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Request for Taxpayer
Identification Number and Certification
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Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the *Name One
to avoid backup withholding. For Individuals, this Is your social security number (SS14). However. for a
reeklent alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities it is your employer kkrntification number (SIN). tf you do not have a number, see How to got a
TIN at 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.
law
Certification
Under penalties of per)tay, I catty that:
1. The number shown on this form is my correct taxpayer Identification number (or I an waiting for a number to be issued to me). and
2. I am not subject to backup withhdding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
SONIC. (RS) that I ern subject to backup withholding's& mutt of
to report all interest or dividends. or (c) the IRS has notified me that I an
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below).
Cerlincieflon Irtstuctorts. You must croes out item 2 above if you have been notified by the RS that you we currently subject to backup withhokling
because you have failed to report all Interest and dividends on your tax return. For reel estate transactions, Item 2 doss not apply. For mortgage
Interest paid, acquisition or abandonment of secxr4d property, cancellation of debt, ooMnbutione to an individual retirement arrangement PRA), and
generally, payments other than interest and 4*
you are not required to eign the certification, but you must provide your comsat TIN. See the
!remotions on page 4.
Sign
Here
us. persona
General Instrudtions
Section references are to the Internal Revenue Code w4seenthoWilesti
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 pald, acquisition or abandonment of secured property, cancellation
c4 debt, or contrbuticne you made to an IRA.
Use Form W-1) only if you area U.S. person (including a resident
Ron), to provide your correct TIN to the person requesting it (the
requester) end, when applicable, to:
1. Certify that the TIN you are giving is convict (or you are waiting for a
number to be issued),
2. Certify that you we not subject to backup withholding, or
3. Claim exemption from backup withholding If you are a U.S. scrampt
payee. If applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership Income horn a U.S. trade or business
Is not subject to the withholding tax on foreign partners' slurs of
offeollysty connected Income.
Social security number
/Bole. If a requester gives you a toms other than Form W4 to request
your TIN, you must use the regards?, form If It is substantially similar
to this Form WA.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person If you ens
• An Individual who le 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 that (as defined in Regulations section 301.77014).
Special rules for parthareNpe. Partnerships that conduct a bade or
business In the United States AM 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 V.S. person that Is a
partner In a partnership conducting a bode or Isis/noes 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.
Cet. No 10231X
Fain W-9 ouv.12.2011)
SDNY_GM_00063416
DB-SONY-0026241
EFTA_00173924
EFTA01298560