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efta-01380080DOJ Data Set 10OtherEFTA01380080
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DOJ Data Set 10
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efta-01380080
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Form W-9
(Rev. November 2017)
oewoment cr the Treasuy
Inienve Revenue Senior
Request for Taxpayer
Identification Number and Certification
la Go to www.irs.gov/FormW9 for instructions and the latest Information.
Give Form to the
requester. Do not
send to the IRS.
Print or type.
See Specific Instructions on page 3.
1 Name (as shown on your income tax return). Nan e is required on des Gne; do not teen this line blank
Butterfly Trust
2 Business name/disregarded entity name. if dliferem from above
3 Cheek swop*,
following seven bares.
box for federal tax dassincation of the person vmose name Is entered on Snot. Check
proprietor,"
O C Corporation
0 a Corporation
O Partner:110
LLC
company. Enter the lax deseScaticn (CC corporation 5.5 corporation. P=Partnershie)
ateropriate box in the in. above for the tax classification of the tingle-inonlber mover.
S classified as a artaiihmernber LLC that is disregarded born the owner unless the owner
Is not disregarded horn disowns' for U.B. Wriest la pa-pont Otherwise, a single.mante
from the owner shook) theft the lePlweltdate box toe the tee eleeeteeellen of 0 owner.
only one of the
0 Trust/estate
lb
4 Exemptions
canal" entities,
insbucUons
Exempt payee
Exemption
cede la any)
won.. amextts
(codes apt* only to
not individuals; see
on pogo 3I:
code (I any)
•
Indniztualteole
single-minty
0
Limited Lability
Nola: Check the
LLC a the LLC
another LLC that
is dareguded
O Other (see instructions)►
horn FATCA reporting
Do not CheClc
of the LLC is
LLC that
am fondue can
S Address (number, street, and ate. a arke rho,) it teats.
6100 Red Hook Quarter, B3
Requesters name and address llePtlenee
5 City. state. and Zile code
St. Thomas, U.S.V.I. 00802
7 List account menter(s) here (00tIOnalt
Part I
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this Is generally your social security number (SSN). However. for a
resident alien, solo proprietor. or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see Now to ger a
77N, later.
Note: If the account is in more than one name, see the Instructions for line 1. Also see What Name and
Number To Ghia the Requester for guidelines on whose number to enter.
Social security number
or
Brno/Oyer identification number
2 6
6 6 3 9 7 1
Part II
Certification
Under penalties of pedury, I certify that:
1. The number shown on this form is my correct taxpayer identification number for
wafting for a number to be issued to me); and
2.1am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been nolifted by the Internet Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report ell interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; end
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (f any) indicating that I am exempt from FATCA reporting is correct.
Certification 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. For real estate transactions, item 2 does not apply. For mortgage interest paid.
acquisition or abandonment of secured properly. cancellation of debt, contributions to an individual retirement arrangement (RA), and general/, payments
other than Interest and dividends, yrpr are not required to sign the certification, but you mint provide your correct TN. See the instructions fix Part II, later.
Sign
Here
Signature of
U.B. person ei
I
General Instruction
Section references ere to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to iwnv.tts.gov/FomiWg.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
Information return with the IRS must obtain your correct taxpayer
eleMificatIon number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include. but are not limited to, the foliowing.
• Form 1099-INT (interest earned or paid)
Dow, iobizo
• Form 1099-DIV (dividends, including those from stocks cr mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-8 (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 diem mortgage interest), 1098-E (student loan interest),
1098.7 (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only it you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cal. No. 10231x
Form W-6 (Rev. 114017)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0078212
SONY GM_00224398
EFTA01380080
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