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efta-efta01255109DOJ Data Set 9OtherFarm W-92011)
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DOJ Data Set 9
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efta-efta01255109
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Farm W-92011)
Depsnmert of rho Tinny
Werra RevenueSeMos
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to this IRS.
Pas fas sham on your income UK CetUrie
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Chick appropriate box kg federal tax cleseXicetion:
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nivkluaktiol• prowistor
K C Corporation
Gre/Corporaion
ID Penwell.) O TRef/estate
O Limited lability cowpony. Fits the tax clawfication (C=C corporation. S=S cap:rake. n.:pannershio)s
K Other gee istructors) to
O Exempt owes
rintrai ovtekt. 3
OW. stets and ZIP code
1106//4, (fly
LW moon numberlaiherektatkref
Colcn-
R"queet
name end wickets (OP6ene0
P irt I
Taxpayer Identification Number (TIN)
Eller year TIN in the appropriate box. The TIN provided must match the name given on the 'Nantes line
to avoid backup withholding. For individuals, this Is your social security number (SSN). However, for a
resident Men, sole proprietor, or disregarded entity. see the Part 1 instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
77N on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
lamentationnumber
Part II
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am writing for a number to be issued to me), and
2. lam not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have riot been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report at 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).
Cent floefee instructions. You must cross out Item 2 above if you have been notified by the IRS that you we currently subject to backup withholding
because you have failed to report all interest and el' ;donde on your tax return. For real estatetransactions, item 2 does not apply. For mortgage
orgifributions to an individual retirement arrangement (IRA), and
the certification, but you must provide your correct TIN. See the
interest paid, acquisition or abandonment of sects
*petty, cancellatkin of d
generally, payment other than Interest and dividend'slll you are not
Instructions on pease.
SISPI
Here
Sensture or
U.S. pitmen
General Instructions
Section references are to the Internal Revenue Code tallies otherwise
noted.
Purpose of Form
A person who is required to fie wi 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 contrbutions you made to an IRA.
Use 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 withholdMg If you are a U.S. exempt
payee If applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership income from a U.S. trade or business
Is not subject to the withholding tax on foreign partners' share of
afloat* connected income.
oaten
II a requester gives you • form other than Form W-9 to request
your TIN, you must use the requester's tam r it is substantially similar
to this Form W-9.
Drifirilon of a U.S. person. For fated tax purposes, you are
considered a U.S. person If you are
• M individual who is a U.S. citizen or V.S. resident alien,
• A pannership, corporation. company, or association created or
organized in the United States or under the laws of the United States,
• An estate (other then a foreign estate), or
• A domestic trust (as defined in Regulations section 301.7701.7).
Special rafts for partnerships. Partnerships that conduct a trade or
business in the United States are generally required to pay a withholding
tax on any foreign partners' share of income from such business.
Further, in certain cases where a Form W4 has not been received, a
patnership is required to presume that a partner le a Halo person,
and pay the withholding tax. Therefore, It you are a U.S. person that is a
partner in a partnership conducting a trade or business in the United
States, 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 pe.12.2011)
SDNY_GM_00056795
CONFIDENTIAL - PURSUANT TO FED. R.Q0
NE I D ENTIAL
DB-SDNY-0019619
EFTA_00167365
EFTA01255109
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