Form W

Form W -9 (Rev. Decant* 2014) Monfort of the Treasury Internal Revenue Sente Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. 1 Nara (as shown on your income tax retar). Name Is requhd on this line. do rat loam this dank ,j61-2/rR C.Y c 5 /OS 7 4: // 1, 2 Butness namordluegerded entity name. if different from above 3 check appropriate box for federal tax classificabew check orty one of the following Seven boxes: D InctividuaVsole proprietor or • C Corporetbn 0 SCorpoiation 0 Partnership shpts-memberr LLC o Limited kabilay company. Enter the tax classification (oiC corporation. S.S corporation. P•parinershiP) Note. For a ange-member LLC that is disregardeddo not check LLC; check the appropriate box int* the tax classication of the single-mentor owner. 0 Other (see iraeucilan) th 0 Trust/mate l': 4 Exemptions Conlin ?mitts.; Exempt pa Exemption code al wry) few to wrowirramewmuse• (codes apply only to Odea ) rchnt idualL 8.9 yee code al any from FATCA (sealing line above for We US) 6 Address (number, street and apt a suite no.) ,n 670 0 get, lfoo. C 4-44/2.F0/2 /33 Requester's name and war° IS Optional) 6 ON. state, and VP cede Sr, Mart dk5 , as vz co 8O-2, 7 List socotre nuntherts) here (optionsl) la Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid j Social bethirit7 number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole propnetor, or disregarded entity, see the Part I Instructions on page 3. For other 0 9 0 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 instructions for line I and the chart on page 4 for guidelines on whose number to enter. tem Under penalties of perjury, I certify that: 1. The number shown an 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) Ian exempt from backup on:Inhaling. Or (b) I have not been notified by the Internal Revenue Service (RS) 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 f 0111014in° ; and 3. I ern a U.S. citizen or other U.S. person (defined betow); and 4. The FATCA code(s) entered on this form of any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You m because you have failed to re all interest interest paid, acquisition or donment of generally. payments of han interest and di instructions on page 3. Sign Signature* Here Us. person General Instructions Secton references are to the Internal Revenue Code Lnless Future developments. Information about developmtnts affecting Form W-9 (such as kgislatan enacted after we release it) is at worw.ks.goviter9. Purpose of Form An Individual or entity (Form W.9 requester) who is required to file an information retun wart the IRS must °ban you correct taxpayer Klentacation number aim which may be yaw social security number (SSN), inandual taxpayer identification number (111N), adoption taxpayer identification number (ATM). or inploier identifitaton number (eel), to report on an nfornati0n return the amount paid to you. or other amount reportable on an Womiatcin return. Examples of Information reams Include. but we not hated to. the folkarnig: • Form 1099.INT (interest earned or Paid) • Form 1099-0W (dividends. including those from stocks Cr mutual funds) • Fowl 1099-MISC (various types of income. pares. awards. or gross proceeds) • FaTn 1099-B (Sleek or mutual fund sales and certain Other transactions by brokers) • Form 1099-S (proceeds horn real estate transactions) • Farm 1099-K (merchant cad and third party network transactional Or L/ 3 3 4/ Empower klentliestlen nastily Certification out item 2 above if you have been notified by the IRS that you we Currontty subject to backup withholding dividends on your tax return, For real estate transactions, item 2 does not apply. For mortgage mad property, cancellation of debt, contributions to an Individual retirement arrangement (RA), and ds, you are not requIrectloagn the cakficabon, but you must provide your correct TIN. See the Date. //la 77/ 7 1098 Mane mortgage interest). 1099-E (student loan illerest).109.-T (tuition) • Form 1099-C (canceled debt) • Form tOliN-A (acquisition or *enactment of seated property) Use Farn w.9 only If you area U.S.person encoding a resident Alen). to provide your correct 11N. It you do nee rotten Form W-9 to the requester web a TW, you might eo subject to backup withlwaning. See Whet is bacAup wit/Wading? On page 2. By signing the Had-ail form. you: 1. Certify that the 11N you are giving ks Correct (or you are wasong for a number to be isSuall. 