EFTA Document EFTA01295004

Form Ohm Docarbw2011) Doperrnere Fiera W-9 drhi Tann Request for Taxpayer Identification Number and Certification Gin Form to the requintor. Do not send to the IRS. RwaiusSenice ni I Check ! E 8 E —....--....-- i 0 1 t cE Nam be shown on your income traretuml M iali t . ..PAL Dusan nettercieregwoeci wary nem, i different Ircm Wove 'maroons.* box for fatal tax clesacatIon: 0 Indaballace protestor 0 C Ccrocration [SCorporstion O Pwarartia 0 trustiestets O unshed say carany.Ener the tax ciassicetion (CaC corocretkn. S.-S m onk. ). P;pannership) e O *Mr bee instructionde Exernx Paves Address:7:w° . emerd a rrAr a sk e sti, 3 Rea iest r (oat name and ockfrecs ens coy. Vitt red ZIP eir Dole 110644j (fiti/ CO/P1' LW wawa numberlaihro (abut Part I Taxpayer Identification Number (TIN) Enter your TN in the appropriate box. The TIN provided must match the name given on the Nene line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident elan, sole proprietor, or disregarded entity, see the Part 1 Inatnictions 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 par 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. I Socief security number Employer identification number Port II Certification Under penalties of periwig, I catty that 1. Tice number shown on this fonn is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I em not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Scrubs (IRS) that I am subject to beckon withholding as a result of a blurs to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other V.S. parson (defined below). Certificate instructions. You must cross out hem 2 above If you have been notified by the IRS that you we currently subject to backup withholding because you have failed to report all interest and dividends on you tax retum. For reel estatetransactions, item 2 doss not apply. For mortgage wrang individual retirement aband acqui generally, payments other than interest and dividenditcr ri , co re not the certification, but you must prowide your coact TIN. See the interest acquisition or onment Of recur nflation ofd ntributions to an ernent (IRA), and instructions on page 4. WWI Here Signature el ,, UAL pe on ► / General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to fie an information return with the IRS must obtain your coned 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 contrbutions 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, tot 1. Certify that the TIN you are dung b correct (or you are waiting for a number to be issued), 2. Certify that you we not subject to backup withholding, or 3. Claim exemption front backup withholding If you are a U.S. exempt payes h applicable, you ars 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 /Moot:wt.,' connected income Dee a If a requester gIves you • form other than Form W-9 to request your TN, you must use the requester's form a his substantially similar to this Form W-9. DelWien of a U.S. person. For federal tax purposes, you are considered a U.S. person If you are • M individual who is a U.S. citizen or V.S. resident alien, • A pannership, corporation, company, or association created or organized in the United States or under the laws of the United States, • M *Mate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701.7). Special nabs 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 W4 hos not been received, a partnership is required to presume that a partner 6 a kaolin pawn, and pay thee 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 Income. Cat. No. 10231% Fan, W-9 (Few. 12.201t) SDNY_GM_00053686 CONFIDENTIAL - PURSUANT TO FED_ „QC) .NEIDENTIAL DB-SDNY-0016510 EFTA 00164267 EFTA01295004