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efta-efta01379067DOJ Data Set 10CorrespondenceEFTA Document EFTA01379067
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EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
Fenn vii""9
Mee. DeWitt" 2014)
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
[Bores ..- it ce theTosser,
Interne Rekruo Seance
Print or type
See Specific Instructions on page 2.
1 Name (as shown on your income tax return). Name is rewired on the fine: do not leave aus line blank.
The 2017 Caterpillar Trust
2 Business name/dIvegarded entity name, if different from above
3 CMd appropriate
Ci Indrviduakscee
saga-member
0 Limited tisbity
Note. Fora Single
the tax classiecation
0
Other Noe InsirucConsi
box for federal tea classeicationi check only one of me blowing seven bozos:
prooriela or
0
C Corr-ration
0
S Corporation 0
Partnership
0
Trusteuate
LLC
company. Enter the lax canseicatien (CmC corporation. 9.5 oorpotatIon, Papartriershipt•
4 Exemptions
r
atlijo
" Z ict
Exempt payee
Exemption
cute et WW)
sewn a riirou-i
(codas apps/ only to
orwtor r
ums; in
coda gf any)
from FATCA reporting
-member LLC that is disregarded. do not check LLC: check the epompriate box in the line above !or
of me single-member owner-
l'
...wee easonmuSu
5 Addinase (number. street, and apt- or suite no.)
Theaues!res name and
6100 Red Hook Quarter 83,
addreW Rrationg:
6 cay. state. and 2a, code
St Thomas 0 .08002
7 List account riaaitalt(S) lien (0CPcnag
Pad I
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Gne 1 to avoid
backup withholding. For individualS, this is generally your social security number (SSN). However, for a
resident allen, sole proprietor, or disregarded entity. see the Part I instructions on page 3. For other
entities, it is your employer idemification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. II the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whOSO number to enter.
Social security number
or
I Employer Identification number
Part II
Certification
Under penalties of pequiy. I certify that
1. The number shown on Otis teem 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. or (b) I have not been notified by the Internal Revenue
Service (RS) that I am subject to backup withholding as a result of a failure to report ail imerest 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): and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification Instructions. You must cross out item 2 above h you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and I:Fmk:lands on your tax return. For real estate transactions, item 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
generally. payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page a
Sign
Here
Signature of
U.S. person •
General Instructions
Section references are to tno internal Revenue Code unless OtreninSe noted.
Future developments. Information attOdt developments affectiro Fenn W.9
as legislation enacted alter we release it) is at www.iragovinv9.
Purpose of Form
An inovidual or entity (Form W-9 requester) who is required to Se en information
rats" Min the IRS must obtain your correct taxpayer identification number (T4.4)
which may be your social Sec-wily menber (SSN). indtvklual taxpayer identification
number (TIN). adoption taxpayer hetet:catkin number (ATtN), or employer
identification number (Elm). to repo: en an Information return Me amount pad to
you. or other amount reportable on on information MUD EMMA% of taitranerien
returns include, but are not baited to. the fotiorring:
• Form 10994NT (Interest earned or pale
• Form -MOS-DIV (dividends. ncluding those from stocks or mutual Ands)
• Form 1099-MISC (various types ot ?come. prizes, awards. or gross proceeds)
• Form 1099.8 (stock or mutual fund sales and certain other tame:bons by
brokers)
• Form 1099-S (proceeds awn real estate Minsactiass)
• Form 10994( (rnerchant card and :him party network transacttons)
• Form 1098 agree mortgage intern*. 10984 (Student Man
(mann)
• perm 1099-C lamed debt)
h
• Form teSS-R (aolasition or abandonment of secured property)
Use Form W-9 only if you aro a U.S. Orson unctions' a resident alien). to
provide your MAIM TIN.
If you donor 'alum Form W.9 to ire requester Mtn • TIN, you rnighc be sublet?
to bade°. riatTheiceng. Soo Waal is boohoo wilMokling? on page 2.
By signing toe faledeut form. you:
teensy mat etc TIN you are giving d ccerect (or you are waiting fora number
to be owed).
2. Cern/ that ',ou are no: subtect to backup withecaling.
3 alert exemption from backup withholding If you are a U.S. attempt payee. ir
Widliewele you are also certifying that as a US. person. your alocable ware at
WY partnership InCOme (?ben a U.S. trade or business is not subject to the
withholdro tax on %reign partners' Share of electively Connected Income, and
4. Cattily that FATCA code(s) entered on bid form (it any) indicating that you are
exempt from Ine FATCA reputing, Is correct. Sea Minis FATCA reporting? on
page 2 for further information
tterest). 1096.7
Cat No 1023IX
Form W-9 (Rev. 12-2010
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0076372
SDNY GM_00222556
EFTA01379067
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