Application for a full relief at source from Dutch dividend tax (USA pension funds)

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By using this form, an applicant (fund, entity or other organisation) from the United States may apply for an exemption from, or refund of, Dutch dividend tax. However, this is only possible if the applicant operates exclusively for the purpose of managing or providing benefits by virtue of one or more funds or schemes, or was established for the purpose of providing pension payments or other employee benefits.

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