EFTA01459316.pdf

FOOT (Rev. December 2014) W-9 Request for Taxpayer Give Form to the requester. Do not Deparmen: of the Treasury Identification Number and Certification send to the IRS. Interns Revenue Santa '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 See Specific instructions on page 2. 3 Check appropriate box for federal tax classification; check only one of the fdlowing seven boxes: 4 Exemptions (codes apply only to 0 Indeeduallsole proprietor or • C Corporation • S Corporation • Partnership 0 Trust/estate cns lw;It2-1,0 en,n ution et pag rcteind gr : " 181 see Singlernember LUC Print or typo Barnet payee cods Of any) 1 0 Levied lability company. Enter the In classification (CriC corporation, S4 corporation, PripartnersNp) il• Note. For a single-member t.L.,3 that is dsregardec, do not check LLC; check the appropriate box in the line above fo Exemption from FATCA reporting the tax classification or the single-member maw. code Of any) 2 Other (Bee instructions) a. Non-Profit Corporation 9410111bROWEI RISSIRAWI 01.0101MP US, 5 Address (number, street, end apt or stale no.) Requesters name rd address (optional) 9100 Port of Sale Mall Suite 15 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 I Social security number 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. Of I Note. If the account is in more then one name, see the instructions for line 1 and the chart on page 4 for Employer identification number guidelines on whose number to enter. Part II 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 ust cross out item 2 above II you have been notified by the IRS that you are currently subject to backup withholding because you have failed to rep all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage interest pad. acquisition or nment of secured OW, cancellation of debt, contributions to an Individual retirement arrangement (IR), and generally. payments other non est and dividendl, are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. ; • Sign Sputum of Here U.S. person e Dense be CeCAria as)-/ apt General Instructions • Forst 1098 (home mortgage Interest), 1098.E (student loan interest), 1098-T (tuition) Section references am to the Internal Revenue Coda unless otherwise noted. • Form 1099-C (canceled debt) Future developments. Information about developments effecting Form W-9 (such • Font, 1099-A (acquisition or abandonment of secured property) as legislation enacted after we release it) Is at www.irsgoWfwg. Use Form W-9 only if you am a U.S. person includng a resident alien). to Purpose of Form provide your correct TiN. An individual or entity (Form W-9 requester) who is reouked to file en information N you do not return Farm W-9 to the requester at a TIN, you might be subject rattan with the IRS mist obtain your correct taxpayer identification renter MN/ to backup wftNtokliig. See What is backup withholding? on page 2. Mich may be your social security number ISSN). ricrividdcl taxpayer identification By signing the M edout form, you: number (UM). adoption laspayar idantifcation number (ATIN). Of employer 1. Certify that the TIN you we giving Is coned (or you am waiting for a number identification number (FJN), to report on en information return the amount paid to to be issue* you, or other amount reportable on en information return. Examples of information returns inducts but are not limited to, the 2. Certify Oct you are not subject to backup yethholoing, or • Form 1099-4NT (nterne earned or paid) 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 • Form 1099-DN (dividends, inducerso those from stocks or mutual finds) any partnership beans from a U.S. trade or burliness Is not subject to the • Form 1099-MISC (various types of income, pale. awards. or gross proceeds) withholding tax on foreign partners' share of effectively connected income, and • Fem.; 1099-8 (stock or mutual find See and certain other transactions by 4. Certify that FATCA coders) entered on this form (if any) indicating that you are brokers) exempt from the FATCA reporting, le correct. See Inns! is FATCA reporting? on • Form 1099-S brocade from near estate Iransactbns) page 2 for further Mformation. • Form 1099.K (merchant card and third party network transactions) 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