EFTA Document EFTA01456743

Form W (Rev. August 2013) Department of Ina Treasury Internal Revenue Service -9 Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. c•i Name las shown o your ncome tax return) Business name/disregarded entity name. it different from above Check appropriate box for federal tax clasmfcation: 0 Inds/dual/sole proprietor 0 C Corporation 0 S Corporation 0 Partnership 0 Trust/estate O Limited liability company. Enter the tax classification (C=C corporation. S=5 corporation. P•partnership)e O Other (see instructions) le Address (number. street. and apt. or suite no.) Exemptions (see instructions): Exempt payee code Iff any) Exemption from FATCA reporting code (if any) City. state, and ZIP code List account number(s) here (optional) Requester name and address (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. f he 1 IN 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 Part I instructions on page 3. For other entities, it is your employer identification number (EIN). 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. Part II I Social security mintier Employer identificabon number 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. or (b) I have not been notified by the Internal Revenue Service (IRS) 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), 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 if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends 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 3. Sign Signature of Here U.S. pereone Date e General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. The IFS has created a page on IRS.gov for information about Form W-9. at www.irsgov/w9. Information about any future developments affecting Form W-9 (such as legislation enacted after we release 4) MI be posted on that page. Purpose of Form A person who s required to file an information return with the IRS must obtain your correct taxpayer identification number (Tea) to raper( for example. income paid to you. payments made to you in settlement of payment card and third party network transactions. real 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 fincludng a resident alien). to provide your correct TN 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 to be issued), 2. Certify that you are not subject to backup withholding. or 3. Claim exemption from backup wthhdding 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 U.S. trade or bus mess is not subject to the withholding tax on foreign partners' share of elfectivety connected income, and 4. Certify that FATCA code(s) entered on this form fit any) indicating that you are exempt from the FATCA reporting, is correct. Note. If you are a U.S. person and 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 substantally similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the bws of the United States. • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the Urvted States are generally required to pay a withholding tax under section 1446 on any foreign gannets' share of effectively connected taxable ncome from such business. Further, rn certain cases where a Form W-9 has not been received. the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 mihholding tax. Therefore. if you are a U.S. person that is a partner in a partnership COnduCtong a trade or business in the United States. provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. Cat. No. 10231X Form W-9 (Rev. 6-2013) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL SDNY_GM_00262210 DB-SDNY-0 116026 EFTA01456743