Case File
efta-01361683DOJ Data Set 10OtherEFTA01361683
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DOJ Data Set 10
Reference
efta-01361683
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1
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Form W-9
(Rea Aug/402013)
Department er the Treaty
menial ROW.. Sot
Request for Taxpayer
Identification Number and Certification
Give Fonn to the
requester. Do not
mend to heat
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berneeket from FATCA torero
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Taxpayer Identification Number (TIN)
Enter our TIN In the aPorwmate box. The TIN movtdad mat match the name given on the `Name line
I 81:48I Lew", number
to av d backup withholding. For inefividuels. this Is your social security number (SSN). However, for •
mold Ord ellen, sole proprietor, or disregarded entity, see the Nit I Inetruc0One on page 3. For other
entitles, It Is your employer Identification number (EIN). IS you do not have a runty, see Nov to got
TIN on pegs 3.
Nolo. If the account Is in mote than one name, see the chart on page 4 for galdialnes on whCee
nurrter to enter.
Employer Wentlflonlan mores
sas
Certification
Under pendia of perjury, I certify their
1. The number town on lit form le my COMICI tscipayer Identification number gel an welting for a number to be Issued to me), and
2. lam not subject to backup witNicidIng because: (a) I am exempt from backup withholding. or (b) I hen not been notified by the Internal Revenue
SeMce (IRS) that I am subject to backup wilhhoking as a rewil of a Wore to report M Interest or &Mends. or (o) the IRS has notilitol roe that I am
no longer subject to backup vrithholcang, and
3. I ern a U.S. citizen or other U.S. person (defined below), and
4. The FATCA oodepd entered on this Fenn gl any) Indicating Met I ern exempt from FATCA reporting Is oorrect.
Certilketton Instmodons. You mat cross out hem 2 above II you have been notified by the IRS that you at curnmey lubbct to backup withhdding
because you have Idled to report IA interest and diddends on your lax return. For fee) estate transactions, Item 2 does not apply. For mortgage
interest pad, soctulehien or abandonment of secured property, canCaltatiOn of debt, contrlbutIons to an Incroiduai retirement ammgement QM), end
generally, payments other then Interest and dMdands, you use MA Mated to sign the certification. but you must provide yow correct TIN. See the
Instructions on wage 3.
Sign
ga le" el
Here
Us. pineal le
General Instructions
Section reforolOW info the Irani Rinware Coda floe at Wee rabid.
Finn dowlwrnontl. The IRS mat versed a paps en Mem for Iderneder,
about Form W-9. at www.fra
o.9.
ormicon spout gm Miss dooluPwrit•
efiectIng Fenn We Ouch on
•
fl
ied ante we nhun p ene be meted
cm the Moe
Purpose of Form
A person "rho le rifled to No en Monte tan ream with the IRS cruet obtain your
cared depart ricers Ion Nell (UN) to report lor exert/pa frame pawl to
you. payneetti made to you h son
d pawned cod end third Deny network
esnextons. reel emote trensectons. mortgage k, St Wu 04. actatUaliOn
WombOrtle d Wandpeavey, cancelletket of debt, or contrbacns you made
to meta.
Use Form W4 only If you are a U.S. pawn (including a melded Sent to
provide your twat 19 to the 001101 nmerwang a fen rerwaried eel, We
IIPPfable. tOt.
1. Certify tat the TN you re ghttngieo:rnict (r you me dine for • number
to be Issued),
2.. Oen* tat mu ere not steed to becalm eleven.. or
3. Chen wereporn front battiap anhokfThg a yOU nen
wan* payee. If
meekehle, you ere ado rarefying that me a US. person. your allocable dare of
wri cartes,* Weed front • U.& trade or tusinese le net SOW 10 the
li-2-7-1C
on bream tad'
alum el effecters cowebed Wane, ad
4. Certify that FATC.Acoleid end& algid lam Ol awl batty the you are
exempt front the MICA repents is correct
Nate you we
Penal WU a requester gene you • Icon dner men Form
Wg to request ma TIt4.mi mug is the reouostere tom nit wbotanttally
sinner to me Fowl W-Ii.
Oemiton Oen permit Frotederel ma purpose,. you ere omektered a U.B.
pawn 1I you at
• an MAWS who bel& cabal et a
rears seen.
• A Wont,
oorporation, company. or esesolallen ores& a ordeal ti the
union Stem or under the dm or the United Betles.
• An dame (oder man a folio) 44101).
• A domes UIW (as dad in Regulations seen 30 1.m .7),
flpeolea net for partnerships. Partrersdpe that conduct • elide or teaks In
the Untied Suttee me control? 'cooked to dry a Saddens malt warn
1448 on any foreign partners' share of sllecmvuly convected taxable Income from
such bushed. Rorer. In <stele rases was a room W4 hes not been recedeed,
tlN ruem under section 1448 noire aptherafptoixewma tat a partner le •
lady pawl and pod the seabn 1418 vex/among um Therefore. d you So •
U.B. person eat Is • partner h a pennomnip cond.:cling a trader bustnees ki te
UMW Stye, proved Form W Er to the partnershp to tatebash ytha U.B. etas
sod mid section 1440 relethoiding on your don or Pertnerehb
Ca. No.10231%
Form W-9 (Rev. 8-2013)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0050908
SDNY GM Orlinrin,
EFTA01361683
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