Case File
efta-01295004DOJ Data Set 10OtherEFTA01295004
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01295004
Pages
1
Persons
0
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Form
Ohm Docarbw2011)
Doperrnere
Fiera
W-9
drhi Tann
Request for Taxpayer
Identification Number and Certification
Gin Form to the
requintor. Do not
send to the IRS.
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Part I
Taxpayer Identification Number (TIN)
Enter your TN in the appropriate box. The TIN provided must match the name given on the Nene line
to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a
resident elan, sole proprietor, or disregarded entity, see the Part 1 Inatnictions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
77N on par 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
I Socief security number
Employer identification number
Port II
Certification
Under penalties of periwig, I catty that
1. Tice number shown on this fonn is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I em not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Scrubs (IRS) that I am subject to beckon withholding as a result of a blurs to report all Interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding, and
3. 1 am a U.S. citizen or other V.S. parson (defined below).
Certificate instructions. You must cross out hem 2 above If you have been notified by the IRS that you we currently subject to backup withholding
because you have failed to report all interest and dividends on you tax retum. For reel estatetransactions, item 2 doss not apply. For mortgage
wrang
individual retirement
aband
acqui
generally, payments other than interest and dividenditcr ri
, co
re not
the certification, but you must prowide your coact TIN. See the
interest
acquisition or
onment Of recur
nflation ofd
ntributions to an
ernent (IRA), and
instructions on page 4.
WWI
Here
Signature el
,,
UAL pe
on ►
/
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Purpose of Form
A person who is required to fie an information return with the IRS must
obtain your coned taxpayer identification number (TIN to report, for
example, income paid to you, real estate transactions, mortgage interest
you paid, acquisition or abandonment of secured property, cancellation
of debt, or contrbutions you made to an IRA
Use Form W-9 only if you are a U.S. person including a resident
alien), to provide your correct TIN to the person requesting it (the
requester) and, when applicable, tot
1. Certify that the TIN you are dung b correct (or you are waiting for a
number to be issued),
2. Certify that you we not subject to backup withholding, or
3. Claim exemption front backup withholding If you are a U.S. exempt
payes h applicable, you ars also certifying that as a U.S. person, your
allocable share of any partnership income from a U.S. trade or business
is not subject to the withholding tax on foreign partners' share of
/Moot:wt.,' connected income
Dee a
If a requester gIves you • form other than Form W-9 to request
your TN, you must use the requester's form a his substantially similar
to this Form W-9.
DelWien of a U.S. person. For federal tax purposes, you are
considered a U.S. person If you are
• M individual who is a U.S. citizen or V.S. resident alien,
• A pannership, corporation, company, or association created or
organized in the United States or under the laws of the United States,
• M *Mate (other than a foreign estate), or
• A domestic trust (as defined in Regulations section 301.7701.7).
Special nabs for partnerships. Partnerships that conduct a trade or
business In the United States are generally required to pay a withholding
tax on any foreign partners' share of income from such business.
Further, in certain cases where a Form W4 hos not been received, a
partnership is required to presume that a partner 6 a kaolin pawn,
and pay thee withholding tax. Therefore, if you are a U.S. person that is a
partner in a partnership conducting a trade or business in the United
States, provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership Income.
Cat. No. 10231%
Fan, W-9 (Few. 12.201t)
SDNY_GM_00053686
CONFIDENTIAL - PURSUANT TO FED_ „QC) .NEIDENTIAL
DB-SDNY-0016510
EFTA 00164267
EFTA01295004
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