2. Certify that you are not subject to baCkup withholding. or 3. Claim exemption from back* withholding if ye. Wee U.S. normal Pelee. If applicable, you are also candying that as a US. person, you acable share of any partners* income from a U.S. trade or business is not subject to the withhokling tax on foreign partners' shire of effeCthtly connected Mama ri d 4. Certify that FATCA code(s) entered on this form (f arty) inethatio that you are exempt from the FATCA reporting. is carnal. See What is FATCA reporting? en page 2 for further formation. Cat. No. 10231X Form W-9 Rev. 12-2014) EFTA00807279 Form W-9 (Rev. 12-2014) page 2 Note. If you we a U.S. person and a repast& gives you a form other than Form WS to request your TIN. you must use the requesters form Ail is SubStantialy sinter to this Form W-9. Definition of a U.S. person. For federal tax puposes. you are considered a U.S. person if you are: • An indradual who is a US citizen or U.S. resident alien: • A panning* corporation. can nery. or association created oe organized in the United Slates or under the taws a the United States • An estate Wet than a fixegn estate): or • A domestic bust (as defined in Regulations section 301.7701.7). Special ndes for partnerships. Partnere/nips tai conduct a trade or business in the United States are generally required to pay a withboicfreg tax under section 1446 on any foreign partner? share of Mectively connected taxable Income hem Sikh buisnese Further. in certain cases where a Form W-9 has rot been (Moved the rules under section 1446 requiera partnership to presume that is a foreign person. and pay the section 1446 withholding tax. Therefore. If yitu are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form WS to the partnership to establish your U.S. status and avoid section 1446 withholding on your Share Of partmrship incon e. the cases below. the feeowing person must gla Form W-9 to the partnership fee purposes of establishing its U.S. slaws and evoking withhokIng on its Seale there of net income from the partnership conducing a trade er business th the Untied States: • in the case of a disregarded coney with a U.S. owner, the U.S. owner of the diwegarded entity and not the entity; • in the ar e a a granter true with a US. grantor or other U.S. Owner. generally. the U.S. grantor or other U.S. owner of the grantor that and not the bust; and • in the rate a a US trust (other than a grantee trust the U.S. Mat (other than a grantor tnnt) and not the beneficiaries of the that. Foreign person. II you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person. do not use Form Witt/stead. use the appropriate Form WS or Form 8233 (see Publication 515, WI holding 01 Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident seen. Generally. My a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types el income. However, most tax treaties contain a provision known as a 'saving clause.' Exceptions specified in the swing clause may permit an exemption from tax to centime for certain types of income even after the payee has otherwise become a U.S. resident Oen for tax proposes. if you are a US. resident alien who is relying on an exception contained n the Sewing &see of a tax treaty to clam an emnilotion from U.S. tax on certain types of income. you trust attach a statement to Form W-9 that pacifies the fallowing five items: 1. The treaty country. Generally. this mat be the same treaty under which you clamed exemption from tax as a nonresident Own, 2. The treaty ankle addressing the atone. 3. The ankh mentor (or location) in the lax treaty that contains the saving clause and its except:0ns. 4. The type aid amount of income that queries foe the exemption from tax. 5. Sufficient facts to justify the exernmen from tax under the terms of the treaty antic Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for SChotarsho Income received by a Chinese student temporarily present in the United States. Under U.S. law, this student we become a resident alien for tax purposes if his or her stay in the Untied States exceeds 5 calendar years. However. paragraph 2 or the first Protocol to the U.S.-China treaty (dated Apnl 30. 