Providing a false or fraudulent withholding tax statement. • Failure to provide information on a withholding certificate or for filing a false certificate.In order to apply the withholding to the gain, the seller must complete Form NR-AF2 (Affidavit of Seller's Gain) attesting to the amount of the taxable gain. The Form W8BEN, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding PDF is a legitimate US tax exemption document. Our Investigation starts with your report. These statements show the income and any taxes already 'withheld' (paid for you) on that income. Ombudsman Inquiry Form. The Maryland Division of Unemployment Insurance (the Division) offers several ways claimants, employers, and third-party agents can contact us. Unemployment insurance provides short-term income to unemployed workers who lose their jobs through no fault of their own. Are you the surviving spouse of a U.S. armed service member who died on active duty?