DS9 Document EFTA01255056

Sign Here Form law. December p ut Stn. W-9 2011) el bTarry Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. FtwertueSeivks csi t Check , a 1 ! 1 Name (ssehown on your name tax ream) TE 6I, ..r—s&C • Saiwass nthstederegerdad nay nomad, Mont from above targetless 0 Indindualieole CI Untied lebility box for federal tax deteaketiors rtCorporstko CI Pannerthp 0 TessUrerate rxcerletor 0 C Corporation rg / earroeny. Enter ate too ellseallostkn (CaC capontkn. 8=8 oceporsticn nnmernentup) is ...---..—________. .. 0 Elena Meg In COW ONISIMInX,DOM)fr (P nwiter oo rof d WrOvt4.4 , , g name and edctessireakno0 uy, am.. *xi ZIP code .0 5 7- Titan 4-$ 115v/ 0001-- Lot eccout nunixelentere 0400 4 Rag I Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on the 'Name' Fine to avoid backup withholding. For individude, this is your social security number (SSN). However, for a resident alien, sole proprietor. or disregarded entity, see lho Pal I hsbuctions on pipe 3. For other entities, It is your employer Identification number (EIN). If you do not have • number, see How to get a TIN on page 3. Note. If the amount is in more than one name, see the chart on page 4 for guidelines on whose number to enter. I Segel **maw natter Employer Identification number Part Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I Mn 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 RS has notified me that I arn no longer subject to backup withholding. and 3. I am a U.S. citizen or other U.S. person (defined belay). Certification instrucbons. You must cross out item 2 above if you have been notified by the IRS that you ore amenity subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions. hem 2 does not apply. For mortgage interest paid, acquisition or abandonment of property. cancelathan of debt, contributions to an individual retirement arrangement PRY. and generally. payments other than intoning and d , you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. lignenure et U.S. person le General Instructions Section references are to the Internal Revenue Code unless o 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 contrtutions you made to an IRA. Uee 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 we giving is correct (or you are waiting for a number to be Issued), 2. Certify that you we 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 ailocalge share of any partnwsNp Income from a U.S. trade or business is not sutact to the withholding tax on foreign partners' share of effective& connected income. Date a 9/40 3 . 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 Fore W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.& person if you are: • An individual venal* • U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or negotiation created or organized in the United States or under the laws of the United States, • An estate (other than a foreign *state). or • A domestic trust (as defined in Regulations section 301.7701.7). Special mks for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholdng tax on any foreign partners' share of income from such bulness. Further. in certain taus 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 buskins in the United Slates, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. Cat No. 10231X Form W-9 (Rsv. 12-2011) SDNY_GM_00053689 CONFIDENTIAL - PURSUANT TO FED R.QP . AIE I DENTIAL DB-SDNY-0016513 EFTA_00164270 EFTA01255056