EFTA Document EFTA01384429

,.., W.9 Rev. November 2017) Department°, tre Treats? intent Revenue Service Request for Taxpayer Identification Number and Certification le Go to www.irs.gov/ForrnW9 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. Print or type. See Specific Instructions on page 3. 1 Name (as shown on your Interne Lax return). Name is required on the line: do not loam this toe bran. Gratitude America. Ltd 2 Bus mess name:disregarded entity name. If different from above 3 Check appropriate following seven boxes. 0 Inoivielual/sole single-member 0 Limited lability Note: Check the LLC rt the LLC another LLC that is disregarded r2 Other (see insuuctions) box for federal tax ciassiticWion of the person whose name is enured on line 1. Check only one of the O Trust/estate 4 Exemptions certain entities, instructamt Exempt payee Exemption CO of any) ''''''" r•,•». Ina '"'" (codes aPPIY only to not individuals: see on page 3Y code (if any) proprietor or • C Corporation 0 S Corporation 0 Partnership LLC company. Enter the tax classification (C=C corporation. SAS COrPOration, P=Partnership)fr appropriate box in the line above for the tax Clataikation of the single-member owner. is classified as a single-member LLC that is disregarded from the owner unless the is not disregarded from the owner for U.S. Worn tax purposes. Otherwise, a single from the owr.or should check the appropriate box for the tax clas*ification of its owner. I. Exempt Private Organization from FATCA reposing Do not check owner of the LLC is -member LLC that 4" . "" n " an. We l't 1 ' ) 5 Address (number. streel, and apt. or suite no.) See instructions. 9100 Poart of Sale Mall, Ste 15 I Requester's name and addnn.s toptiunab 6 City. stale, and ZIP code St. Thomas, USVI 00802 7 List acount number(s) here Motional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I. later. For other entities. It is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Part II 1 Social security number or Employer identification number 6 6 0 7 8 9 6 9 7 Certification Under penalties of perjury, I certify that 1. The number shown on this form is my correct taxpayer identification number (or I am 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 withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I ant no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The MICA coefe(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions. item 2 does not apply. For mortgage interest paid. acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA). and generally, payments other than interest and dividends. you are not required to sign the certification, but you must provide your correct TIN, See the instructions for Part II, later. Sign Signature of Here us. person la Date la General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to vivemirs.gov/FormVV9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (111N). adoption taxpayer identification number (ATIN). or employer identification number (EIN), to report on an information return the amount paid to you, Of other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards. or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098.E (student loan interest). 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. if you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 11.2017) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL SONY GM_00230790 DB-SDNY-0084606 EFTA01384429