EFTA Document EFTA01298643

rt. *a (Rev Dans Ort i) Docarners el foe Treasury hare Rennie Smite Request for Taxpayer Identification Number and Certification Give Form to the niqUeSter. Do not send to the IRS. See Speak Instructiona l "I" on page 2. Name OS storm on yes heal* MK tftTO m '1067 1p 44 7 E MR/ .L -Acivr ttl* Ca- i Y. ." r ...710 - 3 PTO //AV .i, Boras eiraefearegrecle0 elution If Otos non ee Owe apniceste box for Wesel la denigration 0 Indieclustraole pioneer 0 C Conacretion 0 S Capastion 0 Pernenhip jnervistetri D urea lobar company. Esau OS tat elassficson(C•C anoorsurn. SirS =Mend kn. P•Painriti. 0 Other ton istructiarei 0 Exact payee Maass flUtteenti ca Si, i, , 2A c ii- fie C 6°Cp 'e 4—* t Receaters name and eddies lostrenot Car. sae. lad Ito or i-A-- ,oe.,, i olzk 001-1...-. List dead re/ deviating* iona Taxpayer Identification Num Enter your TN in the appropriate box. The TIN provided must match the name given on the 'Name' line I Sorrel erosity one' to avoid backup withholding. For individuals, this is your social security number (SSI0. However. Ice a resident alien, sole proprietor, or disregarded entity. see the Part I instructions on page 3. For 00101 oribties, it is your employer idemificatka number (EIN). N you do not have a number. see How to get TIN on page 3. Note. If the account is in more than on name, see the chart on page 4 for guidOnn on whose number to enter. Part II Certification rinser. ionstkation numb.. 6 --Mr?111/4/1-- Undo, penalties of perjury. I certify that: 1. The number shown on this kern d my correct taxpayer idealisation number (or I am wailing for a number to be issued to me), and 2. I am not *tibial to backup wthholding because: (attain exempt from backup withholding, or (b) I haw not ban nolified by the Internal Revamp semee (IRS) that I am subject to backup withholding as a reouft of a taiure to meat all interest or dividends. or (c) the IRS has trained me that I ors 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 crow out item 2 above if you have been notified by the IRS that you we currently subject to badwp withholding because you have failed to report all interest and dividends on your tax return. For real estate transaction, hem 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property. cancellation of debt, contributions to an individual retirement arrangement (IRA), and °merely, payments other than interest and dividends. you are oel required to skin the cedification, but you must provide your correct TN. See the insuvetions on page 4. Sign Here Sint" US. person / Ogee 003 General Instructions Note. If a requester gives you a form other than Form W-9 to request your TN. you must we the requester's form if it is substantially similar Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to fie an information natal with the IRS must obtain your correct taxpayer Identification number (TIN) lo report. for example, income paid to you, real eaten transactions. mortgage interest you paid, acquisition or abandonment of secured property. cancellation of debt a contnbvtions 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 (r he 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 vrithholding. or 3. Claim exemption turn backup withholding if you are a U.S. exempt payee. II applicable. you en also certifying that rd a V.S. person, yaw ollocabfe share of any Parthership income from a U.S. trade or business it not subject to the withholding tax on foreign partners' share of effectively connected income. Definition of a U.S. person. For federal tax purposes, you we considered a U.S. person if you we: • An individual who is a U.S. citizen or U.S. resident alien. • A partnership. corporation, company, or association created or organtted in the United States or under the laws of Cu United States, • An estate (other than a foreign estate). or • A domestic trust (as defined in Regulations section 301.7701-7). Special mks for partnerships. Partnerships that conouct a trade a business in the United States an 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 ha 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 pawnor in a pactrerthip conducting e 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 Moor. Cat. No. 102.31% Fenn W-9 (Rev. 12.2011) 7 CONFIDENTIAL - PURSUANT TO FED. CQINI Fe) DENTIAL SDNY_GM_00063551 DB-SDNY-0026376 EFTA_00174059 EFTA01298643