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efta-efta01364052DOJ Data Set 10CorrespondenceEFTA Document EFTA01364052
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Form W
- 9
(Rev. eottneer2014)
temerity* ot the Treaty
mend Fltreweegenao.
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
ti
I
.,.,
a
11
3I
z
a. 0
m 1
2
1 Nan* an shays on your Income tax return). en hl reneed On Ow. Ira: do eel 'we the we bak
The 2017 catatonic* Trust
Stearn nemaAlanaparded snag Mow. If Wane Otto above
3 CM* eFOreteOte box for federal tu clasbecaterc Owe only ens el !Meow:wale seven boxes:
O IntIlAdualhole Pewaaaba 01
O C c.w.o., O 9 Cement on O ParirenhO
sensetuntinter LIS
O United ludelny Consoarry. Emotes tee tTalasece non (CeC COrpOreilaa. 9 e9 °doormen. P•opmenron
Hattie& a tieldromemba AC le; is ouregenhen. docent chedc LW:cheek the womovaie box in
ens
etagere:Wien a We neherfemembor eheae•
O 0.
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,-
.g
Cr r,,,vieww:
•
at Serra:en
;`,..,•"^entat,rner'Llt.
Emmet wow
Eyernolfol
code Of „y,
%WWI iCr4,0
Soden WI Vie to
code Ill sral
from COCA feccnin;
the hoe Seam is
n4M.O.V.Peet/5)
• Atkins evariber, street PIO am. Or ruse rod
6100 Red Hook Quarter EQ.
rictueure AGM* and Sae* Cootit.40
• Qty. Nate. arid ZIP code
St Thomas 0 .08002
7 List account neneeds) hen tooten(
Lail
Taxpayer Identification Number MN)
Enter your TIN in the appropriate box. The nu amigo must match the name ghee on be 1 to avoid
backup withhokrang For indMduatt this le gone/oily yen tdefat security number (SEtha. However, for a
resident Mien. sole proonetor. or disregarded entity, ace the Pert I instnuctiona on page 3. For other
entitles. it Is your employer identification number (Elul II you do not mare a number. see How to get a
TW on page 3.
Note. I( the account Is In more then one name see me Instructions lee /inland It,. than on page 4 for
guidelines on whose number to anon
Sec* seaulty renew
or
emerge Identeicatte4 nurfeen
izialeal
Certification
Under penalties of palsy. I certify that
I. The number shown on this tome Is my correct taxpayer idene9CaliOn number (whim waiting fa a number to be issued to me). and
2. I am not subject to bedwp withholding bedews*: (el I am exempt from backup uFeaiadglg. a (6) I hey, not been flanked by the ireernal Revenue
Service (IRS) Menem magect to backup vinheolding as
of a failure Mreport ell Intentsi or dvIdends. or (C) the IRS has notified me Mat I am
no tenger sublect 10 backup withholcluig; and
3. I em a U.S. citizen to other U.S. Orden (defined boAtest and
4. The FATCA coders) entered on nits form (If any) inceatbg natter, exempt from FATCA reporting IS Correct.
Cerrnication Instructions. You Mutt won out item 2 atter e f you have been notiged by the IRS MO you are coirentle abject both* MtheddIng
because you hove faded to report all truant end dividends on your tot return. For real estate transeCtions. Item 2 Wes net spay. Fa MOrtglge
interest paid acquisition or shandionrretra of
Peeler IV. CanCtillaton el debt, ConlebutIone to on individual retire/ow anangsement 0.4 and
generally, payments other than Intent and
, gat ere net
•
to sign the cerlalcealon. but you 'rat WWI"yourcarnt TIN. See ITat
instruction on page 3,
Sign
Here
Slanetwe a
62) ,
IAA Innen In
General I nstructlo
SCCUO3 reernonces an co the leteffiel Revolva
uOna One
nolfpfl.
Future Oreelepenents intormaky, about envelope* e Owing Form wigglier\
▪ widlonon owned nee we release nn as at vienrein
vevi9.
Purpose of Form
An irowdual or inlay (Form W4 MUMS, wan iStegureo to tar en Abeenefon
return Atn the MS neat Obtain your correct wawa icrernicaeon ronixr aim
wen maybe your sachet secunty MnbM CiSh). 'Whetted texparsi •Attreation
runtelMN).adaPlleal TANYA adentliCantin bumf:SIM INA d . 3)1St1.0
lidentlbcalhan comber (EDO. ta Men on an ineormallOn Velum vie amount pat to
you. W Olnee *moon; reoCetabte on an AformatiOn return. Exeletake of Abernethy,
rem it {Ida b1/41, ate not Omit W. the Weary
• Form 1099-INTIWArost earned a Paid
• Form 109S.DWIdetchavdt. indoelne those Sem Pocks or wont Soda
• Fenn IONA.= OPOOO‘a renown interne. peters sweet, at roastaweadel
• Fan 3099-8 (Neck or mund fund sates One 41•101 at.., cramseelAns by
On:Ars)
• Form 1C119.5 (proceeds tram roe *stale tialintiOnl
• done 1099.K (merchen cod and ink, r
rathmet Irenanottemi
Oola therl
D019
litter- motes Meese. Keen (MAW, loan neeres),
• Fenn tent-C transited *ebb
• Form 10119-A faeernAtion at ebanoComent OS secure° oilmen.)
Use Fenn W4 only ir you we a VS. person Pinang a inure* alert io
monde your coven TW.
I/you do net mum Form W-10 to 2. requests mime Tut you ntgrMa• *teer
to bonito annnabing See needs beet weerbermor n pap 2.
ay signev the need-out loom. eau:
1. Cwelly Inn lee TIN you ate gives 46 *Wig Of you", nil"; for I numbs.
to be istionce.
2. Or* that eau we rat 'OAS to backup vfilbnofovq. a
Gaits lottotaJfiliCiT OSClusp ogr.O0o1) I you Ate a US. 000101 pens. II
VCOCarde. you are ado orukte4) tat n a u.9. person. year Amok two et
try let arsrm incrie ttOrn • U S. ira0a or ovalness Ic not now mate
twintseStas MA On :wear Prancer Inert of etleatfetwf cavemen annals. and
4. gentry Iten FATCA coding nee on this loon 0r and reading net Pin Me
non* Iron sty FATCA r•Porlifis h correct See Mar 4 FeTCAMPriliff, On
Pea 1 to tortNet intreonsect
Cat fro. 70231X
'gm tai-1) gem new
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0054553
SDNY GM_00200737
EFTA01364052
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