Case File
efta-01359521DOJ Data Set 10OtherEFTA01359521
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Unknown
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DOJ Data Set 10
Reference
efta-01359521
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1
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0
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Fri
(nov December
Deertinert
Marl
W'-9
2011)
the Treaty
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
al
Revenue Santa
•
Netts tes shwa en your InCOIDI isr rettrn)
Mose t, „rite .
Business nernekrwedwded entity nom if different from stove
Check *propels%
• Indlekluageole
O Ltd %bey
.
0
Other isee Instructional►
box for federal be caseation:
e
0 Exanvi payee
proprietor
•
C Coreoratica
SCcepretion
0
Partneri/ OTrust/CIS
earperry. Enter the tea classicetion (fee catwalks\ S=S corporation, Pqminnenhip)
li
Us
Requester's name and address fogeat
Part I
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the 'Marne line
to avoid backup withholding. For individuals, this is your tocial security number (SSN). However, for •
resident alien, sole proprietor. or disregarded entity. see the Part I instructions on page 3. For other
entities, it is your employer identification number (Eta). 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 chart on peas 4 for guidelines on whose
number to enter.
Sects seasity number
Employe. Idendleatitt Minton'
Part
Certification
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. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (till have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup eithholding as a result of a faun) to report all Interest or dividends, or (c) the IRS has notified me that I an
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below).
Certiflo•lion instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. Fat real eetzdstratisectione, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of recureci.
cancellation of d
ccrirdribution to an individual retirement arrangement ink, and
generally, payments other than intweet and dividoode4yo we not regi 4o pre the certification, but you must provide your correct TIN. See the
instructions on page 4.
Sign
Scinetwe of
Hero
us. panon►
/
7:7/3/
3
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Purpose of Form
A person who is required to file an information return with the IRS must
obtain your correct taxpayer identification number (TIN) to rethrt, for
example, income paid to you, real estate transactions, mortgage interest
you paid, acquisition or abandonment of secured property, cancellaton
of debt or contrbutions you made to an IRA.
Use Form W-9 only if you are a U.S. person (ncluding a resident
alien), to provide your correct TIN to the person requesting it (the
requester) and, when applicable, to:
1. Certify that the TIN you are giving is cored (or you ere waiting for a
number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee. If applicable. you are also certifying that as $ U.S. person, your
allocable share of any partnemhip income from a U.S. trade or business
is not subject to the withholding tax on foreign partners' share of
offect:yoy connected income.
'Note. II • requester giver. you a form other than Form W-9 to request
your TIN, you must use the requester's form if it is substantially similar
to this Form W-9.
Definition of a U.S. person. For federal tax purposes. you are
considered a U.S. person If you are:
• An individual who Its a U.S. citizen or U.S. resident alien,
• A partnership, corporation, company. or association created or
organized In the United States or under the laws of the United States,
• An estate (other than a foreign estate), or
• A domestic trust (as defined in Regulations section 301.7701.7).
Special rules for peetrierships. 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 horn such business.
Further, in certain cases whore a Form W-9 has not been received, a
partnership is required to presume that a partner Is a foreign person.
and pay the withholding tax. Therefore, if you we 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 V.S.
status and avoid withholding on your share of partnership income.
Cat No. 10231%
Form W-90.v. 124011)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0047605
CONFIDENTIAL
SDNY GM_00193789
EFTA01359521
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