EFTA01384429.pdf

,.., W.9 Rev. November 2017) Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not Department°, tre Treats? send to the IRS. intent Revenue Service le Go to www.irs.gov/ForrnW9 for instructions and the latest information. 1 Name (as shown on your Interne Lax return). Name is required on the line: do not loam this toe bran. Gratitude America. Ltd 2 Bus mess name:disregarded entity name. If different from above See Specific Instructions on page 3. 3 Check appropriate box for federal tax ciassiticWion of the person whose name is enured on line 1. Check only one of the 4 Exemptions (codes aPPIY only to following seven boxes. certain entities, not individuals: see instructamt on page 3Y 0 Inoivielual/sole proprietor or • C Corporation 0 S Corporation 0 Partnership O Trust/estate single-member LLC Exempt payee code (if any) Print or type. 0 Limited lability company. Enter the tax classification (C=C corporation. SAS COrPOration, P=Partnership)fr Note: Check the appropriate box in the line above for the tax Clataikation of the single-member owner. Do not check Exemption from FATCA reposing LLC rt the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is of any) CO another LLC that is not disregarded from the owner for U.S. Worn tax purposes. Otherwise, a single-member LLC that ''''''" is disregarded from the owr.or should check the appropriate box for the tax clas*ification of its owner. r2 Other (see insuuctions) I. Exempt Private Organization r•,•». Ina '"'" 4" . "" n " an. We l 't 1' ) 5 Address (number. streel, and apt. or suite no.) See instructions. I Requester's name and addnn.s toptiunab 9100 Poart of Sale Mall, Ste 15 6 City. stale, and ZIP code St. Thomas, USVI 00802 7 List acount number(s) here Motional) 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 1 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 instructions for Part I. later. For other entities. It is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. or Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer identification number Number To Give the Requester for guidelines on whose number to enter. 6 6 0 7 8 9 6 9 7 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 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 ant no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The MICA coefe(s) entered on this form (if any) indicating that I am 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 property, 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 for Part II, later. Sign Signature of Here us. person la Date la • Form 1099-DIV (dividends, including those from stocks or mutual General Instructions funds) Section references are to the Internal Revenue Code unless otherwise • Form 1099-MISC (various types of income, prizes, awards. or gross noted. proceeds) Future developments. For the latest information about developments • Form 1099-B (stock or mutual fund sales and certain other related to Form W-9 and its instructions, such as legislation enacted transactions by brokers) after they were published, go to vivemirs.gov/FormVV9. • Form 1099S (proceeds from real estate transactions) Purpose of Form • Form 1099-K (merchant card and third party network transactions) An individual or entity (Form W-9 requester) who is required to file an • Form 1098 (home mortgage interest), 1098.E (student loan interest). information return with the IRS must obtain your correct taxpayer 1098-T (tuition) identification number (TIN) which may be your social security number • Form 1099-C (canceled debt) (SSN), individual taxpayer identification number (111N). adoption • Form 1099-A (acquisition or abandonment of secured property) taxpayer identification number (ATIN). or employer identification number Use Form W-9 only if you are a U.S. person (including a resident (EIN), to report on an information return the amount paid to you, Of other alien), to provide your correct TIN. amount reportable on an information return. Examples of information returns include, but are not limited to, the following. if you do not return Form W-9 to the requester with a TIN, you might • Form 1099-INT (interest earned or paid) be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 11.2017) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0084606 CONFIDENTIAL SONY GM_00230790 EFTA01384429