EFTA Document EFTA01368295

IV. TAX ELECTIOWDECLARATION OF TAX STATUS This Account Agreement is designed for use by both U.S. Persons and Non-U.S. Persons. Please check the box next to the applicable Item below. Client certifies that CIlath will notify DBSI in witting immediately ff the representation certified to below ceases to be true and correct. 1.O V.S. Citizen or U.S. Resident Alien Form W9 ...-Request for Taxpayer Identification Number and Certification Substitute c Y)1/42 tVir VI" \ 1 WxCl Vir" ft \ Name