Case File
efta-01372254DOJ Data Set 10OtherEFTA01372254
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DOJ Data Set 10
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efta-01372254
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0
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F. W-9
Ow December 2011)
Dior:roe al tte Treasury
Menal Revue. Serie
Request for Taxpayer
Identification Number and Certification
:live I 'form to the
squoster. Do not
;and 1:0 the IRS.
Name* shoe" at se name tax return)
Butterfly Trust
Busieserernarderogreded entry rem i afferent flan above
Check recroperte box for laded to classification
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Indrricustesore prooneror
K C CaPereen
eaten (nenber. street. and ape a sate no.)
1 6100 Red Hook Guider, S3
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timed ashen cormany. Enter the to essaicatisi (GC oorporstlon. SeS =pore" Paperthenthipi►
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0 Exempt * fee
lily, stew end ZIP code
St. Thomas,
sot=
Lei sown mnbegansee Mein,
Fillgateef norm end edemas plora
to
Taxpayer Identification Number (TIN)
Enter your TIN In the appropriate box The TIN provided must match the name given on the Nene re
to avoid backup withholding. For individuals, this is your social security number (SSN). Flowerer, for a
resident alien. sole proprietor, or disregarded entity, se the Part I instructions on page 3. For other
entities, it is your employer identification number (E W). If you do not have a nimber, see How to pet a
Mon page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number tom*.
Sorel esarity
Employe rdentificath n numbs
216
6 6
9
7 1 1
Part
Under penalties of perjury. I certify that:
1. The number shown on this form is my correct taxpayer identification number (dram waiting fora number to be issued to car
2. I am not sublet to backup withholding because: (a) I am exempt from backup withholding. a (b) I have not been notified by:
Service (IRS) that I am subject to backup withholding as a result of a failure to report alt interest or drvidends. or (c) the IRS hi
no longer subject to backup withholding and
3. I ern a US. citizen or other U.S. person (defined below).
Certification instructor's. You must cross out item 2 above if you have been notified by the IRS that you are currently subject
because you have failed to report it interest and dividends on your lac return. For real estate transactions, hen 2 does not appl
interest paid, acquisition or abandonment of secured property. cancellation of debt, contnbutions to an individual retirement an
generally, payments other than interest and dividends. you are not required to sign the certification. but you mast provide your c
instructions on page 4.
Sign
Here
Certification
SIgnetureol
r
j ...2.1„442 .4
U.S.persioner
General Instructions
Section references are to the Internal Revenue Cede unless otherwise
noted.
Purpose of Form
A peen who is required to tile an information return with the IRS must
obtain your cared taxpayer identification number (TIN) to report, for
example, income paid to you, real estate transactions, mortgage interest
You pad. acquisition or abandonment of secured property, cancellation
of debt, or contributions you made to an RA.
Use Form W-9 only if you are a U.S. person finduding a resident
alien), to provide your correct TIN to the person requesting h (the
coquette) and, when applicable. to
•
1. Certify that the TIN you are giving is correct (or you ere waning 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. II appicable. you are 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 onloreign partners' there of
effectively conoected income.
c and
he Intense Revenue
I) notifkd me that I am
1 backup vrithhoiding
For mortgage
regiment (RA). and
net TIN. See the
Octet R R.o I HI
U Note. If a requester gives you a them ether than F arm W4to request
your TIN. you must use the requester's town
substantmity similar
to this Form W-9.
Deletion of a U.S. person. For federal tax pulp 'ea you are
considered a U.S. person if you We:
• M individual who is a U.S. citizen or U.S. reside r.t alien,
• A partnership. corporation, company. or smock •ion created a
organized in the Linked States or under the laws..! the United States.
• An estate (other than a foreign estate), or
• A hornestic trust (as defined in Regulations zed on 301.7701-7j.
Special nelies for partnersNps. Partnerships
undue a trade a
business in the United States are genteelly retain el to pay a withholding
tax on any foreign partners' share of income from Such business.
Further. in certain cases where a Form W-9 has n betn recemad. a
partnership is required to presume that a partneri a a foregn person.
and pay the vrithhokfirg tax Therefore, if you are 5 U.S. semen that is a
partner in a partnership conducting a trade or bur bees in the United
State, provide Form W.9 to the partnership to ee :ISM your U.S.
status and avoid withholding on your share of par reship intorno.
Cat No. tonty
I Lim Ws9OUV. 12.2011)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0065909
CONFIDENTIAL
SDNY_GM_00212093
EFTA01372254
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