foreign lex dentification number, if any 151 City or town, state or province, country, ZIP or foreign poslal code
12tt Adctress (number and street) 16. Payer’s name 160 Payer’s TIN
P0 BOX 5010
121 lily or lown, stale or provinoe, country, ZIP or foreign postal code 150 Payer’s GIIN 16d Ch. 3 slalus code 16. Ch 4 slatus code
BOSTON MA 02206-5010
130 Recipienl’s Country code 17a SIale income lex wilhheld 17b Payes state lex no. 17c Name 01 stale
MiNSRYOFFiNANCE 0F THE REPUBLIC OF
EN
13c Address (number and streel)
SUUR AMEERIKA 1
13d lily or lown, stale or province, Country, ZIP or foreign poslal Code
TALLINN, EN 10122
Form 1042-S (2024)
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