EFTA Document EFTA01459359

Form W-9 (Rev. December 2014) Dims:men: of the Treasury Internal F-wcrib Sante Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. 2 A Name (as shown on your income lax return') Nun' is rowirud. on IF. Co not leave :nine Mans. Gratitude America, Ltd. 2 Business nanehlaregarded entity name 1 off ire-it her above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 0 Individual/sole propdabor or 0 C Corporation 0 S Corporation 0 Partnership 0 TrusVestate angler ember LLC K ;bated liability company. Enter the tax classification (C=C corporation, S4 corporation, Papartnership) ► Note. For a ansis-mombior tic that is risregardec. do not check LLC; check the appropriate box in the line above for the tax Massificatkin dim sirme.menbor owner. Other (see .nstruoticnie► Non-Profit Corporation 5 Address (number, *Meet, end apt. or stale no.) 9100 Port of Sale Mall Suite 15 4 Exempcons (modes app// only to certain entities. not indsriduals; sea nstrocarvis on page 3): Exempt payee code any) Exemption from FATCA rePorbrig code (of any) A Softly gonna Reesswgi *root nous! 1 6 City, gaitandZIP code St. Thomas, USVI 00802 Requester's name and address (optional List account number(s) here (optional Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals. this is generally 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 (GIN). If you do not have a number, see How to get a T/N on page 3. Note. If the account Is in more than ore name, see the instructions for line 1 and the Chart on page 4 for guidelines on whose number to enter. Part II Social Security number I I _ or Eirmtoyer ideates-at on number Certification Under penalties of perjury. I certify that: 1. The manber shown on tits 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 'Memel 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 nas noticed me that tarn 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 ccde(s) entered on this form Of any) indicating that I am exempt from MICA reporting is correct. Certification Instructions. You I ust cross out item 2 above If because you have failed interest paid, acquisition generally. payments o instructions on page 3. Sign Here Signstuna of U.S. person a have been notified by the IRS that you are currently subject to backup withholding tax return. For real estate transactions, Item 2 does not apply. For mortgage attrition of debt, contributions to an Individual retirement arrangement (IRA), and required to sign the certification, but you must provide your correct TIN. See the betel. b Cecilia tAr Dolt .)os General Instruc Section references am to the Internal Revenue Code unless otherwise noted. Future developments. Inkamation about developments affecting Form W-9 (such as legislation enacted after we release it) is at www.kagovitiv9. Purpose of Form An trwirndual or entity (Form W4 requested who it •eCtincl to file en intonnatlon return with the IRS must obtain your correct tartoayer a:ramification number ;PM *No may be your social sear ty number (SSW). micrividact taxpayer identification number (ITN, adoption taxpayer danaffration number (ATIN), or employer der Acetic, number (13e1), to report on an information return the amount paid to you, or other amount wettable on an inlormation retum. Samples of information realms include. but am not ranked to, the following: • Form 1099-IM (interest earned or paid) • Form 1099.CW (dividends, including those from stooks or mutual funds) • Form 1099•MISC (venous types of income, order*, awards, or gross proceeds) • Form 109943 (stock or mutual fund War, and certain other transactions by brokers) • Form 10a9-S (proceeds from rats *state Vans/it:tons) • Form 1099.K (mothant card and third party nietwun transactions) • Form 1095 (home mortgage Interest), 1096-E (student loan interest), 1096-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquiaition or abandonment of secured properly) Use Form W-9 only if you en a U.S. person (including a resident alien). to provide your correct TN. Myou do not Tatum Fenn W-9 to the requester with e TIN, you might be subject to backup withholding. See What is backup wIchhotding7 on page 2. By signing the Wed-out form, you, 1. Certify that the 11N you are giving Is correct (or you are wading for a number to be issued), 2. Certify that you are riot subject to backup withholding. or 3. Claim exemption from backup withholding if you are a U.S. OXIteltal payee. If aPPINable, you are also certifying that as a J.S. person. your aaotable share of arty partnership Income from a U.S. Dote or business is not subject to the witnholding tax on foreign partners' share of effectively Comities' income, and 4. Certify that FATCA corbel entered on this farm (if any; indicating that y00 are exempt from the FATCA reporting, le correct. See' m: is FATCA reignite" on page 2 for further information Cat. No. 10231X Forrn W-9 (Rev. 12-2014) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0119710 CONFIDENTIAL SONY GM_00265894 EFTA01459359