EFTA01295004.pdf

Form W-9 Ohm Docarbw2011) Request for Taxpayer Gin Form to the requintor. Do not Doperrnere drhi Tann Identification Number and Certification send to the IRS. Fiera RwaiusSenice Nam be shown on your income traretuml M iali t ..PAL .nem, i different Ircm Wove ni Dusan nettercieregwoeci wary ! E I Check 'maroons.* box for fatal tax clesacatIon: 0 Indaballace protestor 0 C Ccrocration [SCorporstion O Pwarartia 0 trustiestets O unshed say carany.Ener the tax ciassicetion (CaC corocretkn. S.-S m onk. ). P;pannership) e 8 Exernx Paves E —....--....-- i 0 O *Mr bee instructionde 1 Address:7:w ° . emerda rrAr a sk e sti, Reariest name and ockfrecs (oat ens 3 t coy.Vitt redZIP Dole cE eir 110644j (fiti/ CO/P1' LW wawa numberlaihro(abut Part I Taxpayer Identification Number (TIN) Enter your TN in the appropriate box. The TIN provided must match the name given on the Nene line I Socief security number to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident elan, sole proprietor, or disregarded entity, see the Part 1Inatnictions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a 77N on par 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number number to enter. Port II Certification Under penalties of periwig, I catty that 1. Tice number shown on this fonn is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I em not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Scrubs (IRS) that I am subject to beckon withholding as a result of a blurs to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other V.S. parson (defined below). Certificate instructions. You must cross out hem 2 above If you have been notified by the IRS that you we currently subject to backup withholding because you have failed to report all interest and dividends on you tax retum. For reel estatetransactions, item 2 doss not apply. For mortgage interest acquisition or abandonment Of recur acqui , conflation ofd ntributions to an individual retirement wrangernent (IRA), and generally, payments other than interest and dividenditcr irre not the certification, but you must prowide your coact TIN. See the instructions on page 4. WWI Signature el ,, Here UAL pe on► / Dee a General Instructions If a requester gIves you • form other than Form W-9 to request your TN, you must use the requester's form a his substantially similar Section references are to the Internal Revenue Code unless otherwise to this Form W-9. noted. DelWien of a U.S. person. For federal tax purposes, you are Purpose of Form considered a U.S. person If you are A person who is required to fie an information return with the IRS must • M individual who is a U.S. citizen or V.S. resident alien, obtain your coned taxpayer identification number (TIN to report, for • A pannership, corporation, company, or association created or example, income paid to you, real estate transactions, mortgage interest organized in the United States or under the laws of the United States, you paid, acquisition or abandonment of secured property, cancellation • M *Mate (other than a foreign estate), or of debt, or contrbutions you made to an IRA • A domestic trust (as defined in Regulations section 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 nabs for partnerships. Partnerships that conduct a trade or requester) and, when applicable, tot business In the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. 1. Certify that the TIN you are dung b correct (or you are waiting for a Further, in certain cases where a Form W4 hos not been received, a number to be issued), partnership is required to presume that a partner 6 a kaolin pawn, 2. Certify that you we not subject to backup withholding, or and pay thee withholding tax. Therefore, if you are a U.S. person that is a 3. Claim exemption front backup withholding If you are a U.S. exempt partner in a partnership conducting a trade or business in the United payes h applicable, you ars 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 income from a U.S. trade or business status and avoid withholding on your share of partnership Income. is not subject to the withholding tax on foreign partners' share of /Moot:wt.,' connected income Cat. No. 10231% Fan, W-9 (Few. 12.201t) SDNY_GM_00053686 CONFIDENTIAL - PURSUANT TO FED_ „QC).NEIDENTIAL DB-SDNY-0016510 EFTA 00164267 EFTA01295004