Case File
efta-01583701DOJ Data Set 10OtherEFTA01583701
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01583701
Pages
1
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0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
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iMPORTANT TAX
INFORMATION
FOREIGN PERSONS
TAX STATUS
u E. etTuaNs AND
RESIDENT ALIENS
TAX CERTIFICATION
• toREIGIT PARSON NAT /ATE 1O cONFLETt ITS PORN w atm OA PORN TUMMY
A 'FORMA PINSON'
MEANS A NOMRSIDOENT ALIEN INDIVIDUAL. • PORTION CO4PONATIONI. • FOREIGN PPPPPP REAM A FOREIGN
TRUST, A FOREIGN
, AND ANT OTHER PERSON
NOT ANTIS PERSON IT ALSO INCLUDES A
FOREIGN "MANCH OR OPTICS OF AN U.S. TINAICIAT INITITUTIO• 04 U.S. CLEANING ONCANWATION If THE
FOREIGN MUNCH II A QUALIFIED INTIMPIDIART.
O
I AM A FOREIGN .114SON. 1 NNNNN Oat 1 ACKNOTWAID4t /PAT YOU ADVISE ME TO READ THE IRS WI
INSTRUCTIONS 'INC/ OM II TRW PACOGEI CAREFUll I AND THAT I NAVE DUN ADVISED TO CONSULT
NT. IAA ADVISOR. Please sign end Mut" the attached WI lone(s).
IF I HAVE NOT CHECKED THE FOREIGv PERSONS TAX STATUS BOX ABOVE.
UNDER
MS OF PERJURY I CIERT1FT. AS nit ACCOWITPOLITE4 IMMO snow. THAT Ii{ THE
Nulatil SHOWN ON MS APPLICATION II TIT CORRECT
'
IDENTIFICATION AMID 40* a AT/
iniTING FON A NOM* TO et ISSUED TO Nil 4%013) THAT IAN NOT SulIJACT TO SUNUP
WITIINOLOONG MASSE. (A) I AM Mart
FROM RUNUP WITIINOLOING. OR III I HAVE NOT DEIN NO NNNN 0
re TNII i
NNNNN Ull SERVICE III131 THAT I AM SUNJICT TO ITACil•uP WITHHOLDING AS A RESULT
OF A FAILURE TO Mt PORT ALL I
AND DIVIDENDS. OM ICI Till IRS HAS NOTIFIED MI THAT I AN NO
LONGED SUOJECT IC BACEMP WITHHOLDING. 4110 II) I ANA U.S. PINSON (INCLUDING A U.S. RESIDENT
ALIEN/
II (ADE NNNNNN THAT 0 I HAYS BEEN NOTIFIED Ilw THE MS THAT IAN SUOMI TO SACK-UP ITITNNOLTHITO
AS A RESULT OF DIVIDEND ON It/ NNNNN UNDERREPORTING. AND s•AVE NOT RECEIVED A NOTICE PROM
THE WS ADVISING TIE THAT BACR.UP WITHNOLOTITO IS - ENS
a MUSE SHONA OR CROSS OUT ENS
INIONNATION CONTAINED IN OM I IN THE PRIMUS PARAGRAPN I THE MA DOES NOT REQUIRE
CONSENT TO ANY PROVISION OF THIS OOCUTIEftf OTNIR /NAN WM CERTIFICATION REQUIRED TO AVOID
SACK-UP WiTIONIXIMIIG.
•LHOTIO Unlit'? • COMPANIES ONLY •
TAT PII•1O1411II THE
HAVE CNOSON TO
Si CLASSIFIED Al AN ASSOCIATION
IS A CORPORATION YOU NAST CHICK ISE 1O1 TO THE LEFT
OF THE WORD WW1' TO SE
FROM fl ea? Vii(THNOLOTTIO ON INTEREST AND DIVIDEND
SSSSSS TS. CEIPWROISE. IAN CLASSIFICATIDA WILL SE DEFAULTED TO A
iP OR AS A SINGLE
OWNER DISREGARDED AS AN ENTITY SEPARATE FROM ITS 3141all
O
(CLASSIFIED AS AN ASSOCIATION - WILE AS A 3O4FOAATTON).
SIGN HERE CD
ALL ACCOUNT
RE ARE REQUIRED TO SIGH MELON:
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Confidential Treatment Requested by JPMorgan Chase
JPM-SDNY-00063412
EFTA01583701
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