1984) aeons the proviSons of Article 20 to continue to apple even after the cheese student becomes a resident alien of the United States. A Chinese student who quases for this exception (wider paragraph 2 ol the test protocol) and is relying on this exception to earn an exemption from tax on his a her sthefarship or Islowsp income would attach to Fenn WS a Watemord that ncludes the information described above to support that exemption. If you we a nonresident seen or a foreign entity. give the requester the appropriate completed Form W-8 or Form 8233. Backup Withholding What is backup withholding? Persons making certan payments to you must untie cenan conditions withhold and pay to the IRS 28% of such PaYmentS. The is called 'backup withholding.' Payments that may be subject to backup withholding inckide Merest. tax exempt interest. dividends. broker and barter exchange transactions. rents. royabes, nonerriperyee pay, payments made in settlement of payment card and third party network traneactions, and certain payments from fishing boat °parolees. Real estate transactions are not subject to backup withholarp. You will not be subject to backup withholding on payments you receive if you gNe the requester your correct TIN. make the proper certifications. and report all you taxable Interest and dividendson you tax return. Payments you receive will be subject to backup withholding it I. You do not Rennin your TIN to the requester. 2. You do me cent' yeti' TIN when repaired (see the Part II heructions on page 3 fee detaes). 3. The IRS teas the requester that you fumiehed an neared TIN. 4. The IRS teas you that you we subject to backup withholding because you did not Mena/your Interest and dividends on yogi tax ream (for reportable interest and cteldendS ONA. or 5. You do not certify to the requester that you we not subject to backup withhoiding under a above (for reportable merest and &Mend accounts opened after 1983 only). Certain payees and payment are exempt from backup wlihnellfifiD. See (FemPi Payee code on page 3 and the separate Instructions for the Rearester of Fenn W-9 for more information. Also see Specie/ rules rot Avow-studs above. What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA) regtees a participating foreign financial infaithtion to report a2 United Stales account holders that we specified United States persons. Celan payees are exempt from FATCA reporting. See Exemption from FATCA Welting code on Page 3 and the Instructions for the Requester of Fortin W-9 for mere information. Updating Your Information Yeti must provide updated informer= to we person to whom you claimed to be an exempt payee if you we no longer an exempt payee and arekiPate receiving reportable perinea In the future From this person. For example, you may need to provide updated inlormaton if you are a C corporation that electsto be an S corporation, or f you no tinge we tax (tempt. In addle n, you mutt !enflame Form W-9 if the name or TIN Changes for the account: for example, if the grantor el a grantor trust des. Penalties Failure to furnish TINA you feel to &mall your correct RN to a requester, you we subject to a penalty of $50 for each such faire trews your fare is due to reasonable cause and not to wilful neglect. Civil penalty for false information with respect to withholdirg. If you make a false ttatOnient with no reaconabln basis that cosies In no brim) withholding, YOU We subject to a $500 penalty. Criminal penalty far fah:dying information. Willluey 'Staying certifications or ilffernthOnS May subject you to criminal penalties nclueng fine andthr imprisonment. Misuse of Ms. II the requester discloses « uses TINs n violation of federal taw. the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one Of the f011Owing on this Ft do riot leave eis me blank The name should match the name an your tax return. If this Form Wig is ft:eagle account, list first and then cede. the name et the person or entity whose ranter you entered in Pellet Form W-9. a. Individual. Generally. entre the name shown on you- tax rem If you have changed your last name "About informing the Social Security Admiestratken (SSA) of the name change. enter your rest name. the last name as shown or, your social security card. and your new last name. Note. MN applicant Enter you individual name as it was entered on your Form W-7 application, line ta. This should also be the same as the myna you entered on the Form 1010/IGKIA/I040EZ you filed with your application. b. eels proprietor or single-member LLC. Enter you individual name as shown on you 1040/10404/104CEZ on hie 1. You may enter yes business. trade. or 'doing business as* (DEIA) name on fine 2. c. Flenemilith LLC that Is note single-member LLC, C Corporation, or S Corporation. Enter the