**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)) - W-BBEN or W-BBEN-E
- A hybrid entity claiming treaty benefits on its own behalf (other than a QI acting as a QDD) - W-BBEN-E
- A foreign person claiming that income is effectively connected with the conduct of a trade or business in the United States - 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, 895, or 1443(b) - W-8EXP
- U.S. entity or U.S. citizen or resident - W-9
- A foreign person documenting itself for purposes of section 6050W - W-BBEN, W-8BBEN-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.)
   - ☐ Nonparticipating foreign financial institution (FFI) (including an FFI related to a Reporting IGA FFI other than a deemed-compliant FFI, participating FFI, or exempt beneficial owner). Complete Part IX (if applicable).
   - ☐ Participating FFI.
   - ☐ Reporting Model 1 FFI.
   - ☐ Reporting Model 2 FFI.
   - ☐ Registered deemed-compliant FFI (other than a reporting Model 1 FFI, sponsored FFI, or nonreporting IGA FFI covered in Part XIX).
   - ☐ Territory financial institution. Complete Part V.
   - ☐ Sponsored FFI (other than a certified deemed-compliant sponsored, closely held investment vehicle). Complete Part X.
   - ☐ Certified deemed-compliant nonregistering local bank. Complete Part XII.
   - ☐ Certified deemed-compliant with only low-value accounts. Complete Part XIII.
   - ☐ Certified deemed-compliant sponsored, closely held investment vehicle. Complete Part XIV.
   - ☐ Certified deemed-compliant limited life debt investment entity. Complete Part XV.
   - ☐ Publicly traded NFEE or NFEE affiliate of a publicly traded corporation. Complete Part XXIV.
   - ☐ Excepted territory NFEE. Complete Part XXV.
   - ☐ Active NFEE. Complete Part XXVI.
   - ☐ Passive NFEE. Complete Part XXVII.
   - ☐ Direct reporting NFEE.
   - ☐ Sponsored direct reporting NFEE. Complete Part XXVIII.

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
7. Mailing address (if different from above)
   - City or town, state or province. Include postal code where appropriate.
   - Country: Bermuda
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
6W8501 3.000