EFTA Document EFTA01294991

Form W.9 (Rev. December 2011) Department 04 the Treasury Inuit& Reins SeMce Request for Taxpayer Identification Number and Certification Give Form to tho requester. Do not send to the IRS. I b YS Check appropriate box for federal tat ci qindMdvaascre proprietor O C Corporafion Name shown on your Income nos rtiun) N A —Nil;Ir 4-K. Eosins nemeddiaraelirded Nary nem& a dins hem above ,Wd 60.cre O $ Corporation O Partnership O That/estate O Limited [meaty company. Enter the tax classification (C-C corporation. S=S Caporatkm, Pipannennip)e O Other ON iretruct•OnV► Add, List Tie 0 tower et O Exempt payee Requester's name and Seen (optional) Illiall 11Ni ayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on the "Name' line 1 Sect security a mean 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 Pan 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 77N on pogo 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 Certification employer kisallfcabon number T r 1 Under penalties of perjury. I certify that: 1. The minter shown on this form % my correct taxpayer Identification number (or I am waiting for a number to be Issued to me), and 2. I am not subject t0 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 (allure 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). 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 as 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 ORA), and generally. payments other than Intst and dividends. you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Sign sosiumo Here I us. pongee. General Instructions Section references we to the Internal Revenue Code unless otherwise rated. 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 abandonment of secured property. cancellation of debt or oontrioutione you made to an IRA. Use Form W-9 only if you are a U.S. person (Including a resident alien), to provide your correct TIN 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 withholding If you are a U.S. exempt payee. If appicable, you are also certifying that as a U.S. person, your abocable 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 inC0Me. Date la /2. / 4 v/3 /- Note. If a requester gives you a form other than Form W-9 to request your TIN, you mull use the requester's form if it is substantially similar to this Form W-9. Definition of • U.S. person. For federal tax purposes, you are considered a U.S. person If you we: • An individual who b 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. Porten that IS a partner in a partnership C0nduCting 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 income. Cat No. 10231 X Form W-9 (Rev. 12.2011) SDNY_GM_00053659 CONFIDENTIAL - PURSUANT TO FED. R.QP .NEIDENTIAL DB-SDNY-0016483 EFTA_00164240 EFTA01294991