gratis name as shown on the ertty's tax return on ino 1 and any business, 'Steer DOA name on Me 2. d. Other entities. Enter your name as shown on repaid U.S. lateral tax documents on line 1. This nano should match the name shown en the charier or ether kcal do&ment Creating the entey. You may enter any business, trade, et OSA name on fne 2. O. Disregarded entity. For US. federal tax purposes an ertty that is disregarded as an entity separate from its owner is treated es a 'disregarded entity? See RegulabOrIS section 301.7701-2(c)(2)(e). Enter the owners name ea line 1. The name of the entity entered on line I should never be a 'disregarded entity. The name on Mei those be the name shown on the leer* lax earn on which the thorn* mould be reported. For warmth. it a foreign LLC that is treated as a disregarded entity fee U.S. federal tax pepoaa has a lania Waxy that b be US. person. the U.S. ownees name is reamed to be wooded on Fe 1. II the died owned the entity is also a disregarded (Witty, enter the fret owner that IS not disregarded for federal tax purpose. Enter the disregarded entity's name on Yid 2, 'Business name/disregarded entity nine? If the owner el the trattgalded entity Is a foreign person, the owner trust complete an appropriate Form W41 mend of a Form WS. This is the case even d the foreign person has a U.S. TIN. EFTA00807280 Form W.9 Fee 12-2014) Page 3 Line 2 If you hereon:sires name, trade name. OEM norm,, or deregated entity nano. you may enter 4 on Me 2. Line 3 Check the appropriate box h line 3 for the U.S. federal tax dassthcation of the person whose name is entered on line 1. Cheek only one box In Ine 3. Limited Liablity Company (LLC). If the name on Me 1 is an LLC treated as a pertnerstip for U.S. federal tax purposes. check the -tirrined theility Company' box and enter la' in the space provided. II the LLC has Ned Form 8832 or 2553 to be taxed as a corporation. check the 'Limited Liability Company box and N the space provided enter 'C' Ice C corporation or •S' for S repeater. li t is a sing4e.member LLC that Is a disregarded era's, do not check the Uneed Lisa/4y Compare* box, instead chock the rest box In ine 3 enclivraVer proprietor or sirglemembet LLC' Line 4, Exemptions If you are exempt from barm withholdng ardor FATCA reportit, enter en the appropriate space In tine 4 any codes) that may apply to you. Exempt payee code. • Generray. irewiduas endure solo proprietors) are not exempt from bart withholdng. • Except as provided below, corporations are exempt from backup withholding for certain payments, ncluckig interest a-id &beers. • Corporations are not exempt tern backup w voice:rig for payments Tad* ri settlement of payment card or third party network transactions. • Corporations are net exempt from backup withholding with respect to attorneys' fees or grins proceeds paid to attorneys. and corporations that provide medical or health are services we not exempt with respect to payments reportable on Form 1099-MISC. The blowing codes Identity payees that are exempt from baclap wirofing Enter the appropriate code n the space it Me 4. 1—An organization exempt Iran tax under section 501(a), any IM, a a custodial account under section 403(0X7) t the account satisfies the rearemente a section 401(!2) 2— The United States a any of a agencies or instrunentataies 3—A state. the District of Columbia. a U.S. comnerwearm « possession, or any of thor political subdivisions a inseurnentalitles 4—A foreign gOVeTrileflt or any of its political sublvisions. armee Or instrumentalities 5—A corporation 6—A dealer n securities or conmodees required to register in the limed States. the District of Columbia, a a US. cormionevealth or possession 7—A futures catenate merchant registered with the Commodity Futures Tradkig Commission *—A real estate investment trust 9—An entity registered at al times raring the tax year under the Inverter Company Act of 1940 10—A corrrisso Mot fund operated by a bank under section 584(a) 11—A franca Institution 12—A middleman known n the :vestment conformity as a nominee or Custodian 13—A trust exempt from tax wider section 664 or deSCribed in section 4947 The following chart shows types el payments that may be exempt from backup wtvciding. The chart apples to the exempt payees Wed above. 