EFTA Document EFTA01459316

FOOT W-9 (Rev. December 2014) Deparmen: of the Treasury Interns Revenue Santa 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 (as &hewn on your income Cu return) Nan* is required on this fine: do not leave metre Nana. Gratitude America, Ltd. 2 flusinese namebearegarded entity name, if different hon• above 3 Check appropriate 0 Indeeduallsole Singlernember 0 Levied lability For a single the tax classification 2 Other (Bee instructions) box for federal tax classification; check only one of the fdlowing seven boxes: 0 Trust/estate il• 4 Exemptions cns lw;It2-1,0 en,nution et Barnet payee code Of any) 9410111 b ROWE (codes apply only to pag rcteindgr " : 181 see cods Of any) 1 proprietor or • C Corporation • S Corporation • Partnership LUC company. Enter the In classification (CriC corporation, S4 corporation, PripartnersNp) -member t.L.,3 that is dsregardec, do not check LLC; check the appropriate box in or the single-member maw. a. Non-Profit Corporation m FATCA fro reporting Note. the line above fo Exemption I RISSIRAW I 01.0101 MP US, 5 Address (number, street, end apt or stale no.) 9100 Port of Sale Mall Suite 15 Requesters name rd address (optional) 6 City, stets and ZIP coda St. Thomas, USVI 00802 7 fist account number(s) hem (optronah 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 Part I instructions on page 3. For other entities, it is your employer identification number (CINO. If you do not have a number, see Now to get a TIN on page 3. Note. If the account is in more then one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Part II I Social security number Of Employer identification number I Certification Under penalties of perjury. I certify that: 1. The number shown on this form is my correct taxpayer Identification number (or I am waking for a number to be issued to meN and 2. I am not subject to backup vAthholcfing 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 am no longer subject to backup withholding: and 3. I em a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form Qf any) indicating that I am exempt from FATCA reporting is correct Certification Instructions. You because you have failed to rep interest pad. acquisition or OW generally. payments other non instructions on page 3. ; • Sign Here Sputum of U.S. person e ust cross out item 2 above II you have been notified by the IRS that you are currently subject to backup withholding all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage nment of secured , cancellation of debt, contributions to an Individual retirement arrangement (IR), and est and dividendl, are not required to sign the certification, but you must provide your correct TIN. See the Dense be CeCAria as)-/ apt General Instructions Section references am to the Internal Revenue Coda unless otherwise noted. Future developments. Information about developments effecting Form W-9 (such as legislation enacted after we release it) Is at www.irsgoWfwg. Purpose of Form An individual or entity (Form W-9 requester) who is reouked to file en information rattan with the IRS mist obtain your correct taxpayer identification renter MN/ Mich may be your social security number ISSN). ricrividdcl taxpayer identification number (UM). adoption laspayar idantif cation number (ATIN). Of employer identification number (FJN), to report on en information return the amount paid to you, or other amount reportable on en information return. Examples of information returns inducts but are not limited to, the • Form 1099-4NT (nterne earned or paid) • Form 1099-DN (dividends, inducerso those from stocks or mutual finds) • Form 1099-MISC (various types of income, pale. awards. or gross proceeds) • Fem.; 1099-8 (stock or mutual find See and certain other transactions by brokers) • Form 1099-S brocade from near estate Iransactbns) • Form 1099.K (merchant card and third party network transactions) • Forst 1098 (home mortgage Interest), 1098.E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Font, 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you am a U.S. person includng a resident alien). to provide your correct TiN. N you do not return Farm W-9 to the requester at a TIN, you might be subject to backup wftNtokliig. See What is backup withholding? on page 2. By signing the M edout form, you: 1. Certify that the TIN you we giving Is coned (or you am waiting for a number to be issue* 2. Certify Oct you are not subject to backup yethholoing, or 3. Clan akafftpkOn from backup withbakkoO if you we a U.S. exempt payee. applicable, you are also ovrtilyng that as a U.S. person, your allocable Mare of any partnership beans from a U.S. trade or burliness Is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA coders) entered on this form (if any) indicating that you are exempt from the FATCA reporting, le correct. See Inns! is FATCA reporting? on page 2 for further Mformation. Cat. No. 10231X Form W-9 (Rev. 12-2014) CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0119648 CONFIDENTIAL SDNY_GM_00265832 EFTA01459316