📄 Extracted Text (439 words)
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 DBSI In wilting Immediately If the representation certified to below ceases to be two and correct.
1.0 U.S. Citizen or U.S. Resident Mien
Fenn W9 Request for Taxpayer Identification Number and Certification
Substitute
74inctip,taxmum)
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Namelitrown ont
Business name/dist aidedentity ne e, if rent from above
check appropriate box for federal tax classification Required)
1 3 Indhridualkole proprietor❑C Corporation ❑SCorporation ❑ Partnership al'Irth:tri,!Ntate • Exempt payee
ij ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, Papattnershro) ,
Other ,
Addre
City,
Rot i Taxpayer Identification Number (TIN)
ty Numbor
EMer 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 0 - on-ma
entitles. it is your employer Identification number (EIN). Employer 'thentrflcaoon Number
Rut 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 waiting for a number to be Issued to me), end
2. I am not subject to backup withholding because: (all em 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 falkire 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. parson (defined in the instructions).
Certification instructions. You must cross out Item 2 above II you have been notified by the IRS that you are wrrently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.
agn Signature of
person
Here
eDmvu—,L. Date 0 ClfIL 1/ 3
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 W'8 with this form to certify my foreign status and, d applicable,
calm tax treaty benefits.
For example: Client Is not a U.S. parson (Including a U.S. resident alien). Client agrees to provide ()BSI with this application the applicable Internal Revenue
Service (IRS) Form W43 to certify the client's foreign status. W-8 forms and instructions are available on the IRS website at wwwirs.gov.
6
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0105824
CONFIDENTIAL SONY GM_00252008
EFTA01450272
ℹ️ Document Details
SHA-256
2b307982548fabe1491740c84b9e5b03d8823c009411e60d7264c2830f6ada74
Bates Number
EFTA01450272
Dataset
DataSet-10
Document Type
document
Pages
1