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efta-efta00316380DOJ Data Set 9Other

Acceptance

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DOJ Data Set 9
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efta-efta00316380
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Acceptance You understand that this application is subject to acceptance by DBICA. AuMoi 'red Sion:, Authonted Sun°. 6; ) 'et Name Print Norm Data Dote For Bank Use Only Reviewed by: Son, Name Title Date Accepted by DBTCA: Sionettne Name Title Date Account numbers: DDA NOW MIADA COIDEIAG W1.1147246 017524 002017 EFTA00316380 Form W-9 (Rev. December MO Department of ere Timmy Yuma Reverts Senioa Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or typo See Specific htstnictions on page 2. 1 Name (as shown on you Income tax return). Name is Muted on this erne: do not leave 'haling blank The 2017 Caterpillar Trust 2 Business narnWdisregarded entity name. if different from above 3 Check approputo box for federal tax classification: check only one of the toloonno seven boxes: 0 Individual/sole proprietor a 0 C Corporation 0 S Corporation Partnershb a TrusVestate single-membet LLC 0 Limited Mossy company. Enter the tax classification (C=C corporation, SeS atirporation-Pepartnership) i• Note. For a save-member LLC that is disregarded, do not check u.C: check the appropriate box in the we above for the tax clasercatica of the tingle-member owner. ID Other (see Instructions), 4 Exemptions certain entitles. instructions EXIMPI payee Exemption code lit My) tome rererwerieemeee•enterre (codes apptj only to not inaividualS; see on page 3)- code Of arty) from FATCA reporting till 5 Address (number. street. and apt. a suite no.) 8100 Red Hook Quarter B3, Requester's name nd address (ocreame e City. state and ZIP code St Thomas 0 ,08002 7 Ust account nurnborn/ here 0080W Part I Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on fine 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 Part I instructions on page 3. For other entities. it Is your employer identification number (E1N). If you do not have a number, see How toper a 7W on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number or Employer Identification number I Part II Certification Under penalties of perjury. I certify that 1. The number shown on this tom 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 witItoltinE) 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 an 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): end 4. The FATCA code(s) entered on this form (d any) indicating that I am exempt from FATCA reporting is correct. Certification Instructions. You must MOSS Out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report ail 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 we not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Bombes of US. parson e Dale ie6 .3t General Instructions Section references am to Ow Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such *sepia/Ilion enacted after we release 01 Is at wwwinvoillW9. Purpose of Form M Main:bat or entity (Form W-9 requester) wino Is required to foe an information renew with the IRS mist obtain your correct taxpayer Identification number (IN) which may be your social security number (SSN), individual taxpayer idontitr.ation number (MN). adoption taxpayer krontilcation number (AIN), or employer Identification number (EIN). to reporl on an information return the amount pad to you. or other amount reportable on an information return. Examples of Woman:to roams include. but are not limited to, tee following: • Form 1099 INT (interest earned or pad) • form 1099-ON (dividends. inclsding 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 I099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and theta party network transactions) • Form 1096 (home mortgage inf crest). 1098-E (student loan Merest). 1096-T (tuition) • Form 1099-C (canceled MIN) • Form 1099-A Moduisition or abandonment of secured Properly) Use Form W-9 only if you are a U.S. person (Waning a radon alien), to provide your correct TN. Hsu do nor neon Fonn W-9 to the AVM* with a YIN, you might be Subject to blow Mthhokting. See other a beelna 9-49Fylding? on M42. By signing the Ned-Out form, you: I. Certify that tne TIN you are giving is correct (or you are waking for a number to be issueol. 2. Certify that you are not afibeCI to backup withhoickfl9. 3. Maim exemption Iran backup withholding A you are a US. exempt payee. If appltable. you we also certifying that as a U.S. person. your allocable Share of any Partnership Income irOM a U.S. trade a business is not subject to Me withholding tax on foreign partners' share of effectively connected Income. and 4. Certify that FATCA code(s) entered on this form Of any) IncecatIng that you are exempt from the FATCA reporting, is correct. See teemed FATCA reporting? on page 2 for tunnel intorinatiOn Cat. NO. 10231X Form W-9 (Rev. 12-2014) EFTA00316381 Deutsche Bank Wealth Management Signature Card Deutsche Bank Trust Company Americas The 2017 Caterpillar Trust Account Holder Title Individual ITRPODIATP Joint, with Rights Joint, Tenants 0 of Survivorship in Common Si nature S , • awr. Signature Print Name Signature Print Name Approved Date Power of Attorney Specimen Signattue For I/POD/ATP Sir Suppl >e t it bins and COndiliOnS 111111111111111111111111111111111111111 Account Number Corporate Limited Liability Number of Signatures Corporation Requited: 1 Partnership J Other trust Daphne Wallace Pont Name Lesley Groff Pant Name Date of Power of Attorney WM178934 006678 062817 EFTA00316382

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