EFTA01194924.pdf

Financial institutions RIORTONROSEFULBRIGHT Energy Infrastructure, mining and commodities Transport Technology and innovation Life sciences and healthcare Change to contact information Important notice January 2015 We have changed the legal name of our law firm to Norton Rose Fulbright US LLP. Please make all future payments to Norton New remittance address: Rose Fulbright US LLP and discontinue using the name Fulbright Norton Rose Fulbright US LLP & Jaworski LLP. P.O. Box 844284 Dallas, Texas 752844284 As you know, in June 2013, our firm became part of Norton Rose Fulbright. At that time, we retained the legal name Fulbright 8e Wire or ACH Jaworski LLP. Since that time we have concluded that continued instructions: use of our former legal name is potentially confusing to our clients and the public, and we have decided to adopt a legal name, Norton Rose Fulbright US LLP, that better reflects our combination into Norton Rose Fulbright. The other members in Norton Rose Fulbright are Norton Rose Fulbright LLP, Norton Rose Fulbright Australia, Norton Rose Fulbright Canada LLP, and Norton Rose Fulbright South Africa Inc. Although the members in Norton Rose Fulbright remain separate legal entities, we operate as a single legal practice. We also want to take this opportunity to inform you of our practice regarding the sharing of non-privileged information with other members. Our global practice ranks among the largest and most prestigious in the world. In the aggregate, Norton Rose Fulbright has more than 3800 lawyers and other legal staff practicing in over 50 offices around the world. We share with other members non-privileged information about our practice and clients for research, practice management, training, administrative and other business purposes. Confidentiality agreements are in place among all members. If you have any concerns about this sharing of non-privileged information that relates to you, please promptly notify us so that we can address your concerns. If you have any questions, please contact our Revenue and Accounting Center at Our mailing address: 713 6515252 or via entail to RAChoustonenortonrosefulbright.com. Your cooperation is appreciated. Norton Rose Fulbright US LLP 666 Fifth Avenue New York, New York 10103-3198 (212) 318-3000 EFTA01194924 Form (Rev. 2014) W'9 I Request for Taxpayer Give Form to the requester. Do not n0ir Deprave el iherreramry Identification Number and Certification send to the IRS. (menet Revenue SeMce I Name (as shown On yew Income tax return). Nimbi rewired on UM IMe: do not leave 'Ns by blank NORTON ROSE FULBRIGHT US LLP 2 Business nemalcistegeMea entity name, a different from above See Specific Instructions on page 2. 3 Check appropriate box tor federal tax classificallon: check only One of the following seven boxes' 4 Exemptions (codes apply only to certain entities. not ine victuals. see 0 indulduaVsON prOaletOr a El C Corporation ID S Corporation 0 Partnership INI Trust/estate anetn•dtiam on page 3): single-member LLC Print or type Exempt payee code Of MIN El Limited baba ty company. Enter the tax Muskat:on (CxC corporation. SeS corporation. Pxpannershrol b P Note. For a smote-member LLC that Is disregarded. do not check tie: check the appropriate box In the line above for Exemption from MICA reporting sane tax classification of the %Male-member owner. code Of any) 0 Other (See instructions) n Apatite aran,As.Yered Ana PAU SI 5 Address (number. street. and apt. or safe no.) Requester's name and addreSS (OplOnall 1301 McKinney, Suite 5100 6 Cily. state. and ZIP code Houston, TX 77010-3095 7 WI Keeled number(*) here (optional) IL Pawl I Taxpayer Identification Number (TIN) Enter Our TIN in the appropriate box. The TIN provided must match the name given on line I to avoid Social security number back p withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien. Sole prOpnetOr. Or disregarded entity, see the Part I instructions on page 3. For other entities. 4 is your employer identification number (EIN). If you do not have a number, see How 10 gat a 7)N on page or Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 guidelines on whose number to enter. Part II Certification Under penalties of penury. I certify that: 1. The number shown on this loam is my correct taxpayer identification number (er I am waiting for a number to be issued to me): and 2. I am not subject to backup withholding 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 withhold ng: and 3. I am a U.S. citizen or other U.S. person (defined below): and a. The FATCA code(s) entered on this form Of any) indicating that tam exempt from FATCA reporting is correct. 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. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured properly, cancellation of debt. contributions to an individual retirement arrangement (IRA). and generally, payments other than interest and dividends. you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Signature of Here U.S. person, Date• l — z/^fS General Instructions • Form 1098 (INN,* mortgage interest). 1098.E (student loan interest 1098.1 (turban' Section references are to the Internal Revenue Code unless otherwise noted. • Form 1099•C (canceled debt) Future developments. Information about developments affecting Fan) W-9 (Such • Form 1099-A (acquisition a abandonment of secured PrOPOnY) as legislation enacted atter we release hits at www.TagOvi•w9. Use form W.9 only if you are a U.S. person (inducing a resident alien). to Purpose of Form provide your COrrecl TIN. An individual a entity (Farm W-9 requester) who is required to file an information ft you do not return Form w.9 to the requester with a PIN, you night be sulaect rehire with the IRS must obtain yaw CareCI taxpayer Identification number (TIN) to backup wehhokAbg. See Whet a backup wahhokbefg2 on page 2. which may be you WON security number ISSN). Indrhdial taxpayer identification By signing the kted-out form. you: number PUN). adoption taxpayer Identificaton number (ATIN), or employer 1. Comfy that the TiI you are giving Is correct (cv you are waiting for a number *demarcation number ON). to report on an Information return the amount paid 10 to be ISSued). you. or other amount reportable on an intonation return. Examples of Information return, inCtude. but are not limited to. the taunting: 2. Certify that you are not subject to backup withholding, or • Form II799.INT (Merest earned a paid) 3. Claim exemption from backup withholding if you area U.S. exempt payee. If • form 109PDN (dividends. Induding those from stocks or mutual funds) voiced ,. you are also certifying that AS a U.S. PlirsOn, yOur allocable Share of any partnership Income from a V.S. trade Or business IS not sublect to the • P4irm 101•444ISC (various types of Income, pens, awards. or gross proceeds) withholding lax on foreign partners' Shale of effectively connected Income, and • Form 1099.8 (stock or mutual fund sales and certain other transactions by a Certify that FATCA cocktail entered on this lam al any) indicating that you we brokers) exempt from the FATCA reporting,, correct. See What is FATCA mooring? on • Form 1099.5 (proceeds from real estate transactions) page 2 tor twiner information. • Form 1099•K (mere: ant Card and Pad party network Irani/SOWN Cat. No 10231% Form W-9 (Rev. 124014) EFTA01194925