Delhaize ADS Registered Holders
Notification to Registered Holders
Citibank, as ADR Depositary, has arranged with Acupay System LLC to provide certain tax relief services to holders of the American Depositary Shares ("ADS") of Delhaize Group SA, CUSIP: 29759W101.
On June 9, 2015 your annual Delhaize dividend payment was distributed less a 25% mandatory Belgian withholding tax. Under the terms of the Convention between the U.S. and Belgium for the Avoidance of Double Taxation (referred to as a "Tax Treaty"), and the similar Tax Treaty between Canada and Belgium, as well as other countries, Delhaize shareowners who are U.S. or Canadian taxpayers are eligible for a reduction in Belgian withholding taxes from 25% to 15% for this dividend – representing a refund of 10% of the gross dividend to which you were entitled – as well as refunds of excess Belgian withholding taxes deducted from the 2010, 2011, 2012, 2013 and 2014 dividend payments.
Please see the below detailed information and instructions, including copies of forms and documentation necessary to claim your refund.
Annex A: Belgian Tax Treaty Countries and Treaty Rates
Annex B: Limited Power of Attorney
Annex C: Cover/Transmittal Letter
Annex D: Obtaining an IRS Form 6166 – via Online IRS 6166 Wizard
Annex E: Frequently Asked Questions (FAQ)
Annex F: Obtaining an IRS Form 6166 – Filing Form 8802 Directly with IRS