Text extracted via OCR from the original document. May contain errors from the scanning process.
Fran W-9
(Se Decanter 2011)
Owertmen of the Tresary
Never ROWANS Seine
Request for Taxpayer
Identification Number and Certification
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Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided mutt match the name given en the lire
rill
to avoid backup withholding. For individuals, this a your social security number (SSN). NOSS for a
resident alien, sole proprietor. or disregarded entity. see the Part I instructions on page 3. For other
entities. it is your employer identitioation number (Flat). If you do not have a nember. see How to get a
TIN on page 3.
Note. N the account is in more than one name, sot the chart on page 4 lot guidelines on whose
number to stet
rent t
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Employer identleeetknnwnbr
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Certification
Under penalties of penury. I certify that:
1. The number shown on this lone is my correct taxpayer identification number Oxfam waiting fora number to be Sued to net s and
2. lam not subject to backup withholding because: (a) I am exempt from backup withholding. cc (b) I have not been notified by he Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or efnidends. Of (c) the IRS h. a notilkd 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).
Certification instructions. You must cross out item 2 above it you have been notified by the IRS that you we currently subject s backup withholding
because you hive failed to report YI interest arid dividends on your tax return. For real estate transactions. hem 2 does not appl% For mortgage
interest paid, acquisition or abandonment of secured property. cancetation of debt contributions to an individual retirement am tiger ns it (IRA). and
generally, payments other than interest and dnidends. you are not required to sign the certification, but you most provide your c :nett TIN. See the
instructions on page 4.
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AS A
General Instructions
Section references are to the Internal Revenue Code testers otherwise
noted.
Purpose of Form
A person who is required to fiat 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 propery cancellation
of debt or contributions you made to an IRA
Use Form W.9 only a you are a U.S. person (including a strident
alien), to provide your oared TIN to the person requesting it (the
requester) and, when applicable, to
•
I. Certify that the TIN you we giving is correct (or you are wading lor a
number to be issued).
2. Certify that you we not subject to backup withholding, or
a Claim exemption from backup withholding if you we a U.S. exempt
payee. If amicable, you aro also mortifying that as a US. Pelson. your
allocable share of any partnership Moans, from a U.S. trade or business
is not subject to the vrithholdfrig tax onifavign pannam share of
effectively conceded noorne.
R I 7,c) I r
Nets. If a requester gives you a form other than f amt W.') to request
your TIN, you must use the isqueeter's form 4 il i substantially similar
to this Form W-9.
Definition of a U.S. person. For federal tax puns;
you em
considered a V.S. person if you are:
• An individual who is a U.S. citizen or U.S. residi :t alien,
• A partnership. ortPonthen, conPany or anon ion created a
organized in the United Stales or under the laws. ' the United Slates.
• An estate (other than a foreign name). or
• A domestic trust (as defined in Regulations sect on 301.7701-7).
Special rtes for partnerships. Partnerships the ,itinduct a trade or
butanes& in the United States we generally remit:id to pay a withholding
tax on any foreign partners* share of income from such business.
Further, in certain cases where a Form W-9 has n Y beenreceived, a
partnership is required to presume that a partner) s a lore!gn person.
and pay the withholding tax Therefore• if you are 1U.S.. reface that is a
partner in a partnership conducting a trade a but pax in the United
States, provide Form W9 to the partnership to et :shish your U.S.
status and avoid wrthhoiding on your sham of par monship incauo.
Cat No.10231X
CONFIDENTIAL
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e)
W-9 trket. 12.2011)
SCINY_GM_C0037699
DB-SDNY-0000523
EFFA_00148308
EFTA01282296