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efta-01380755DOJ Data Set 10Other

EFTA01380755

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DOJ Data Set 10
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efta-01380755
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Forn W-9 (not Decernte 20:4) >erten or Me neamy I/1mM Froyamo Sonate Request for Taxpayer IdentificatIon Number and CertlficatIon Glye Form to the requester. Do not send to the I RS. N §, & 8 1 S a. *. I 6100 Y dS t neme las glymn ans« ram las Mbrna "Snoe .s mq..44en an h CO m1 leme ital .1ne blank Southern Trust Company. Inc. 2 Buens namordineweed @Møy nanki. e danen from anave Southern Feiende', ISC 3 Check oppropa» n L, IndvIcuaireols langbanamber a ankect liabirny Now Fa • sngle.menber the tex otaceifbaer OMN (wa Innuelle~ for federol daificatbn: fettrMen D Troevestaur le 4 nsercisOmn h ni el?..: rk,;..tt Emnet pens Ext" ti°n cocli yit errA Wittesameanard (mana/c* or4 to on n ra 11-3;."sat sa pm* pode re regt rex creedc orer orm ot mo somt Onn: proprbtor or O C CorwatIon 0 a Co:porsar G Ponnsen4 LLC company. Fatte Me tro desseicaran (CoC corporadon SeS capandr, Pepasr~ LIC Mat h dammene do not check RC: check te innvortes bOx or the seenamentrer emner. " In FATCA n" ribili Ma bm *bom br ~ IN VI; 5 ~me @urter, set. end ape a aula nol Red Hook Quarter. B3 acCentlera nane end arm (Optitne s em, man and istecode St. Thomas, USVI 001502 7 LM eCOM-4 memb041,1b44110~1 Pa IS I Taxpayer IdentMcatIon Number (TIM etter ymte litt In Me oppropet'a bOx. lherN provIdied mutt match the name given 011 fine 1 to avlid bisirup •ro' ind;ooLals, Ibis la genwally your social securtty number Ø. HOWCY1M, for a resident aten, We propeletor. or ceiregarded enfly, sa the Pan I hagellons on nage 3, For other °Meies, d B your employer Identikation nurober (EIN) d you do not havne number, ses How to gote DM or page 3. Hote. MIM ~ant is In moro Man ene name, sog tno eratmclIons lor Snei and Me cha' on naga 4 for i " IST& laLmaacraion numbed guld•lineS on whose ~ber lo enter. seouila ~flot Certrficatron Under pene/gos ol parlere. I ~dy tøt 1. ne mynter *ho« on this foren d my ~OM texpayer Idonnficallon number (or I am metting for tt nutubor ro be 'spued lo mo); and 2. I em not sub;ect to gack ep witM,ot&% benause: gg I am ekornet Iran bactiup wilhltokang, or (b) I have not bnr nobliecl by Un bremas ~ut Service (PS) tist I am subjaa to backup vathtokIng sa a ntet.lt atal/taum to report sl! Innerest or dividends, or (c) the IRS nes nollled me Mai I am no longer subjaa lo bedage waleedaingt and 3. I am a U.S. druen or dh« U.S. person Nollled bokse): and 4. The FATCA bodet,' ~red On Iles tomt (if any) indlcallng [holrom exempt kun FATCA repOrtIng le corroct. Cerefleardon tristructions. You muse posa out Item 2 Wen li you havs been marked by the IRS that you are CUllilfilly 5UblOCt to backup untrholclIng botause you have foged to report se Intenst and dividende on your lax return. For real °state trancasliont, dom 2 dons not appty. Fot 4111122MM Inler0s1 pa4, teocesleldon or abandonerer' ol SOMM1X1pnmetty. cancellation ol det4, °rettarbota lo an nclirkruar talkumen* streng 'Ment (MAX end generalry. payrrents °Med than Intenst ond &ridende, you are not roquIred » eign die cortificadon, Celt yd/ must bratne your come% na See the 'nyttast ons on >ege 3. Sign I eignarre Hors ud. .. •riont r , l ~Ml General Instructions ~Ion referert» am to the Imamar Rome Code enten othenetsenoted. Futura dnesiopmente Iniarraket toa development. fl atna Form Yir.fl huen tl legine len enacred arter vm Memo /gan walraw.~. Purpose or Form M IniMdui or entity gorm Visa i c c :.19~WhO b •equien b rio m blonnaen wen eim ihttnS mutt omen yos coaa aaan L'oraFat flata (tre) Mit, mal be ytt, soda rumba ;Sarg. tidvclual aspene der,tirione, nember i, ros. leSnotbnraapreyor IdenalicatIcn rumler (A71N), w enebyer ktemiricalcn rumba (EIN), to report on al neamacel sum Itle smurd pai to yot or aner annan monen on en ni:ensar snurre Øgla al kf armane moms ildne. tut ere not klemd lo, the Voving: • fonn toe9.INT penne etened or ad) • Fall lan•DFF fellerkeeda. Includno Iler» Ironi »eks or muta Iun • Face ICO9•14;SC (saalem14101. al letene, yta astam. or green oracemb) • Fonn 1099.8 teak amme and snes ard ~dh« mineactions by brokar') • Fot 10»-Sfproceede tent me ende transacioen • Form t0944t enerchent cad end med party noteark versaskets) Den> -2/21/20/ • Fonn 109e(nonte monnet borent.10gbE (9~ lort riene. 1096-T Polane • Form 1090-C f cencercd eobn • Fr 1099A text" y raardameni or sømer oropona) Use Form W.9 orer e you Gro • U.S penon 0rnMIng a modent dere ro pnaide mur correct TIK ff ye,o ab nor attom Fem W.9 it ~moen« WiCle YOtibl‘gbf k Slett te taktø wfrokivp. Sat tenaristeclorp wrY~42 m Vold 2. By signing ne lieWout tonn, you: 1. ~prat Mella you ant gid» te COneel (ot yao ~Ang kr ~gir to te flabeek 2. CarIM UiR you are raa!~ to barJcup altoldiaz, or 3. Cern ~glan from bode.• vahhokang f yenen a U.S. ~opi rayon 3 sopiaao, ya, no tO sor./IyO2 Mal as aU3 pastorn yeur ~satte ~le Or am trio ‘2, o ~ro hem a u s. trade or tuantos b na Wact to be wl, ,Mbrg las on boks pannw rors of offectire~ed Ikorn and 4 Gny !KU FMCA ende>: *torron em lone (4 onn 'Watere sot you as e...r,m from l^o rATCA zaGeet-'11. is onne«. Sere Woot e FATCA rantirx?y on paoo 2 fa furta a otainn. Cal No. 10231X Form W-9 Man 12.2214) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0079282 SDNY GM_00225488 EFTA01380755

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