EFTA01449104.pdf

IV. TAX ELECTION/DECLARATION OF TAX STATUS This Account Agreement is designed for use by both U.S. Persons and Non-U.S. Persons. Please check the box next to the applicable item below. Client certifies that Client will notify OBS, in writing immediately if the representation certified to below ceases to be true and correct. 1.O U.S. Citizen or U.S. Resident Alien Form W9 Request for Taxpayer Identification Number and Certification Substitute useless name/disregarded entity name, if erent from above appropriate box for federal tax classification (require Individual/sole proprietor 0 C Corporation 0 S Corporation 0 Partnership 0 Trust/estate El Exempt payee O Limited liability company. Enter the tax classification (C=C corporation, 5=5 corporation, P=partnership) Other MAI 110.4 Taxpayer Identification Number (TIN) Social Security Number Enter your TIN in the appropriate box. The TIN provided must match the name given on the -Name" line to avoid backup withholding. For individuals, this is your social security number ISSN). For other entities, it is your employer identification number IEIN). ml ee LL 1I 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: la) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service FIRS) 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 am a U.S. citizen or other U.S. person (defined in the instructions). 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. Sign Here 2.0 Non-U.S. Person I am not a U.S. person (including a U.S. resident alien). I am submitting the applicable Form W8 with this form to certify my foreign status and. if applicable, claim tax treaty benefits. For example: Client is not a U.S. person (including a U.S. resident alien). Client agrees to provide OBSI with this application the applicable Internal Revenue Service (IRS) Form W-8 to certify the client's foreign status. W-8 forms and instructions are available on the IRS website at www.irs.gov. 13-AWM-0198 6 012145.032813 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0104366 CONFIDENTIAL SDNY_GM_00250550 EFTA01449104