EFTA Document EFTA01385750

Form W-9 (Rev. December 2014) Chwrirrant of the Tre Servias ceury !Memel fithenue Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or typo See Specific Instructions on page 2. I Name Os shown The Haze Trust on income tax return). Name 4 required Ns Inc do lean this Lee tame your on not 2 Business nameldleregarded entity name, If different from above 3 Check mercer:ate box for federal tax classification: check only one or tris followiiq seven boxes: O IndivSduellitsfer proprietor or O C Corporation O 5 Corporation O Partnerstep single-member LLC O limited liability company. Enter the tux classification (C•C corporation. SS corporation. O.portnergesr) Note. Fora single-member LLC that is esrogarciod, 00 not check LIG; check the appropriate box in the tax dassificadon of the tingle- member owner. • Other (tee insteucTalePfr 0 That/estate a. 4 Exemptions certain entitles. Exempt payee Exemption code Of any) Avow ro neva (codes )ply only to s. rid on pag Indviduais: see e 3): code (14w) from FATCA reporting the line show for wrinroveranrown• us) inlINIIIIIIMP3i) Requester's name and address (oPtiona0 6 Gay. Stele. and 7P code St, Thomas 0 ,00802 7 List account rwenter(s) here foment' Part I Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on ;ins 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 Part I Instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on pege 3. Note. If the account Is in more than one name, see the instructions for line 1 and the chart on page a for guidelines on whose number to enter. Social security number or Part H Certification Under penalties of perjury, I certify that: 1. The number shown on this tom Is my correct taxpayer identification number (or tarn 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 withholdmg as a result of a failure to report ail interest or dividends, or (c) the IRS has notified me that 1 am no longer subject to backup withholding; and 3. I am a US. citizen or other U.S. person (defined below): and 4. The FATCA code(s) entered on this form (rf 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 tailed to report all interest and dividends on your tax return. For reel estate UW98060,15. item 2 does not apply. For mortgage interest paid, acquisition or abandonmen f *emu d property, cancellation of debt, co Pone to an individual retirement arrangement plik), and generally. payments other than in and divider, • you are not required to • • e certification, but you must provide your correct TIN. See the Instructions on page 3. Sign Here Signature of U.S. person K2' Datn" arnit0 11 - General Instructions Section referenCe5 we to the Internal Revenue Code unless othe Future development& Information Bout developments affecting Fo as 'egoist:Won enacted after we release It) is at www.la-Cloeltwt. Purpose of Form An Individuel or entity (Form W-9 requester) who Is required to Re an ink:rotation return with the IRS must obtain your contact taxpayer Identalcation number Map which may be your social security number (SSN). inenicluet taxpayer identification number (Inall, ard00tion taxpayer Identification number (ATINI, or emuoyer identification number tan). to report on an information return the amount paid to you. or other amount reportable on an information return. ExaMple3 of information returns Include, but are not limited to, the ft:Cowing: • Form loge-INT (interest earned or paid) • Form 1099-DIV (dividends. including those from stocks or mutual funds) • Form 1099-MISC (various typos of income. Prize, awards, or gross proceeds) • Form 1099.8 (stock or mutual fund sales and Certain other transactions by brokers) • Form 1099-13 (proceeds from reel estate transactions) • Form 1099-K (Merchant card and third party network transactions) se noted. h Om 1095 (borne mortgage kiltreSg. 1099-E (Student loan interest), 10984 oration) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured properbi Use Form W-9 only if you area U.S. pence (inducting a resident eke). to provide yOUr correct TIN, u you do nor Mum Form VA9 re the requester with a TIA4 you mgtl be eubiecl to b&s'p withholding. See Whet 4 backup withhokeng? on page 2. Sy signing the tilled-out form, you: 1. Certify that the TIN you are giving is correct for you are wading for a number to be Issued). 2. Certify that you are not subject to backup withholding. or 3. CLOT exemption from backup withholding if you are a U.S. exempt payee. If applicable. you we also unifying that as a U.S. parson your allocable shwa or any partnership ;morns from a U.& trade or business is not ambler.* to the withholding tax on foreign partnere' share of effectively connected Income, and & Certify het FATCA codes) entered on this fOrm p any) indlCating that you are exempt from the FATCA reporting, is correct. Soo What is FATCA reporting? on page 2 for further information. Cat. No 10291% Form W-9 Ny. 12-2011) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0087088 CONFIDENTIAL SDNY GM_00233272 EFTA01385750