1 through 13. IF the payment is for... THEN the payment IS exempt for... Interest and dividend payments Al etemPt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and at C corporations. S corpcalicets must not enter an exempt payee code because they we theme, only for sales of nor-owed sautes amaired prior to 2012. Bate exchange transactions and patronage dividends Exempt payees I @wane 4 Pelmets over 5600 regained to be reported and deect sales over 55.0001 Generally. exempt payees 1 through 51 Payments made iii settlement of Parent and a third party network transactions Exempt payees I through 4 I See Form 1099-MISC. Miscellaneous Income. and b insbbons 'However. the f 01010n9 naYrnents made to a corporation and reportable on Form 1090MISC are not exempt from backup withholding: medical and health care payments. attorneys' fees. gross proceeds paid to an attorney reportable under section 6oism. and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The blowing codes de sty payees that we exempt kern reporting under FATCA. Thar codes Star to Persona thbrrelting Mis form for accounts maintained outside of the Unted States by omen foreign Mancial :restitutions. Therein if you are only skating the form for an erase you hold is the United States, you may leave the field blank Consult with the person requesting this form if you are wenn d the linnet institution is subject to these requirements. A recpaiWer may indicate that a code is not required by providing you with a Form W.9 with 'Noe Applicable* (or any simile indication) written or parted on the Me for a FATCA exemption code. A —An organization exempt from tax under section 501(a) or any individual retirement pan as defined In section 7701(y07) Et — The United States or any of its agencies or astrumentalaies C—A state, the District of Cokembia. a US. commornvealthcepOssession, or any of the political subdivisions or instrumentalities 0—A corporation the ark of which is regularly traded on ore or more established securities nudists, as deserted in Regulations section 1.1472-1(cKlIg) E —A corporation Tan o a member of the same expanded ateuted group as corporation described in Regulations section 1.1472-1(cyle0 F —A dealer' in securities. commode:its, a derivative Mangle netruments enclosing notional principal contracts, futures, forwards. and options) that as registered as such under the laws of the Unted States a any slate G —A real estate investment trust H—A regulated investment cream as defined n section 851 or an entity registered et all times during the tax mar under the Investment Company Act of 1940 I —A corner trust fund as defined n section 564(a) J —A bank as defined in section 581 K —A broke L—A truth exempt from tax under section 664 or desated i section 4947(a)(1) M—A tax exempt !WV under a section 403(0) pith or section 457(9) plan Note. You may with to consult with the financial insetutian requesting this form to Ottoman° whether the FATCA orb and/or exempt payee code snood be complied. Line 5 Enter your address (number, street, and apersent or suer curled. This is whore the requester of this Form W-9 will mad your information returns. Line 6 Enter your ca, state. and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN In the remarks% bee. If you are a resident awn and you do not have and are not *able to get an SSN, your TIN is your IRS individual taxpayer identification number (MM. Enter II in the social security number box. If you do net have an ITIN. see Now fo get a YIN below. If you are a sole proprietor and you have an EIN. you may enter either your SSN EIN. However, the IRS prefers that you we your SSN. II you are a single.mernter LLC that is disregarded as an entity separate from its owner Pee Limited :Jab* Company iLLC) on this page), enter me owner's SSN (or EIN. if the owner has one). Do not enter the disregarded enta's EIN. If the LLC darted a a corporation or partnership, enter the entity's EN. Note. See the chart on page 4 for fuller clarification 01 name and TIN combiners. How to get a TIN. If you do not have a TIN. apply for One immertety. TO apply or an SSN, get Form SS-5. Application for a Social Socenty Cat, from your local SSA office or get the form online at www.ssagov. You may also get this form by calling 1-800772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Nunes, to apply to an MN, a Form SS-4. Application for Employer Identification Number, to apply toe an ON. You can apply for an EIN erne by accosts.