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efta-efta00292755DOJ Data Set 9OtherDS9 Document EFTA00292755
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DOJ Data Set 9
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efta-efta00292755
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roan
December
W-9
201e
of ~neater
Reverte Straka
Request for Taxpayer
Identification Number and Certification
Give Formro the
requester. Do not
send to the IRS.
Ftw.
Deprheent
Interred
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13
I Name (es shown
The 2017 Caterpillar
income tax
Name is
the 1w do
heve die ane
on your
reborn
rumen on
not
bank.
Trust
2 Bosinne nerneidtaragerdn entity name II allvendMon above
3 Check appopret• box tor ledges tax dearcelion: check omy one of
Nonbone
0 meralts•Vide proodesor or
0 ocaporatk. 0 scorn°. 0 PwwenhU
segle
er
O LI/rated %tartly company Enter the up mane:aeon (MC corporation. SeS commie& Fie pannennet
Note. F
a • sciliocarmeaf Il
mat IS 00: 0900010. 00 MS cited,1.LC: sack the appropriate box in
the tax ceastriwbon of the sing ternember owner.
,--,
1..) Other isop instrscliCA) P
DI Tnadialice
a
4 Emmett"
certain enema.
instructions
cent Payee
Miometkin
con el any)
~a is xeseenwerseinerer
teaswri., only to
not
viduee sin
on paint
orde ft any)
Ma FATCA reporting
me ere above kit
NNW
IS kern% (numb... street. Mil apt. or seia ro.)
Red Hook Quarter 83,
Iniquetters tome and address letnionati
8 City. Slat and ZIP coo*
St Thomas 0 ,08002
T bal =Cunt numbertfl here kddonla)
kgrli
Taxpayer Identification Number (TIN)
Enter yourT1N In the appropriate box. The TIN provided must match the name given on Melt° avoid
backup withholding. For inceviduals. INa is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Mart I Instructions on page 3. For other
entitles. it Is your employer identification number (FIN). If you do not have a number. see How 10 get a
77N on page 3.
Note. II the account is in more than one name. see the instructions for tine 1 and the chart on page a tor
guidelines on whose number to enter.
Social novelty number
0 9 o I -
or
4 4
314 e
F.mII
ptoyer IdestbfIcedon number
Certification
Under ratetaltles of perjury. I certify that
1. The number shown on this form is my correct taxpayer identification number (colons waling for a number lo be issued to me): and
2. I an not subject to backup withholding because: (a) tam exempt from backup withholding, or (b) I have nol been notilied by the Internal Revenue
Sent. gRiS) that lain subject to badiup withholding as a result of a failure to report all retest or dividends, or (c) the IRS has notified me Matt am
no longer subject to backup withholding: and
3. I am a U.S. Caren or other U.S. person (defined below); *MS
a. The FATCA cadets) entered on this form (11 any) Indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You Must Øs out item 2 *bon If you have been notified by the IRS that you are currenthi subject to bar.kup withholding
because you have tailed to report all Interest and &skiers* on your tax return. For real estate transactions, kern 2 does not apply. For mciOCIIIIS
interest paid acquisition or abandonment of secured properly, cancellation of debt. contributions to an individual retirement arrangement (tRA), and
generally, payments other than interest and dividends, you are not required to sign the certification. but you must provide your correct TIN. See the
Instructions on page 3.
Sign
Here
Signature of
E.)
U.S. person •
General Instructions
Sieben references an to the Internal renn,. Code Wets aneroa noted.
Future developments. elormatien about acudopmants altecteg Fenn W-1) (such
kodaiation ensued afar we manse n) a el wsw.ireposVhvg.
Purpose of Form
M ineviont or entity (Form W-9 requester) who Is requited to Pk en inkonstion
nib" with the IRS mutt obi* your coned taxpayerr IdentAcatien number (TIM
valor( may be your soon security rum*. team),Ircariduel eaten kerimIcallon
number Ø. ~peon taxpayer 'Sena/alien number (ARM. orernpieyerr
demakation number (EIN). to wren on an Inkeraden return the amount paid to
you. or other amount reportable On an Mornation return. ~Mead ~men
returns Inclglim. We an not Nmeed to. Pe kdowind.
• Font , 1099-M (Merest Mad Or Paid)
• Form 1000-ON (dkedends. echo:Ant those teem slem or mutual funds)
• Form 1099.14(SC (vartous types of Income. prima. awards, Or sea proceeds)
• tom 1099-B (stook or minuet Md sates and an
other transactions by
brokers)
• Foint 1099-S (proceeds from real estate transactions)
• Fono 1099.K (merchant card and Ingo party network innsactionsl
J.Q-4L(-52`--
Pete >65) -11
2 1 2 Oi g
• Form1098 (home mortgage Interest). 1
E (shamed loon tolenip, 1098-T
Neon)
• Fpm 10911-C (canceled cIabl)
• Form 1099-A (acooed« or abonOonmeni of secured omarms)
We Form Veg only II you en a ti S. person crewel/garner, wen). to
prowdeyour conga TIN.
N you do nee 'Sten Form VAS ro rov nrQuin4e, tath • TEN, you mere Oe RAN'« i
o bodes waNwiden. see meet o backup wdniYokhn97 on Woe 2
By sky"? the raled-out Ø. you:
I. Certify m the TIN you are gene s coned kr you are waning 1ot a number
to be nertice
2. Gently dat yOu an not subreel to backup waNutetang.
3. Ctilm exempt», ham backvp ~heeling 9 Tenn* V.S. Øt
septa you uro Rio ceettlyng Mot matt& wreak your allocable shin el
any partnership income from a vs trade et peens :snot wage to the
waNgkilng tap, imam banners' sit ro el gasolinic connotes ikon, and
e. CanIN met FATCA codes/entered on tue form tel any) indaire that you are
woman som the FATCA ~tingle correct. Sae mart ‘• FATL reporthr on
moo 2br turile ~km
Cal. No. 10231X
Form W-9 elev. 12-201a)
EFTA00292755
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