📄 Extracted Text (424 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 OBS, in writing immediately if the representation certified to below ceases to be true and correct.
1. 0 U.S. Citizen or U.S. Resident Alien
Form W9 Request for Taxpayer Identification Number and Certification
Substitute
usiness 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 AA 1104
Taxpayer Identification Number (TIN)
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 ION). ml rl n ifi i n im r
Port 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: 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.
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CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0104341
CONFIDENTIAL SDNY_GM_00250525
EFTA01449083
ℹ️ Document Details
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5047f47eb45eef507f540f83ec5daa024aff6d989fc4ebe2d55e8ee8416b7a9a
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EFTA01449083
Dataset
DataSet-10
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document
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1
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