EFTA Document EFTA01294990

Form wag (Rev. December 2011) Deptnenent d the Treasury lowed Revenue Semco A Name Request for Taxpayer Identification Number and Certification exusese namaiosregattleci entity name, d minded Irem above Check OPPreinite box for federal tax classification: Indteduallsole proprietor O C Corporton Ds Corporation O Pannership O Trust/estate p Limited liability sensory. Enter the tax classification (C-C corporation. S'S comonicon. P•paruiershiral• CI Other (see irstnciticesi► List accoult nsrr here OT Give Form to the requester. Do not send to the IRS. Requester's name and address (optioned Logi Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN 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 alon, sole proprietor, a 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. Exempt payee T *eclat security number Employes Identification number _I, MEE — 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 (RS) 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 witMolding. and 3. I am a V.S. citizen or other U.S. person (defined below). 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 arrangenent (IRA), and generally, payments other t the certification, but you must provide your correct TIN. See the instructions on page 4. Sign Denature of Here U.S. porton • Deter. 11 /Z2, 11:470/ 3 General Instructi Section references are to th noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer Identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid. acquisition or abandonmnt of secured property, cancellation of debt, or contributions you made to an IRA Use Form W-9 only if you we a U.S. person (inckiding a resident alien), to provide your correct TIN to the person requesting It (the requests) and, when applicable, to: 1. Certify that the TIN you are giving is correct (cc 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 withholding if you are a U.S. exempt payee. II applcable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. ote. If a requester gives you a form other than Form W-9 to request TIN, you must use the requester's form if It is substantlaly 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 we: • 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 laws 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 United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, In certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership notime. Cal. No.102MX Form W-9 (Rev. 12-2011) SDNY_GM_00053658 CONFIDENTIAL - PURSUANT TO FED. R.QP .NE I DENTIAL DB-SDNY-0016482 EFTA_00164239 EFTA01294990