EFTA01388758

kern W i" 9 (Rev. November 2017) Department of theTreasury internal ReremeSewice Request for Taxpayer Identification Number and Certification I. Go to www.irs.gov/Forml1/9 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. i Name (as shown on your tncome lax return). Name is required on this fine: do not leave this line blank, Gratitude America, Ltd 2 Business nameldisreganleid entity name. if different from above 3 Check appropriate following seven boxes. 0 individual/sole senora-member 0 Limited liability Note: Check the LLC it the LW another LLC that is disregarded 0 Oliwo (see Instructions). box toe federal fax classification or the person whose name is entered on line 1. Chock only one of the 0 Trustrestate 4 Exemptionsbodes certainentities, instructions Exempt payee Exemption of ono Oxen 10JOC apt* only to not indancitiats: see ea Page 3): code of any) proprietor or • C Corpomtion 0 5 Corporation 0 panneahip LLC company. Enter the tax classification (CuC corporaMon. SeS 00r6OcaliOn, P.PannerS*), appropriate box in the line above for the tax classification of the single-member owner. is Classified as a single-member LLC that is disregarded from the owner unless the Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single from the owner should check the appropriate box for the tax dassification olds owner. Exempt Private Organization from FATCA rePonirg Do not check owner of the LLC it -member LIZ that “na“<sec P. ti 3) 5 Address (rlumber, street, and apt or suite no.) See instructions. 9100 Poart of Sale Mall, Ste 15 Requester's rame and address (opener) 6 City, stale, and ZIP code St. Thomas, USVI 00802 7 List account number(s) here (optionae 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, sole proprietor, a 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 How to get a TIN, later. Note: If the account is in more than one name, see the instructions for ine 1. Also see That Name and Number To Give the Requester for guidelines on whose number to enter. l iagl Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am walling for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been ratified by the eternal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has rue/lied me that I am no longer subject to backup withholding: and 3. I am a U.S. citizen or other U.S. person (defined beitaw); and 4. The FATCA code(s) entered on this town Of 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 yhtholding 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 intent paid, acquisition or abandonment of secured property. cancellation of debt, contributions to an individual retirement arrangement (IRA), and geneally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions !or Part II, later. Social security number Or Employer klendfleation member Sign Here Signature of k U.S. person a. k t to, N-\2A General Instructions Section references are 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 wiinvirs.gov/ForrnW9. 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 Identification number (TIN) which may be your social security number (SSN), Individual taxpayer Identification number (MN), adoption taxpayer identification number (ATIN), or employer Identification number (EIN), to report an 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 following. • Form 1099-INT (interest earned or paid) Date Ilk • Form 1099-ON (dividends. including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes. awards, or gross proceeds) • Form 1099-B (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) • EOM 1098 (home mortgage interest), 1098-E (student loan Interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (incksding a resident alien), to provide your correct TIN. If you do not return Porn, W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding. later. Cat. No. 10231x Form W-9 (Rev. 11-2017) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0092499 SDNY GM_00238883 EFTA01388758