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IV. TAX ELECTION/D€CLARA I ION OF TAX STATUS
Res Account Agreement is designed for use by both U.S. Persons and Non-US. Persons. Please check the box next to the applicable item below.
Client certifies that Client veil notify DESI in writing Immediately il the representation certified to below ceases to be we and correct.
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• I Taxpayer Identification Number (TIN)
Request for Taxpayer Idaatification Number and Certifioation
Sign
Here
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The TIN provided must match the name given on the "Name tine
to avoid bacimp withholding:F& individuals, this is your soda) security number ISSN). For other
entities. it Is your employer Identificabon number WIN).
Employer Identificabon Number
00-EIDE1 I CID
Certification
Under penalties of penury. I certify that:
1. The number shown on this loren is my correct taneyer Identification number for I am waiting for a number to be Issued to me). and
2. I am not subject to backup withholding because: lal lan, exempt from backup withholding. or lb) I have not been notified by the Internal Revenue
Semite (IRS) that I am subject to backup withholding as a result of a talk» to report all interest or divklinds. or (c) the IRS has notified me that I am
no longer sublet* to backup withholding. and
3.1 am a U.S. citizen or other U.S. pars
in the instructions).
Østion
instruction.. You
st cross out earn above if you have been
by the IRS the' you ale cirrendy subject to backup wilhholifing
because you have failed to
rt all interest and d
ude on your tax
2.0 Non-US. Person
I am not a U.S. parson Including a U.S. resident alien). I am submitting the applicable Form W-8Ø this form to Daddy my toregn status and. if applicable,
claim tax treaty benefits.
For example. Client is not a LIS. person lincludin9 a U.S. resident silent. Client agrees to provide DBSI with this application the applicable Internal Revenue
Service (IRS) Form W.8 to certify the char Cs foreign status. W-8 forms and instructions am available on the IRS website at www.irs.gov.
(THIS SPACE INTENTIONALLY LEFT BLANK]
12.PVVM-0573
e
012145 011113
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0041003
CONFIDENTIAL
SDNY_GM_00187187
EFTA01355743