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efta-01393068DOJ Data Set 10Other

EFTA01393068

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DOJ Data Set 10
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efta-01393068
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EFTA Disclosure
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A Form W-9 (Rev. November 2017) Depxtment d the Treasury Internal Revenue Senice Request for Taxpayer Identification Number and Certification la Go to iwnv.irs.goviForrnW9 for instructions and the latest information Give Form to the requester. Do not send to the IRS. I Name (as n on your Income tax return). Name is required on this line; do not leave this line blank. Butterfly Trust 2 Business name/disregarded entity name, it different from above 3 Check appropriate box for federal tax classification of the person whose name b entered on line 1. Check only one of the following seven boxes. O Individual/sole proprietor or 0 C Corporation 0 S Corporation 0 Partnership CI Trust/estate single-member LLC o limited kablity company. Enter the tax classification (C-C corporation, S-S corporation. P-Partnership) ► Notee Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC it the LW is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LAC that is not disregarded from the owner for US. fades tax purposes. Otherwise, a single-member LLC that is disregarded horn the owner should check the appropriate box for the tax classification of its owner. f--1 Other (see instructions) P. 5 Address (number, street. and apt. or suite no.) See instructions. 6 City, state, and ZIP code St. Thomas, U.S.V.I. 00802 7 List account number(s) here (optional) 4 Exemptions (codes apply wily to certain entities. not individuals: see instructions on Page 3): Exempt payee code arM Exemption from FATCA reporting code (if any) AsoSit to acco.. lased 3410. IM 4.13J Requester's name nit address (OW 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, 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 How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Part II Certification I Social security number or Employer Identification number Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting 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 notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (e) 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); and 4. The FATCA coders) entered on this form (if 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 backuethhokling because you have failed to report all Interest and dividends on your tax return. For real estate transactions. item 2 does not appfyor mortgage interest paid. acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retiremeetrangement (IRA). and generally, payments other than interest and dividends, you are not required to sign the certification, but you musirovide your correct TIN. See the instructions for Part If later. Sign Here Signature of U.S. person► Dote lo General Instructions Section references we 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 vnymirs.gov/ForrnW9. Purpose of Form M 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 (f IN) which may be your social security number (SSN). individual taxpayer identification number (ITN). 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 en information return. Examples of Information returns include, but are not limited to. the following. • Form 1099-INT (interest earned or paid) • Form 1099-DW (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) • Form 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 (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. Cat. No. 10231X Form W-9 (Rev. 11-2017) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0098440 CONFIDENTIAL SDNY_GM_00244624 EFTA01393068

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