EFTA Document EFTA01295008

Form W - 9 (Rev. Decade 20tt) Depethent d the tray tent Revenue Sink* Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. . i Namep shown ere bat income tat fawn) nou A pv ci.c. cgstearded may mew, a deferent from above deck appropriste O b.,,smcknysora Efi linited Wiley C1 on. (i. naruclion.). box for leckneItor desenoadon PDO-t r.r4taa-L-q-- pt.:crimp • C Corporatka O S Corporation • PartnershiP O Trueleststo snow. Free the Is deselficanan (C=C ccrpenelon, geS corpcselko. Parer/MI Br . ot Pero GA44 ts7 kirr eil ri/7147".444442 got Recuesteea named addressfaXionag Wooden u 5yr cioSa'Y Clew Ste. and Sr Dummis„. Liat wan number(*) here leMiails. Pad I Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on the 'Nos' line l Social soCurill nil/1w to avoid backup withholding. For individuals, this is your social security number (SSN). However, for • resident alien sole proprietor. or disregarded entity, see the Pat I instructions on page 3. For other entities, it Is your employer identification number (ELM If you do not have a number, see How to get a TIN on page 3. Note. It the account Is In more than one name, see the chart on page 4 for guidelines on whose number to enter. Part II Certification Employer Identifier:fon nitro*. C 7 I Under penalties of perjury, I certify that 1. The number shown on this foam Is my correct taxpayer Identification number (orient waiting 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)1 have not been notified by the Internal Revenue Service (IRS) that I ant 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 ern no longer subject to backup withholding, and a I am a U.S. chase, or other U.S. person (defined below). Cerlifleation Instructions. You must cross out itent2 Cove it you have been notified by the IRS that you arecurrently subject to backup withholding because you have failed to report a• intereiderirldwi on your tax return. Format estate transactions, hem 2 does not apply. For mortgage interest paid. acquisition or abandonMentof secured , ea:collation-ardent. contributions to an Individual retirement rurarcement ORA), and 9enotelth PeYrnente other than interW and dividends. owe .ragred to is the certification, but you must provide your convect TIN. See the Instructions on page 4. Sign Hem fageseare U.S. person I. General Instructi0ns Section references are to the Internal Revenue Cods unless otherwise 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, cancellatkm of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (indud rig a resident alien), to provide your correct TIN to the person requesting it (the requeeter) and, when applicable, to: 1. Croft that the TIN you are 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 we a U.S. exempt payee. If appficable, 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 effectively connected income. Note. 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 Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701.7). Special flies 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 W-9 has not been received, a partnership is required to presume that a partner is • 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 business In the United States, provide Form W-9 to the partnership to establish your U.S. statue and avoid withholding on your share of partnership income. Cat No. 10231X Rem W-9 pw. t2-2011) SDNY_GM_00053695 CONFIDENTIAL - PURSUANT TO FED. R.QP IDENTIAL DB-SDNY-0016519 EFTA_00164276 EFTA01295008