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efta-01381180DOJ Data Set 10Other

EFTA01381180

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efta-01381180
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Form (raw. Decorber Demers. Hanoi W-9 2011) d en Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. eavey RiewnaSP ervke Print or type Sal Spool.* Insiructiorts on page 2. Name (as shown on yaw kicaris tax rosin) Butterfly Trust Busereas namerdaregarded entity name. II deferent horn above Check Appropriate 0 indiyicorageroe Limited liability 0 Other gee bethesticns) box for Word tax cissericaticer a 0 (aril% WM. proprietor C Cceporabon 0 SComerarlion 0 Partnedhp IS TIILIVOSIZIIII company. Enter theta dosser:aeon (CC corporstIon. SoS corporation. Pwannarship) a Arkkess (number, test aid apt. a sate no.) MOORS Hook Quarter, III3 Risdiesteis name end address (0Perrisi) City. ZIP code 00802 steak and St. Thomas, U.S.V.I. Lint account nurrinetelnera Wilma* Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the 'Name' line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Past I instructions on page 3. For other entities, it Is your employer identification number (EIN). If you do not have a number, see How to get a 77N on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Part II Certification Seidel security nunber I Employer identiltostien rxrtbm Under penalties of perjury, I certify that 1. The number shown on this form is my correct taxpayer identification number (or I an waiting for a number to be issued to me). and 2. lam not subject to backup withholding because: (a) I am exempt horn backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a laws to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above ri you have been notified by the IRS that you are currently subject to backup v.ithhokling because you have failed to report all interest and dtviderxls on your tax return. For real estate transactions, hem 2 does not apply. For mortgage interest paid. acquisition or abandonment of secured property, cancellation of debt, contributions to an IndMdual retirement arrangement (IRA), and generally. payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Sign Here Signature of U.S. Demon► 72):X/W44, General Instructions Sector references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who Is required to file an information return with the IRS mat obtain your correct taxpayer identification number (Tel) to report, for example, income paid to you, real estate transactions, mortgage interest you paid. acquisition or abandonment of secured property, cancellation of debt, or contra:whom you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you we giving is correct (or you are waiting for a number to be issued), 2. Certify that you we not subject to backup withholding, or 3. Claim exemption from backup withholding Jr you are a U.S. exempt payee. if applicable. 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 on foreign partners' share of effectively connected income. Dad. X eS 0 I FS* Note. If a requester gives you a torn other than Form W-0 to request your TIN, you must use the requester's form If h is substantially similar to this Forrn W4. Definition of a U.B. person. For federal tax purposes, you are considered a U.S. person If you are: • M individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States. • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign ostlers' share of Income from such business. Further, in certain cases where a Fenn W-9 has not been received, a partnership is required to presume that a partner Is a foreign person. and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership Income. Cat. No. 10231 Farm Wfa (Rat 12-2011) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0079969 SDNY GM_00226153 EFTA01381180

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