**Form W-8IMY**
Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax Withholding and Reporting

Section references are to the Internal Revenue Code.
Go to www.irs.gov/FormW8IMY for instructions and the latest information.
Give this form to the withholding agent or payer. Do not send to the IRS.

Do not use this form for:
- A beneficial owner solely claiming foreign status or treaty benefits (other than a qualified intermediary (QI) acting as a qualified derivatives dealer (QDD)). Use W-8BEN or W-8BEN-E
- A hybrid entity claiming treaty benefits on its own behalf (other than a QI acting as a QDD). Use W-8BEN-E
- A foreign person claiming that income is effectively connected with the conduct of a trade or business in the United States. Use W-8ECI
- A disregarded entity with a single foreign owner that is the beneficial owner (other than a QI acting as a QDD) of the income to which this form relates. Instead, the single foreign owner should use W-BBEN, W-8ECI, or W-BBEN-E
- A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 893, or 1443(b). Use W-BEXP
- U.S. entity or U.S. citizen or resident. Use W-9
- A foreign person documenting itself for purposes of section 6050W. Use W-8BEN, W-8BEN-E, or W-8ECI

**Part I Identification of Entity**

1. Name of organization that is acting as intermediary: Aon Bermuda QT Holdings Ltd.
2. Country of incorporation or organization: Bermuda
3. Name of disregarded entity (if applicable), see instructions

**4 Chapter 3 Status (entity type) (Must check one box only):**
- ☑️ QI (including a QDD). Complete Part III.
- Nonqualified intermediary. Complete Part IV.
- Territory financial institution. Complete Part V.
- U.S. branch. Complete Part VI.
- Withholding foreign partnership. Complete Part VII.

**5 Chapter 4 Status (FATCA status) (See instructions for details and complete the certification below for the entity's applicable status.)**
- ☑️ Publicly traded NFEE or NFEE affiliate of a publicly traded corporation. Complete Part XXIV.

**6 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a registered address):**
Aon House, 30 Woodbourne Avenue
City or town, state or province. Include postal code where appropriate. Pembroke, HM 08
Country Bermuda

**7 Mailing address (if different from above)**
City or town, state or province. Include postal code where appropriate.
Country

**8 U.S. taxpayer identification number, if required ▶ 98-0242757**
- ☑️ QI-EIN
- WP-EIN
- WT-EIN
- EIN

**9 GIIN (if applicable)**

**10 Reference number(s) (see instructions)**
Aon (Bermuda) Ltd.

For Paperwork Reduction Act Notice, see separate instructions.
Form W-8IMY (Rev. 6-2017)
JSA
6WB501 3.000