° the IRS wiebaito at vanykspoyfttaJnesses and dome on Empiefer toreetitcatir Number MIN) tale Starting a Business. You can get Forms W.7 and SS-4 tem the IRS by visiting IRS.gov or by calling 1.800-TAX-FORM (1-800.629.3676). If you are asked to cantata Form W-9 Si do not have allN. apply fora TIN and write 'Applied For In MO space for the TIN, sign and date eye form, ire give to the requester. Fa interest ad dividend payments. and certain payments made with respect to ready tradable itstruments. generally you will have 60 days to get a TIN and give it to the requester before you are eerie to backup maholdng on payments. The 60 day rule does not apply to other types of payments. You will be subject to backup wthhoking on al such payments wild you provide your 714 to the requester. Note. Entering *Applied For' means that you nave meaty applied for a TIN or that you intend to apply for one soat Carom A disrepraeled US. onto That nes a *stair owner must use the anprOpeiate Po:meet-A EFTA00807281 Form W-9 (Rev. 12-2014) Page 4 Part II. Certification To estatifsh to the wehholdng agent that you are a U.S. person. or resident e'en, sign Form W-9. You may be requested lo sign by the withhokfing agent even if Items 1.4. or 5 below indicate otherwise. For a pant account. only the person *lose TIN is shown in Part I Should sign (when required) In the case of a doegarded entity, the person Identified on The 1 met sign. Exempt payees. see Exempt payee code earlier. Signature requirements. Gametes the certification as incfcated 0 items 1 through 5 below. 1. Interest. eividend, and barter exchange accounts opened before 1984 and broker accounts considered active dunng 1983. You must give your correct TIN. but you do not have to sign thU Cectficaten. 2. Interest, dividend, broke+, end barter exchange accounts opened after 1983 and broker accounts considered inactve during 1983. You must sign the certificates or backup withholding mit apply. If you aro subject to backup vrenholcing and you we merely providing your correct TIN to the requester, you trop oron out Ocen 2 in the certification before signing the lam 3. Reel estate transactions. You mint sign the aitilloaben. You may clefs out kern 2 of the certification. 4. Other payments. You must give your correct TW. but you do not have 10 sign the certifcation Legless you have been notified that you have weer* given en hone/ TIN. -Other payments' include payments made in the course el tee requesters trade or business for rents, royalties. goods (Ow than bis for merchandso). medical and health care services (including payments to corporations), payments to a nonemployee lot services. garments made in Seteentent of payment card ad thed parry network tansadions. payments to cotes feting boat orow members and fithenren, and gross proceeds paid to attorneys (rocluang payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA. Coveedell ESA, Archer MSA or NSA contributions or distributions, and pension distributions. You must 0* your correct TIN, but you do not have to tgn the certification, What Name and Number To Give the Requester Far this type of account Give name and SSN of: 1. Indira's) 2. Two or more indiveluals (pint account) 3. Custodian account of a minor (uniform Get to Minors Act) 4. a. The usual revocable savings trust (grantor is also trustee) b. So-called mist account that is not a legal or veld trust under state Law 5. Sole proprietorship or disregarded entity Owned by an individual 6. Grantor trust filing under Optional Form 1099 Fling Method 1 (see ReguiSPOS section 1.671-4(b)N(I The indivieual The actual owner of the account or. if combined funds, the first Individual on the accent' The minor' The gramontrustee The actual owner' The owner! The grantor For this type of account Give name and EIN of: 7. Thetegaidel entity not owned by an 8. A wild trust. estate. a pension bust 9. Corporation or LLC elm:trig corporate Status co Form 8832 a Form 2553 10. Association, club. religicus, charitable. educational, Or other tax- exempt organization 11. Partnership or mule-member LLC 12. A broker or registered nominee 13. Accord with the Department 01 Agrieuture n the named a pubic entity (such as a state or local goverment. school district, or prison) that receives agriculture Seer payments 14. Grantor trust filing under the Form 1041 Fig Method or the Optional Form 1099 We Method 2 (see Reg its section 1.871.4(b)(2)0) 931) use snit as cede ow name of tie pence time meter youeenah. II Cat one ptmonon Idis accast has an We milt emcees weber must be turrahed. 