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efta-efta01353258DOJ Data Set 10CorrespondenceEFTA Document EFTA01353258
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EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
Form W-9
(Rev. December 2019
Department N the Treasury
Internal Revenge Service
Request for Taxpayer
Identification
Number and Certification
Give Form to the
requester. Do not
send to the IRS.
Print or typo
See Specific Instructions on page 2.
Name OS 010.41 on your Income tax retten)
Southern Trust Company, Inc
Metre IVITe/disregated entity name. rf deferent from above
ate* appropriate box for federal tax classification:
0 Inellvkluatbole proprietor
CI C Corporation
0 S Corporation
U
Pannershes li bust/estate
O funded Hanky company. Enter the tax el:indention (CmC corporation. STS corporation. beg:isn't-rasp) or
__--_
0
Other (see r etruCtiOns),
LI Exempt payee
Address (number, street. and apt. or suite not
6100 Red Hook Quarter 83
I Re:penes an and abbess (000300
City, slat and ZIP code
St Thomas, USVI 00602
I
List eocount numberts) here (optervaa
lall
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The T1N provided must match the name given on the 'Name* line
to avoid backup withholding. For individuals. this is your social security number (SSN). However. for a
resident alien, sole proprietor, or disregarded entity, see the Pal I instructions on page 3. For other
entities, It Is your employer identification number (Elt4). If you do not have a number, see How to get a
TIN 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.
Iran
Certification
Under penalties of perjury, I certify that
1. The number shown on this form is my correct taxpayer Identification number (or I am 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, a (b) I have not been notified by the Internal Revenue
Service ORS) that I am 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 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 if you have been n:otiked by the IRS that you are currently subject to backup withholding
because you have failed to report 8a Interest and dividends a1 your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment_Oaecured peoperty, cancellation of debt. contributions to an individual retirement arrangement ORA), and
generally, payments other than interest aid d? ?ends, you are not re cjsect-to sign the certification, but you must provide your correct TIN. See the
instructions on page 4.
Sign
I Signature of
Here
u.s. person►
General Instructiods
Section references are to the Internal Revenue
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, reel estate transactions, mortgage interest
you paid, acquisition or abandonment of secured property, cancellation
of debt, or contributions 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 are giving is correct (Or you are waiting for a
number lo be Issued),
2. Certify that you are not subject to backup withholding. Or
3. Claim exemption from backup withhacfing 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 V.S. trade or business
is not subject to the withholding lax on foreign partners' share of
effectively connected Income.
Social .sooty
bar
Hi I
Employer Identlfleation number
7 7 9 8
1
Dell.
<2'
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
Ise
to this Form W-9.
Definition of a U.S. person. For federal tax purposes. you are
considered a U.S. person if you at
• M Individual who Is a U.S. citizen or U.S. resident alien,
• A partnership, corporation, company, or association created Or
organized in the United Slates or under the laws of the United States,
• An estate (other than a foreign estate), a
• A domestic trust (as defined in Regulations section 301.7701.7).
Special rules 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 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 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 eV. 12-2011)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0037564
SDNY GM_00183748
EFTA01353258
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