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efta-01387592DOJ Data Set 10Other

EFTA01387592

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efta-01387592
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Form W '''9 :Rev. ocambrunq bessniatia of the Petrel enema Range Swam Request for Taxpayer Identification Number and Cert ification Give Form to the reqUeSter. Ro not send to the IRS. or ; .6. ! t S 7st Now a, sc‘ z E t to a I team age shown on yore Inccens um rehem Name :a coquar0 on This vier. di nial ifsbV0 1 I Sl• blank Southern Trust Company, Inc. Burm a ma itamoklartmanSed only tame, aMorey from above Southern Financial, LLC 3 Check approortale O infiTletelik011 sircps-menter O Uglier! Welly For a s.nakameriber ate In Veneerer:in box for federal loft etreelfratIon: check a* an of the tortorAng seven tome Prof:Meat of O COVFOMFOrl OSCaporatIon O Penarnhip O Frweeslato U.0 company. Iota the tax PAC capor3440. SwS Ceeporallon. Peparecesh94F LLC WM 4 esreiertlecy de net Mack CSC; Omer< the ups/role box 4 No rebore tor 0 The AS mambo/ Cr "CY . a 4 afienipliens gas° anttpagrEiter31 EA anti payer b.mpda each (if ear) lose a raw.r...arwei.sts (=MOS mot, 0410 fee code et end If= FATCA M CC'S Ill Dow how rains:cony) ...US) F F49Mes (00400,.* 041. video. ceaes red 6100 Red Hook Quarter, IfS3 RagvetYla rune and edemas amliceot I City. stale, anclta? cote St. Thomas, USVI 00802 7 Ust acorn nootene) Nee Optletal) Pa-t f: Taxpayer Identification Number (TIN) Enter your RN In the appropriate box. The TIN provided must match the name given on lir e 1 to avoid 16oda aro backup withholding. Foe Individuals. Iles Is generally your social security rWMber (SSU). Howevot, tore resident alien. ado proprietor, or disregarded Drafty, too Ns Part I Instructiora on page 3. For other t rades. It Is your employer IdenlIticatiOn number (EIN). It you do not have a number. see How Co get 0 TIN on page 3. or Note. If the account Is in room than ono nano. see the Insuuollons for line I and than on page 4 lot richtioacof friefeittoe3On numbs: guldeines on whose number to *MCC Certification Undo/ penalties a I perjury. loon& that 1. The number shown on this loon Is my correct taxpayer identlatallon number (or I am waking (outnumber to be Issued to met and 2. I ant not suofect to backup withhoietng because, (a) I ern exempt from backup withholding, cr (o) I have riot been noWied by the Internal Rennin Service (RS) that I ern subject to backup withholding as o roster of a tailors to repal all Interest or cry/Wends, or the IRS has notiSed me that I em nO longer subject to backup withholding; and 3. I em a U.S. citizen at other U.S. person (defined blank end 4. The MICA code(a) entered on tNt form al any) indicating that I am exempt from FATCA roporliry b canct. Careflearean Instructions. You must cross out Item 2 above II you ham been notified try the IRS that you ate currently subject to backup ietthholeeng because) you have railed to roper all Interest and &Mends on your tax return. For real estate hansacaons, Item 2 does not apply. For Monne interest paid. acquisition or abandonment ce secured property. contention of debt, contributions lo an indvidual retirement arrangernent OM), one gencireity. payments Other than Interest and dividends, you are not required to sign the cerlikettort, lea you mint provide your correct N. Seethe instructions mi pegs 3 Sign siemtm, Nero its. pa General Instructions 26:110n filOt Otos Mlle the front Rennes coos UM= othenvisa noted. Future devoloprnener. htoonsuen abaa deveraenierts aides, Form W.9 bush • WOhtillbri enactor/ ever we release is is a thrwvottaperollva Purpose of Form An Waykiulg a wiey (Forst W-9 roomers) Me) te !metro to No an bionneeket with ale MS mat oblein yaw co-reel trarrayer looreirearren menbor (MO itniat Mr be Your Facial 1,90-MY number PSN).kiNklial taxpayer idenlait4e01 robe( pfNy aotptIon taxpayer tersekellon number (Allen. or emosayer irlenaricaton Maxtor (EIN). to roped n en eiforthrion Wien iho sett P0410 you, or caw amount reporlobie on ors arkentalker nun. EX/InpIel of btfOrMation Want iv-We. Out are not United to, the lama* • For/310094W (ran% tamed or pall • Form I092-DIV (Selena& :taxing those Irani nods a mused krodst • Fenn 1099-MISC (voids trees of Income, pram emeek. or creep prOcoode) • Fenn 1099-0 Wei or mutual fund sake era anal other tramacdom by broken) • Form nigeliS ;proceedb lions red ewe wreathe/el • Form ttraditt enentent card aro, third parry network iranstelIC05) ono It90 1 i* • ewe 109a pone mortgego heereso. 1098e tee/dere loan Internet/ 1091-T autroat • roan 1099.0 (canoe** (so • Form trieWi(anallatiortrabaneitinclotcluctired POWS Use town W-li only! you we a U.S person Cnduiare a ofislami 0 04 Oa Feavkieloor correct Jul. tr)eirob red maim town 19-9 so me tequasth (watt • MN, tau nth! be Abet to Now sekrerokono see Multi bachpMooring? on page 2. By Saha the lillrefrOu1 roars YOU: 1. CS* Om the Tor you are poky Is end jur you aro *Wing kr a camber 10 be Sued). 2, Coney that you are nth 3111:00.1 to bolero withhokerm, 2. Clain oacmptron ham baCkup..yelloldrog X you ere a U.S. exempt men If eppecetle. yarn 6•20 CerlayS2 teal meat pooch yew amble Mare of any porereohlp Ircome Porn a U S. trade or out Min e not ouVcact to the wimhodirg lex on Wean pad"., aye el elfrothehr comorafrd lecovs. old 4. Corley that FAT CA ©GOO* Orem* cel fib lOml ar vry) haunt% the you aro exam from the FATCA cranky. le cemict See whet 4 MICA naturf?on ono 2 to kinky hkernerisu Cat. No. 10 alit Form W-9 (Roe 12-201e) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0090600 SDNY GM_00236764 telly number EFTA01387592

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