|
Lampiran |
|
Surat Edaran
Direktur Jenderal Pajak |
|
Nomor |
: |
SE - 68/PJ/2008 |
|
Tentang |
: |
FORMULIR SURAT KETERANGAN DOMISILI (FORM 6166) AMERIKA SERIKAT |
DEPARTMENT OF THE TREASURY
INTERNAL REVENUE SERVICE
PHILADELPHIA, PA 19255
Date: 3/26/2008
| Taxpayer |
: |
TAXPAYERS NAME |
| TIN |
: |
XXX-XX-XXXX |
| Tax Year |
: |
2008 |
|
|
I certify that, to the best of our knowledge, the above-named taxpayer
is a resident of the United States of America for purposes of U.S.
taxation. |
Ivy S. McChesney
Field Director, Philadelphia Accounts Management Center
| Form 6166 (Rev. 2-2008) |
Catalog Number 43134V |
Department of the Treasury-Internal Revenue Service |