EFTA Document EFTA01368407

Fenn W '''9 dkov. ocarfferene basenstest el the Owen. Numb R•70140 Unita Request for Taxpayer Identification Number and Certification Give Form to the reqUeSter. Co not send to the In. • no ; .li. ! t S 7st Now * s, z E t in a I Name pa shown on your Income tat ratan} Name :4 toque", on This wteo not DM, s Sy blank Southern Trust Company, Inc. ambi t ma namerearegardee enbly news, a callevern eon above Southern Financial, LLC 3 Check approortaie O 534545U445:010 seslomenter O Lanka %salarycompany. For a sontootcriba am tax ounlecakon box tor federal lax ctreelecaban: OW airy ere of the tonotAng seven box= Minim or ❑O C Censeration 0 S Corporation O Penner-hip O IneVestaro U..0 Foto the tea clastaketkm PAC caporation. SeS corporation. Paparewesh10) lo LLC that ts C..voientIce. do not creek tsc; chock tne futon/NOM box ln the aterarer°, 0 the Ace member C r AC Y. • 4 Exemptions icniir n anttipaewlerta" ExerPOI payee bemPtic" code et err) Imam e sammemeeseeme kenos Keit Otto see ma (4 9'1 keen FATCA159"5 lie Dow pee -euuceo nut, 5 P4554333 (4,34004. *OMl and at. otaes red 6100 Red Hook Quarter, Et3 RagvetYle mete and a cene (opiO1a e Cite. stilt anelte? COOS St. Thomas, USVI 00802 7 Lot maount ntantspi here Matadi Pa -t c Taxpayer Identification Number (TIN) Enter your TIN In the appropdate box. 11101114 provided must match the name given on Cr e 1 to twold backup withholdIng. Foe Individuals. Una Is generally your social security number (SSN). However, tor e resident alien. sole piraerletor, or dtcreparded entity, too the Part I Inatructiora on page 3. For other snide,. It Is your employer Identikab011 number (EIN). It you do not have a number. see How CO gilt e TrN on page 3. Note. If the account Ls In more man ono nano. see the Insuucttons for line I and the than on page 4 lot guldens* on whose number to snot. Soda tufty numbs, or rempieser ktentitiormon number • Certification Under homilies of perjury. leen& that 1. The number shown on this form Is my correct taxpayer identiOCation number (or t am waiting for a number to be moved to mot and 2. lam not subfect to backup withhoierng because, (a) I an exempt from backup withholding, cr. (D) I have riot been nothied by the Internal Romeo Service MS) that I ern subject to backup withholokne as o result of a failure to /opal ell Interest or dividends. or (c) the IRS has noticed mo that I em no longer suttee% to osekup wIthholenth and 3. I em a U.S. citizen or other U.S. person (defined Wont end 4. The MICA code(a) entered on this tom el ant in:Scaling that I am exempt from MICA reporting le =Met. Cardfleattlen Instructions. You must cross out kern 2 above If you have been notified try the IRS that you ere currently subject to backup setribaldna because you have failed to report all Interest end dkridends on your tax return. For real estate hansackona, Item 2 dorm not apply. For snongegs interest pair'. acquisition or abanconmont of secured property. cenceaadon of debt, C.OntributiOn3 loan Moviduel retheMent arrangement (MK end gencreity. payments other than Interest and dividends, you me net required Wargo the cerliCositork but you muSt provide your corral TN. Seethe instructions on pegs 3. Sign Hero SIgnefore el US. person General Instructions BadlOCI Wet OICIS 010 le the Mint Anus CCOO Unitise otherwise noted. Future develOprnentt. htonneton abate develooments Intorno Form W.9 Dash of teebtarlon enacted saw we release it) i as wwvottspovihe9 Purpose of Form An MK/up; Or way (Form W-9 I counIcr) ten Is /mtor! to Do an inforrnaition rttsn with MOMS Mal obtain your ca-rect to Pryor lomalicaten mote (134 ores, get ,' be your seamy sods number PSN),kihqual taxpayer ideninitatfon number pus aotptitm taxpayer teranieloellon number (Mint or emoseret alesinceeon Mar bra (ON). to report on en Inkanadon rotten the amontt paid to you. or other amount model* an on atIcestakrt Man Examples of beOrMatIon Want ar..isdel. but Ore net limited to, the lams** • Form 1009.INI (intereet tented en peke • Form 1099-DIV (Sulseneb, ineludno those bum nods a award West • Fenn 1099411SC (webers types of income. prim nth. of ontea prOcooth) • rant, 1099-0 trio* or mutual fund sans Wasson ohs tramactiore by broken) • Form ‘039.S ;proceeds born red estate woodland • Form t099-K One tent card arc third parry network kanracilens) with 1/410/ziO1* • Fenn low swims manatee Nees°. 1098M tovolennean Inane/ C0SVI SteAM0 • Form 1099.0 (cancesea oeto • Form i099.A(okartslice 44 se t 34 waged PloPeral the roan W4 only a you =au& parson Criquans a hishinni Mat inevkielert earedTIM If swot no4 'alum Ftem 19-9 to me tequaste (wk., • fig ea.; rnient be seopel to Now seentiokane. See Marl heap tePriekrrd? on page 2. Starke the lined-Oa bark Put 1. Certify Pm the UN you are Imam Is owed pr you ere *Ong kr a mother to be Sued). 2 Certify that you are not Sulackel to brekuls withhokline, or 2. Ctirn exemption ham backup swthheldue aypu ere a U.S. ammo payee If sppecetle. you an extra Catayatty that meat porton your amble mare of any eortnennip 'room* Worn a U.S. vale a Ike nen le not ineViect te to wanhoktirg ea at heal cannon' etatt of elfrethebt Conlotaled Doom rot 4. C,erOfy that MICA co64(s1 ereensa al Mb lam Of tow ) bdpnky vut you aro °henna; awn the FATCA lerenine, scored See whet a MM.* npauti?on ono 21r kite: bkonerion. Cat. No. 10231X Form W-9 flee 12201q CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0060136 SDNY GM_00206320 EFTA01368407