Text extracted via OCR from the original document. May contain errors from the scanning process.
Fain W.9
(Rev December 2011)
ed.
apeman a so mean
antral R
Sarno.
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
&
a
0
°
S
1
i
0
I
Nene fel shomemow g1COM
etajax
t
rthrft -
-fei.N
Banns
otila
Lem dalete torn above
falitle
t t
d
MA) 1)
'
spy
tnolocka
gr
Robe
•box
SVIStalf140 .
for federal tat clumacatka
ClEximpt purrs
pouring?
U C Corpcnten
0
SCorocrecon
0
istnnentip 0
Trustresurie
Enter en
dessificeticriree
Sr
P4WIMOIMS.
NI tares &bay oormany.
tax
corner;
--S OXPOrlinn
_sass..
.........................
Othle 44)•
Add
rev.
bleed, t,
..I.L.RI5 al
no
k
0
VAti
8
1$
Fleas/Ws nes and amnia (onto*
etc. elate. wid.Z. ZIP code Tics,ii
4 5
IA vi
oc;c502...„
Lie noon numbiels) two looticon
Part I
Taxpayer Ithenbficatiott Number (TIN)
Enter your TIN in the appropriate boa The TIN provided most 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 alien, sole proprietor. or disregarded salty, tee the Part I instruct:ins an page 3. For other
entities, it is your employer identification number (FIN). N you do not have a number. see How to gore
TIN on page 3.
Note. lI the account Is In more then one name. see the chart on page 4 for guidelines on whose
number to enter.
Enthieyer klenaratten manlier
IMUL
Certification
Urder penalties of perjury. I certify that:
1. The number shown an this loan is my correct taxpayer identification number (orient 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 withhokling or (b) I have not been notified by the Internal Revenue
Service ORS) that I am subject to backup withholding re a result of a faiure to report a interest or dividends. or (c) the IRS has notified me that I ern
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. paean (defined below).
Ceortflestion instruceons. You must cross out Item 2 above if you have been notified by the IRS that you are currently eubamt to backup withholding
because you have failed to report all Wrest and dieidende on your tax Mum. For real estate frantaations. nein 2 does not apply. For mortgage
Interest paid. acqubilch or abandonmentotmoured property, cancegatkin
.debt: Contributions to an indniclusl retirement anngarrient (IRA), and
generay. payments other than Interest end dkidends, you are not
to sign the certification, but you must provide your coned TIN. See the
Insbuction a on page 4.
Sign
Sienstre or
HOT*
us. parson •
General Instruthions
Section references we to the Internal Rover \Cods
noted.
Purpose of Form
A person who is required to file an information Mum with the IRS nwst
obtain your correct taxpayer identification number (TIM to report. for
marralo, inane paid to you. real estate Pernaction% mortgage interest
you paid. &NS:Shinn or abandonment of secured rimer/, ceralloson
of debt a Contrthuticen you made to en IRA
Use Fans W-9 oaf), if yes area U.S. person (ooluding a resident
alien). to provide your sanest TN to the person fe200111019 It (the
requester) and, when applicable, to:
1. Certify that the TIN you we gtving is correct (or you we wang for a
number to be issued).
2. Certify that you are not subject to backup withhold-g. or
3. Claim exemption horn backup whhholderg if you we a U.S. exempt
Payee a applicable. you am also certifying that as a U.S. person. your
a/locale share of any partnemhip income from a U.S. trade or business
is not subject to the withholding tax of foreign partners' share ol
effectively oonnected insane.
1T
Debt •
70
1 4/
Note. It a requester gnu you a loan other than Form W-9 to request
your TIN, you must use the requesters Icon k it is substantiay mnilr
to this Form W.9.
DefiNtion of a U.S. person For fedora two purposes, you are
considered • U.S. person if you are
• An individual who is a U.S. citizen or U.S. resident Wien.
• A partnership. corporation. company, or association created or
organized in the United Slain or under the laws of the United Slates
• an estate (other than a Ionian estate), or
• A domestic Not (as defined in Regulations section 301.7701.7).
Genial Sea for partnerShiPs. Partnere/lips that conduct a bade or
business in the United States am generally required to pay a withholding
tax on any foreign partnere share of income born 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 your. a U.S. Waco that is a
partner in a partnership conducting a trade or lousiness n the United
States. provide Form W-9 to the partnership to establish your U.S.
status and avoid withhceding en your share of oartnenthip tea
001. NO. 10231X
Form IN-9 (Rev. 12-2011)
CONFIDENTIAL - PURSUANT TO FED. CCIN Fe) DENTIAL
SDNY_GM_00063546
0B-SDNY-0026371
EFTA_00174054
EFTA01298638