EFTA01299114.pdf

Form W-9 December Request for Taxpayer Give Form to the requester. Do not fi r. Dapersaant dthe2011) Treeary Identification Number and Certification tend to the IRS. Hetet Revenue Sevier fiersofrali al en wso you iscorrte tax ratime snrw . NC vile, 1-1-t ditlwora firm Nee. a Businen ' witty new, if Check oppropriate boa for federal tax deestycaticw • wayeastisa. r,rccnsor 0 C Corperation 0 s Corporation 0 Owtnarstib II Inetrastat• 0 Exempt payee EK.ImIted lability ourpony. Enter the to ciaasiratation (GC corporation. S.S careratirn. larlatrawrilia Fajahi7:219 vela ervn i I Moth" pie intaxsonq 9. I i mir .0O anber*ettitr City, al;e..ird Zia if etnit i )1D) Ot-nr- Li 1 V/ 53 0 °S°2---- Recureure name and orates (apiarist the accouit martens) hers Rani Ian Taxpayer Identification Number (TiN) Enter your TIN In the appropriate box. The TIN provided must match the Darns °hen on the 'Name' line Social wordy mentor to avoid backup with/yoking For individuals, this is your social now* number (SSN). However, for a resident alien, *ode proprietor. or dieregarded entity. see the Pal I instructions on page 3. For other entities, it is your employer Identification number (EIN). II you do not have a number. see How to pet a 11N on pope 3. Note. If the account is in rnore than one name, see the chart on page 4 for guideinee on whose number to enter. I Employer tdereificathan °weber L Part II Certification Under penalties or perjury, I certify that: 1. The number shown on this form a my correct taxpayer identification number (or I am waning 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, a (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a Mute to report all interest or dividends, or (c) the IRS has notified me Matt am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out it114 2 above if you have been notified by the IRS that you we currently subject to backup withholding because you have felled to report el interest and di rends on your tax m. For real estate transactions, item 2 does not apply. For mortgage interest paid. acquisition or abandonment of secur property, of debt. contributions to an Individual refinement anangement (IRA), and generally, payments other thaninterest and dividends, not required toNqn the certification, but you must provide your correct TIN. See the instructions on page 4. / Sign o ilmen of 1.1920 U.S. personI; Dan Vaiii General Instructions Note. If a requester gives you a form other than Form W-9 to request your TN, you must use the requester's form If it Is substantially similar Section references are to the Internal Revenue Code unless otherwise to this Form W-9. noted. Definition of a U.S. person. For federal tax purposes, you are Purpose of Form considered a U.S. person if you as A person who is required to fa an information return with the IRS must • An individual who lea U.S. citizen or U.S. resident alien, obtain your correct taxpayer identification number (TIN) to report, for • A partnership, corporation, company, or association created or example, Income Field to you, real estate transactions, mortgage interest organized In the United States or under the awe of the United Slate., you paid, acquisition or abandonment of secured property. cancellation • An estate (other than a foreign estate), or of debt, or contributions you made to an IRA. • A domestic trust (as defined in Regulations action 301.7701-7). Use Form W-9 only If you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the Special rules for partnerslips. Partnerships that conduct a trade or requester) and, when applicable, to: business in the United Static are generally required to pay a withholding tax on any foreign partners' share of income from such business. 1. Certify that the TIN you we giving is correct (or you are waiting for a Further, In certain cases where a Form W-9 has not bean received. a number to be Issued). partnership is required to presume that a partner is a foreign pinion 2. Certify that you am not subject to backup withholding. or and pay the withholding tax. Therefore, if you are a V.S. person that is a 3. Claim exemption from backup withholding If you are a U.S. exempt partner in a partnership conducting a trade or business in the United payee. If applicable. you are also certifying that as a U.S. person, your States, provide Form W-9 to the partnership to establish your U.S. allocable share of any partnership boom* from a U.S. trade or business status and avoid withholding on your share of partnership incans is not subject to the withholding tax on foreign partnere' share of effectively connected income. Cat No 10231X Form W-9 (Rev. 12.2011) SD NY_GI,l_00064811 CONFIDENTIAL - PURSUANT TO FED_ R.QP AKE IDENTIAL DB-SDNY-0027636 EFTA_00175314 EFTA01299114