EFTA01394815.pdf

Form W-9 (Rev. 11-2017) Page 5 1. Interest, dividend, and barter exchange accounts opened For this type of account: Give name and EIN of: before 1984 and broker accounts considered active during 1983. 14. Account with the Department of The public entity You must give your correct TIN, but you do not have to sign the certification. Agriculture in the name of a pubic entity (such as a state or local 2. Interest, dividend, broker, and barter exchange accounts government. school *Oct. or opened atter 1983 and broker accounts considered inactive during prison) that receives agricultural 1983. You must sign the certification or backup withholding will apply. If program payments you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the 15. Grantor trust filing under the Form The trust certification before signing the form. 1041 Fikng Method or the Optional Form 1099 Filing Method 2 (see 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. Regulations section 1.671-408(2)()03)) 4. Other payments. You must give your correct TIN. but you do not ' List first and circle the name of the person whose number you furnish. have to sign the certification unless you have been notified that you If only one person on a joint accoun has an SSN. that person's number have previously given an incorrect TIN. "Other payments" include must be furnished. payments made in the course of the requester's trade or business for ' Circle the minor's name and furnish the minor's SSN. rents. royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to ' You must show your individual name and you may also enter your a nonemployee for services, payments made in settlement of payment business or DBA name on the -Business name/disregarded entity" card and third party network transactions, payments to certain fishing name line. You may use either your SSN or EIN (if you have one), but the boat crew members and fishermen, and gross proceeds pad to IRS encourages you to use your SSN. attorneys (including payments to corporations). ' List first and circle the name of the trust, estate, or pension trust. Po 5. Mortgage interest paid by you, acquisition or abandonment of not furnish the TIN of the personal representative or trustee unless the secured property, cancellation of debt, qualified tuition program legal entity itself is not designated in the account title.) Also see Special payments (under section 529), ABLE accounts (under section 529A), IRA, Coverdell ESA, Archer MSA or HSA contributions or rules for partnerships, earlier. distributions, and pension distributions. You must give your correct 'Note: The grantor also must provide a Form W-9 to trustee of trust. TIN, but you do not have to sign the certification. Note: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. What Name and Number To Give the Requester For this type of account: Give name and SSN of: Secure Your Tax Records From Identity Theft 1. Indrodual The individual Identity theft occurs when someone uses your personal information 2. Two or more individuals (joint The actual owner of the account or, if such as your name, SSN, or Other identifying information, without your account) other than an account combined funds, the first individual on permission, to commit fraud or other crimes. An identity thief may use maintained by an FF1 your SSN to get a job or may file a tax retum using your SSN to receive the account' a refund. 3. Two or more U.S. persons Each holder of the account (joint account maintained by an FFQ To reduce your risk: • Protect your SSN, 4. Custodial account of a manor The minor' (Uniform Gift to Minors Act) • Ensure your employer is protecting your SSN, and 5. a. The usual revocable savings trust The grantor-trustee • Be careful when choosing a tax preparer. (grantor is also trustee) If your tax records are affected by identity theft and you receive a b. So-caned trust account that is not The actual owner' notice from the IRS. respond right away to the name and phone number a legal or valid trust under slate law printed on the IRS notice or letter. 6. Sole proprietorship or disregarded If your tax records are not currently affected by identity theft but you The owner entity owned by an individual think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credt report, contact the IRS Identity Theft Hotline 7. Grantor trust filing under Optional The grantor' at 1-800-908-4490 or submit Form 14039. Form 1099 Filing Method 1 (see Regulations section 1.671.4(bX2Ni) For more information, see Pub. 5027. Identity Theft Information for Taxpayers. For this type of account: Give name and MN of: Victims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that 8. Disregarded entity not owned by an The owner have not been resolved through normal channels, may be eligible for individual Taxpayer Advocate Service (TAS) assistance. You can reach TAS by 9. A valid trust. estate. or pension trust Legal entity calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 10. Corporation or LLC electing The corporation 1-800-829-4059. corporate status on Form 8832 or Protect yourself from suspicious smalls or phishing schemes. Form 2553 Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act 11. Association, club, religious. The organization is sending an email to a user falsely claiming to be an established charitable, educational, or other tax- legitimate enterprise in an attempt to scam the user into surrendering exempt organization private information that will be used for identity theft. 12. Partnership or multi-member LLC The partnership 13. A broker or reentered nominee The broker or nominee CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0100859 CONFIDENTIAL SONY GM_00247043 EFTA01394815