EFTA01365776.pdf

IV. TAX ELECTION/DECLARATION OF TAX STATUS Please check the box next to the applicable item below. gas Account Agreement Is designed for use by both U.S. Persons and Non-U.S. Persons. the representation certified to below ceases to be true and correct. Client certifies that Client will notify OBS! in writing immediately if 1.O U.S. Citizen or U.S. Resident Alien Form W9 Request for Taxpayer Identification Number and Certification Substitute Name (as shown on your income tax return) Business name/reneger:led entity name, It different horn above Chock appropriate box for federal tax classification (required), O Individual/solo proprietor pc Corporation ❑ s Corporation II Partnership ❑ Taistreostate O Exempt payee 0 a O Limited liability company. Enter the tax classification (C=C corporation, S-S corporation, Pspartnership) Other a Address (number, street. end apt or suite no.) City, State, and ZIP code diTaxpayer Identification Number (TIN) um 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 entitles, it is your ernpknier identification number DICENITT1 Employer Identification Number LEI-EDIIMOD Part II Certification Under penalties of penury. I certify that: for a number to be Issued to me). and 1. The number shown on this form Is mycorrect taxpayer identification number Sartain waiting 2. I ern not subject to backup withholding because: (a) I am exempt from backup withholding. or (h) i have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a remit of a tenure to report all Interest or dividends. or fa) 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). are currently subject to backup with/to/ding Certification instructions. Y ;mai-cross sOZ item 2 above if you have been notified by the IRS that you because you have failed pen all interest 44 cfividends on Sign Signature of Here U.S. person a Date f 2.0 Non-US. Person Form W-8 with this form to certify my foreign status and. H applicable. I am not a U.S person anducfing a U.S. resident alien). I am submitting the applicable claim tax treaty benefit OBS! with this application the appicable Internal Revenue For example: Client is not a U.S. person (including a U.S. resident alien). Client agrees to provide available on the IRS website at www.irs.gov. Service (RS) Form VV-8 to certify the client's fOriegn status. WEI forms and Instructions are 11AWM-0196 6 012145.032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0056871 CONFIDENTIAL SDNY_GM_00203055 EFTA01365776