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efta-01424632DOJ Data Set 10Other

EFTA01424632

Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01424632
Pages
3
Persons
0
Integrity

Extracted Text (OCR)

EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
W-9 Qive Form to th« requester. Do not send to the IRS. Request for Taxpayer Identification Number and Certification Form (Rev. December 2011) Department of the Treasury Internal Revenue Service Nartte (as shovitn on your Income tan return) 3. Epstein Virgin Islands Foundation, Inc. Business name/dbregerded entity name, it different from above of Check appropriate box for federal tax classification: 1-1 IndKridual&ole proprietor Cl C Corporation D S Corporation Cl Partnership Q Trust/eslate g Cl Exempt payee K Limited liability company. Biter the tax classification (C=C corporation, S=S corporation, P=partnership) I El other (see tistruclions)b- Private Foundation Requester's name and address (optidria0 Address (msnber, street, and apt. or suite no.) 6100 Red Hook Quarter B3 City, state, and ZIP code St. Thomas, U.S.V.1.00802 List accomt number(s) here (optional) Taxpayer Identification Number (TIN) Part I Social aecurf^ number 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 Part 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 TIN 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. EFTA01424632 Em lo er MenWicetioo number Certification Part II 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 (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 insiructions. You must cross out Kern 2 above if you have been notified by the IRS that you are currently subject to backup withholding 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 interest paid, acquisition or abandonment of secured property, cancellation of debt Contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not r"uired to sign the certification, but you must provide your correct TIN. See the instnjctions on page 4. " " 7 Sign I ?(( 13 Signature of Here U.S. person^ Datek- Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, cotporation, 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 partners' share of income from such business. Further, in certain cases where a Form 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. EFTA01424633 General Instructions Section references are to the Internal Revenue noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) 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 contributions 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 are giving is correct (or you are waiting for a number to be issued). 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if 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. unless otherwise Form W-9 (Rev. 12-2011) Cat. No. 10231X EFTA01424634

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