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efta-efta01388034DOJ Data Set 10CorrespondenceEFTA Document EFTA01388034
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EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
Fenn W
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:Tr oca.warmida
Onetere of the Peony
nuns Rene Swan
Request
for Taxpayer
Identification
Number and Certification
Give Form to the
requester. Do not
send to the IRS.
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I tram ICI awn on rut Interne lex worn} Name :4 toque", on This hornet00 noi Dave, Mt Ina blank
Southern Trust Company, Inc.
sum
s
ma namardentpanded enbly newt, ii Mows Item above
Southern Financial, LLC
3 Cheek appwatale
O MeM2Ualkeile
snedmenter
O Periled Celilrify
For a ongto.mcriba
the tax conlectnen
box for Warn' Mx ctroailloatlan: 0W sly eve of the torteerg seven box=
Mines or
O CCureerellart
0
S Caporals O
Partnership
O Sne-Vestato
LLC
company. Filar the tax ciaefetattan (000 cceporMIco. SeS corporation. imparberstIP0R
tiC Int 4 3.3:coatptcy do net &pep LLC; rhea to appropnale box D the rabant to
of the omit momoot CFACIf.
•
4 Eareptions
tcnila an anttpaprEiterr"
EA root payee
EA8MOCI1
coda RIM
Pans a muntrammearamo
(codes appit Otte
see
oar tt ma
keen FATCA M et"
Ill other thee inzi.neetioro)
roar
5 11/455/033 5/Uriter• orar. and tot treat red
6100 Red Hook Quarter, B3
RagletYla rums and addmse (optima/
e Cite. suet anclte? code
St Thomas, USVI 00802
T Let sat unt nutter by. @pare
.:pao c
Taxpayer Identification Number (TIN)
Enter your TN In the appropriate box. The fifiN provided must match the name elven on Ens 1 to mold
backup wohholdIng. Foe Individuate. this Is goneralty your social security number (SSW HOwevot, for o
resident alien. sole proprietor, ot disregarded entity, goo the Part I Instructions on paged FM other
snide,. It Is your employer IdantlicaU00 nuenbor (FIN). It you do not have a number, sr How CO got e
TN on page 3.
Note. If the account Is N more than ono namo. see the Insuuctlons for linefeed the chart on page 4 lot
guldernos on whose number to enter.
nodal
why numbs,
or
Reno/over IdentirmatTon number
a s
0 7 7 9
711.
Certification
Undo/ smear of perjury. Icon& that
1, the number shown on this tom Is my correct taxpayer Wendt/Alton number forlorn waiting (outnumber to be issued to met and
2. I ant not suofect to backup withhoterng because, (a) I an exempt from woken withholding, of (o) I have not been noWied by the Internal Ravens*
Service (IRS) that I ern subject to backup withholding as o mull of a failure to report all Interest or cihrktends. or
the ins has notiRed no that I ern
no longer subtract to tutomp wIlhbolit2n2; and
3. I em a U.S. citizen or other U.S. person (defined be4ow) end
4. The MICA code(a) entered on tNt form QI any) in/foaling Meilen exempt from FATCA reporting b erect.
Cartgeattlen Instructions. You must cross out hem 2 above If you have been notified try the IRS that you ere currently subject to backup rerholdIng
braise you have failed to roper enteral end Oh/Wends on your tax return. For real estate bansacaons, kern 2 door not apply. For Monne
Interest paid. acquisition or abandonment ot secured property. caneandon or debt, COntributlen3 loan (noviduel retirement arrangernent (If%), end
gooney. payments other than Internal end dividends, you are not required to elfin the cerliCootton, but you must provide your correct TN. Seethe
instructions co pegs 3.
Sign
stiwn,,,
Here
U.S. p•
General Instruc
26:1100100tOICIS 010 le the front Flamm. 0:00 Wane othrmitse noted.
Future Oevaleprnentt. Intoner", abaa develooments I(ectee Form W.9 (such
al esibtaibn enacted eller we release it) i
ithenttuovInve
Purpose of Form
An lectMduiX Or way (Form W-9 i0nunIcc) etc Is icq•ecid to rota an rifler,
rttsn with ale 145 Mat obtain your catreel taxpayer lomalleatun name (1514
*flith 515, be bus var-5,5 500-511/ number PSN). SW:kW taxpayer idenieitatfoe
number ulna adorn tamer( lesmennilon number (ATM. or emokler
klercilicron number (3714 to report on tm Itifiertudon rotten ireasioseU paid to
you. or of
meant reportable an on racenatIO3 return. EmarnIes of triernletkin
Want irrintel but ire nos limited to, the leaarno:
• Form 1099-IM (room* nn
of midi
• Fenn 1092•DM eRvisavri, ncludno those err soda a most hinchl
• Fenn 1099AISC Milantypes of Income, prim armada. or onte3 preceeth)
• For 1099-0 err or mutual laid sake ase amok other trarrederfa by
broen)
• Form 1099.5 poredi born red nun wreathe/at
• Form 1092-K (nentenr cad and VOW patty netwark transactICO5)
au> 1,6VAI*
erPam UM Dane mortgage Nemo. 1098M onvolenl Man Infer,* 10914
OtAkin)
• F can 1099.0 (cancetui (so
• Form 10994 lerCulatimi fr ltbDrsiorment cf soared ProPorSt3
Use roan Mil only a you we a U.S. person (miludna a Kern 0 0 4 /0
firevIdeffer carod TIN.
I/swotred mew/ Fenn 19-9 to me teettssiti wk., a MN, set net& be sopa
body* onkrthordino See Molts Soap viMbakerm? on mope 2.
By sQtq to lineenOut loan you;
1. Cite* OW the TN you ate phew Is cares ler you ere *WIn9 kr a umber
lo be betted).
S Cattily that you ara no "Meet to backup wishboklim
2. Wm ascreptto ham backup withheldieg you we a U.S. exempt payee If
appecebie. you are 640 Catarbg the any& person year afar Mare of
any porremnip Income Porn a U S. trestle or bus nen e not *dies le the
wehhodirry tax on mien pains:' toe of elhotheD Contorted Moms. and
4. Gay that FAT CA coolatti entered on rob IOMI (i any) harry th you am
°hernia; ant Ille FATCA relienhe. a creel Sc, Kew i MICA ntiethet?on
POP 2 for erne hkernartse.
Cat. Ms 10231%
Form W-9 (Res 12-20lq
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0091358
SONY GM_00237542
EFTA01388034
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