EFTA Document EFTA01392883

IV. TAX ELECTIOWDECLARATION OF TAX STATUS INs Account Agreement is designed for use by both U.S. Persons end Non.U.S Persons. Please check the box next to the applicable item below. Client airlifts that Client will notify 0851 in writing immediately if the representation certified to below ceases to be true and correct. 1.1:1 U.S. Citizen or U.S. Resident Alien Form W9 Request for Taxpayer Identification Number and Certification Substitute i t Mania (as shown on your income tax retum). Business name/disregarded entity name, d different from above Check appropnate box for federal tax classification (required): El Individual/sole proprietor D C Corporation 0 S Corporation 0 Partnerehip II Trust/estate 0 Limited liability company. Enter the tax classification (C=C corpOration, 5=5 corporation, Pepartnership) 0 Other 0 0 Exempt Payee Address (number, street, and sot or suite no.) City, State, and ZIP Code 'Taxpayer Identification Number (TIN) Part I I Sign Here Enter your TIN in the IMPropnate box. The TIN provided must match the name given on the "Name" line to avoid backup withholding. For individuate, this is your social security number ISSN). For other entities, it is your empbyer identification number (FIN). oCial security FIT} ;trident, identrffeetionNiffilest Certification Under penalties of perjury, t candy that. 1. The number shown on this form is my correct taxpayer IdentitieatiOn number (or i am waiting for a number to be issued to me). and 2. I am not subject to backup withholding because: lapin exempt from backup withholding. or Million not boon notified by the Internal Revenue Service (IRSI that I em 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 he longer subject to backup withholding. and 3. I am a U.S. citizen or other U.S. efined in the instructions). Certification instructions. You at erO9a o t item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to r all interee nit dividends on return. 'Signature of Pert90 Pere q ii113 I am not a U.S. person (including • U.S. resident alien). I am submitting the applicable Form W'8 with this form to certify my foreign status and, if applicable, claim tax treaty benefits. For example: Client is not a U.S. person One/wing a U.S resident alien). Client agrees to provide DaSt with this application the applicable Internal Revenue Service (IRS) Form W-8 to certify the client's foreign status. W.8 forms and instructions are available on the IRS websita at www.irs.gov. 13.AWMCI96 6 012145 032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0098179 CONFIDENTIAL SDNY_GM_00244363 EFTA01392883