'Circle the Inner. name and rumen the minor's ESN. The *ems Legal entity The Dammam The organisation The partnership The broker or nceninee The public entity The Mast 'You met sew yds needed name and neu may also enter you buses or CEA rare Co the 'Bushes nernektreauded reply' nano line You may ere ether aye SSW to EN Of you ham ce.). a.4 the IRE ercaroges you to uee yVV SSN 'list Yet and ado Be name d the rust elate. a mimeo two too nor rumba the TN of the prams reoweentsam e, Mateo etas the legs entity t will is not deematee nth. 6[0:Kart Mit) MAO see Specialoks lorparonees on pen 2. 'Note. Grantee also neat prando a cam W.9 to feat°, or Mat NOte. It nO name a Girded when more than one name is listed. the lumber will be considered to be that of the first name listed. Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal infOrMatiOn Sint es your name. SSN, a other Identifying information Mthout yOtr per to corm* fraud a other cranes. An identity thief may isle your SSN to get a lob or may file • tax return using your SSN to receive a refund. To reduce your risk: • Protect yew SSN. • Enure your employer le protecting yaw SSN. and • Be careful when choosing a tax preparer. If your lax records are affected by Identity theft and you rare a notice from the IRS. respond right away to the name and phone numbs anted on the MS notice ce letter. II your tax records are not currently affected by identity theft but you think YOU we at risk due to a lost a stolen purse a we ltd. questionable credit card safety or credit report. contact the IRS Identity Theft liodne at 1-800433-4490 or submit Form 14039. For more isformabon. see Publication 4535, !dotty Theft Prevention and Victim Assistant*. Victims of Identity theft who se experiencing economic harm a a system Problem. Or we Seeking help in resolving tax problems that have not been restated trough normal channels, may be eligible Ice Taxpayer Advocate Service (TAS) assistance. You can reach TAS by Carp the TAS toll-free case ntske line at 1477-7774778 or TTY/TOO 1-800629-4059. Protect yourse“ from suspicious snails or phishing schemes. Pheshing is the creation and use of email and websites designed to min* legitimate business snails and websitos. The most carmen act is saving at erns to a user fats* claiming to be an eV-lb/reed legitimate enterprise in an attempt to scan the user into summckeng private information that voi be used la identity theft. The IRS does not initiate contacts with taxpayers via emits. Also, the IRS does not request persons detailed information through email ce met tuPaYers for the PIN numbers. paeSwOrclE. Or similar secret access laceration b their credit card. brink. Or other financial accounts. II you receive an Lemolloted email Musing to be from the IRS. forward the message to periringOiregov. You may also report misuse of the IRS name. Ingo. or other RS property to the Treasury imp000r Geese for Tax Administration (WM) at 1400.366'4484. You can forward suspicious malls to the Federal Trade Con minion at: spantucsgov or contact them at www et gOvfitltheff Or 1-87740T/4M 04M-43S-4334 Visit IRS.ocre to learn rncro about Identity theft led how to reduce your risk Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to prow* you correct TN to persons enrAding federal agencies) wise are required to fie Informatien returns with the IRS to report interest. (*Wends, or certain other name pad to you: mortgage interest you paid: the acquiseim or abandonment of secured property: the canceration of debt. Or contributions you made to an IRA. Archer MSA a NSA The person collecting this form uses the irdameben on the loran to fee Info motion returns with the IRS. reporting the above inform:Mon Routine uses of this hlormatcn include giving 4 to the Department of Melee tix civil and Crinti apatite, and to cities. states. the District of Columbia. and U.S. commonwealths and possessions foe use in administering their awe. The intonation also may be disclosed to Other' countries under a treaty, to federal and state agencies to enforce civil and crintinal laws, or to federal law enforcement and intelligence agencies to combat terrorism You must prow:fey*: 11N vottether or not you aro required to file a tax return. Under section 34436, panes must genial withhotcl a percentage of taxable glow* clividellet, and certain ether payments to a payee who dues not give a TIN to the payer. Cereal penalties may also apply for CeOvideg false or fraudulent Information. EFTA00807282