Case File
efta-01362843DOJ Data Set 10OtherEFTA01362843
Date
Unknown
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DOJ Data Set 10
Reference
efta-01362843
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1
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0
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Form W
'''9
(Rm. ocarierene
Navin* of the Own(
Nun Range Santa
Request
for Taxpayer
Identification
Number and Certification
Civil Form to the
requester. 0o net
send to the IRS.
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I Nam as sawn on yew Inecene lax worn} Nome :4 a °quirt", on This lint. 00 not tem ,Mt Inn blank
Southern Trust Company, Inc.
pum
a
ma namereistegardoci enely Ire, Nallorenf Item above
Southern Financial, LLC
3 Crack *egoistae
O lnenagli5,350
shyomenber
O Untied Malfit
tort a brogbalictibel
Ow Ia ounlecterm
box ter Wen lax otaaellhagon: OW on a.. el the tonotrIng swan ton=
groan et
❑O 0 Caverebe
0
S Canteen O
Panne-We
O Tne-Vesiato
U..0
'compsy. Iola the tar ciamaketka PAC oceporattn. SeS corporation. PaparacrahhOP
tic WI 4 C.3:0904130, se net enek LW; rhea he appnen3le box D the raban3 for
lhO sign mamba/ CFACIf.
4 Exemption
gas° anteogrEiter31
EA anti payee
bemPtic"
coda et my)
64.0.. ex vannhavaniorvavo
(codas aceit Otto
fee
eon et ash
keen FATCAnPerni
Ill pow foto InstnaoroP•
...vat
5 11/454•333 (nUelber•Onet. and sp. ceaes tied
6100 Red Hook Quarter, .B3
Requesara mete and addiff4 amino/
aCity. stilt snarl'? cot*
St. Thomas, USVI 00802
7 Ust account maenad Nee leptieral
:Pa -t c
Taxpayer Identification Number (TIN)
Enter your TIN In the appropriate box:therm provided must match the name given on tine 1 to avoid
backup withheldIng. Foe tide/ duds. IMS Is generalty your social security number (SSN). However, for o
resident alien. sole plOcat0f, or dtcreganled entity, sea the Part I Instructions on paged For other
amides. It Is your eMployerldentIDCOUOCI number (EIN). If you do not have a number, see How CO 911!
TIN on page 3.
Unto. If the account Is hi mote lhan one name. see the Inaltuollons for line I and the chart on page 4 lot
guldenes on whose number to enter.
God*
unynumber
or
Rendes& Identification number
alb
0 7 7 9
7i;
Certification
Undo/ ponaftles oI perjury. leen& that
1. The number shown on this form Is my WOOS taxpayer identification number (or t am waiting (outnumber to be VMS to me) and
2. I arn not sugect to tedittp withhtheing because, (a) I ern exempt from backup withholding, a Mitt/Ivo riot been nothied by the Internal Raven.*
Service fit/St that I ern subject to backup withholding as o /mat of a Wily!a to facial ell interest or divklends. Of
the IRS has notified no that I OM
nO longer subject to backup velthholenth and
3. I em a U.S. citizen or other U.S person (defined Wont and
4, The MICA coding entered on tNs form W any) indicating thole/a exempt from FATCA reporlinolscarect.
CartHleadan LnatructIons. You must cross out Rent 2 above If you have been notified by the IRS that you we currently subject to backup sidithilIng
because you have failed to report shinier/al end dividends on your tax return. For real estate hansackons. kern 2 (loan not apply. For trion0.96
interest paid. acquisition or abandonment of secured property. cetneellation of debt, cOntributiOn3 loan haviduel Munn! arrangement (MK end
generally. payments other than Interest end dividends, you ere net required Wean the cerliCostiort, but you neat goads Your correct 11N. Seethe
instructions cm doge 3.
Sign
Hero
SIgnalure el
US. porton►
General Instructions
Seaton telOtelbes 010 le the bon' Flower 0300 Unbent Otherwise noted.
Future davelOprnenb. Inter make and awelooments anectue Form W.9 (nth
as agistabn enacted *nor we release igi s I I tort...input/W.
Purpose of Form
An frollyktue; Or any (Form W-9 'Daunted en is imp:ye 10 Do an intention
rttsn wkh the OX.Itnat obtain yea cerroet to Wave losolteabon umber 1DM
*nth "thy bows sor-bi (00-erf manta PSNOellidual taxpayer identaitatron
number prin, adoption tamayor tOinielcellon Dauber OM or emSayel
dendficalion Marto: (En to report on an Inhanadon rotten ineamowtt paid le
you, or she anoint reportable an on DIcarnaeCct return. Example, or Informatan
nuns eclat. but ore net linked to, the loaner
• Form 1099-IN! (edam amen or pad)
• Fort icied-DIV (thisenco, hoaxing those ham node a mond West
• Fenn 1099•MISC furioustypos of Income, prim awan. or onte3 precoech)
• Fenn 1099.0 Ono* or mutt e fund Ste on anal OS trareactions by
broken)
• "coo 1039.S owned. from red estate Uareadlond
• Form 1099-K (montane cad and tiled pasty network ranractlats)
este Ida0L901*
• Fenn %ea a'cm'e mortgage Neese. nett "dent lean snag. flYST
(tuktorn
• Form 1099.0 Panned (so
• Form i099•Agerariatin et &Wm:err:lent of mewed Property)
Use Then Wei orkft you we a U.S person Padua% a resdeni 0 04 00
rgaVloe yaw *wool TIN.
drarob nor mom Foam Vi-9 so me neensity wk., • MN, stu Mentes rope
to becatanirthokang, See Mats soap niabokerd? on page 2.
By sQtq to leadout loon you:
1. CerVify ewe the Tor you are ono Is owed lor you aro *Wing barman
to be bough.
2. Coney that you an not sung to beekuo wencher**, ow
2. Ctirn manglon ham backup milleldlog If you ent a U.S. aueret payee if
appease you are 640 Cenlyhg Meg meat person your allombh awe of
any pornorolp 'room* Porn a U.S. trade or aunt b not oi•Ofoof a he
watmodirg tax on Wean MOW tat Of elfvelhobe cuaiedod le4014. at
4. Cagy mat FAT CA onart need nab Ion ef ere helical% hit you Na
Mutat from Via FATCA teronhg. acanc. Soo Mot a MICA topenni?on
WW2 tor bier hformation.
Ca. No. 10230(
Form W-9 (Rot 12-201q
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0052492
SONY GM_00198676
EFTA01362843
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