EFTA01255652.pdf

Fenn W-9 (Rev. Deseyber Request for Taxpayer Giver Form to the 2011) Department of to beady Identification Number and Certification requester. send to theDo not IRS. Head to &tyke Name (as shonn on your IncaseIn murt TEC e1 _I-tc, nine,V different Iran above ni Maims nerneldereecled entity 1 puck IPPlaxiele box for federal tat direellicabore M redivremavade proximo( 0 C Corporetbn II S Comoretim 0 Partnenner 0 Tnatiestete 10 QLInOd liability metre. Fear the ley ckucsifrralica (C.0 topcoat:" S, S corPorat el. P-_psdenho), Crew (see instructions) e E I . 0........ CleurnPt Mee floq.ostflrams end addeea(ga &) City. add,IntlDP code 4r rieptets, yv cc-is t; L List somas nartmr(a)hem Waal) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the Name line Seed ',aunty number to avoid backup withholding. For individuals, this is your social *murky number (SSI4), However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, his your employer identification number (EIN). if you do not have a number, see How to get a 77N on page 3. Note. If the account is in more than one name. see the chat on page 4 for guidelines on whose Employer idereecatIon weber number to enter. Part II Certification 11 Under penalties of perjury, I certify that 1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be issued to me), and 2. lam not subject to backup withholding because: (a) I arm exempt from backup withholding. or (b) I hen not been notified by the Internal Revenue Service (IRS) that I err, subject to backup wfihttokting as • result of • (alum to report all interest or dividends, or (c) the IRS has notified me theft am no longer subject to backup withholding. and 3. I am a U.& citizen or other U.S. person (defined below). Certification instructions. You must crow out item 2 above if you have boonnotiRed by the IRS that you we currently subject to backup withholding because you have failed to report all interest rind dtvidehrls on youriex rethin. For reN estate transactkna Item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured p etatkan of debt. cgntributions to an individual retirement arrangement (RA), end generally, payments other than Interest and dividends are not required to tilgny certification, but you must provide your correct TIN. See the instructions on Page 4. • ith Sign sic real , r7 Here us moon.; Date e General Instructions Note. If a requester gives you a form other than Foram W-9 to request your TIN, you must use the requester's form if It is substantially similar Section references we to the Internal Revenue Code unless otherwise to this Form W4. noted. Definition of a U.S. person. For federal tax purposes, you are Purpose of Form considered a U.& person if you we: A person who is required to file an information return with the IRS must • An individual who Is a U.S. citizen or U.S. resident alien, obtain your correct taxpayer identification number (TIN) to report, for • A partnership, oorporartIon, company, or association created or example, Income paid to you, reel estate transactions, mortgage interest organized in the United States or under the laws of the United States you paid, acquisition or abandonment of secured property, cancellation • An estate (other than a foreign estate), or of debt. or contributions you made to an IRA. • A domestic trust (as defined In Regulations section 301,7701.7). Use Form W-9 only if you are a V.S. person (Including a resident alien), to provide your correct TIN to the person requesting it (the Special rules for partnerships. Partnerships that conduct a trade or requester) and, when applicatie. to: business in the United States are generally required to pay a withholding tax on any foreign partners' share of Income from such business. 1. Certify that the TIN you en riving Is correct (or you are wafting for a Further, in certain cases where a Form W-9 has no been received, a number to be Issued). partnership is required to presume that a partner is • foreign person. 2. Certify that you are not subject to backup withholding, or and pay the withholding tax. Therefore, if you are a V.S. person that is a 3. Claim exemption from backup withholding If you we a U.S. exempt partner in a partnership conducting a trade or business in the United payee. If applicable, you are also certifying that as a U.& person, your States, provide Form W-9 to the partnership to establish your U.S. allocable share of any partnership income from a U.S. trade or business status and avoid withholding on your share of partnership Income. is not subject to the withholding tax on foreign partners' share of effectively connected income. Ca No. 1023IX Farr W-9 (Rev. 12-2011) SDNY_Gfel_00063434 CONFIDENTIAL - PURSUANT TO FED. R.QP . AIE I DENTIAL DB-SDNY-0026259 EFTA_00173942 EFTA01255652