EFTA00301200.pdf

Farm W-9 Request for Taxpayer Give Form to the requester. Do not Department Glee Timex" Identification Number and Certification send to the IRS. keener Peenue Seisms Name ias shown on your trtChhe :ate reran; Business namedieregarded entity name. if different from above See Specific Instructions on page 2. Check appropriate box for federal tax classrfceion- Exemptions (see nstructionse O ,„,,,„,,,,„„„,,, propr,„ or O c copormc. O s cnner,auc., Li Partnern- ip O Tnirdestate Print or type Exenv Payee code (A any) D Limited liabrAy company. Enter the tax dassifranan (C=C corporation. SS ocrecration.Pr.partrership) lh Exemption from FATCA reportrg coda el any) O Other (see as-gut:Wrist • AddreSS (Minter. street. and apt or suite nO I Requesters name and address tookonad City, state. and ZIP code List account nutmeat here raptorial) Part I Taxpayer Identification Number (TIN) Enter Our TIN in the appropriate box. The TIN provided must match the name green on the "Name" Ire Social security ntereer to avoid backup vnthholdng. Fa individuals, this a your social seventy number (SSN). However. for a resident alien, sole propnetor. Or diSregarded entity, see the Part I instructions on page 3. For other entities. It is your employer identification number lEIN). If you do not have a number. see How to get a TIN on page 3. Note. If the account is in more than one name. See the chart on page 4 for guidelines on whose I Employer elentnication number number to enter. Part II Certification Under penalties of perjury. I certify teat: I. 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 I am not subleSt to backup withholding because: (a) I am exempt from backup withholding, or lb) 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 am no tenger subject to backup withholding. and 3. I am a U.S. citizen or other U.S. person (defined below), and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reponing is correct. Certification instructions. You must cross out item 2 above it 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 :nstructions on page 3. Sign I SgpletUre Of Here u c_ oerson Date. General Instructions wfthhokling tax on foreign partners' share oleflettively connected income. and 4. Certify that FATCA coders) entered on the form /it eny1indiCalrng that yOJ me Jo untEgS otherwise fluted exempt from the FATCA reporting. is correct Future developments 'b., 4.ar on IRS gOv for information Note. If you are a U.S. person and a requester gives 'muse:4m other than Form taut Form W-9. at www its gpisior nfvecnatOn about any future developments 'N-9 to request your TIN. you must use the requester's form it e is substantially affecting Form W-9 fare, as legislation enacted after be relents th we be posted similes to the Form W-9. co mat Page Definition of a U.S. perfect. Fa federal tax pumoses. you are consi0ered a U.S. Purpose of Form persona yOU are' A OersOn wino e, fogadOd to foie an tilormabon return with the MS met obtain you • An neltvadual whO is a U.S. citizen or U.S resident alsen correct taxpayer dentItCabOn number IN) to report. lot exempt*. income pact to • A partnership. CO, poelbOn. COrnPany. Or aikinciatiort created or organized n the vou, payments made to you n settlement of orient cad and third party network Urged States or under the laws Or the United States. transactions. real estate tu•Sactiond mortgage merest yOu pan, acquisition a • Ni estate (other than a foreign estate). a atondonmera of secured PrOPerty. Canceesson of debt or contribuhre you made to an IRA • domestic vire ;as oared n Root:rations section 301.7701-4 Use Form w-9 eery if you as a U S person tincture a resider'[ alien). o Special rules for partnerships. Pannersnos that conduct a trade or forams n provide yes crect TIN to me person rectum-we a WV reclueStee and. wren the United Stales are generally requred to pry a Mttholding tax under section amicable. to. 1446 co any 'amen partners' snare Ol etledtteh corrected taxable ...come from such business. Further. n Cedar Cases where a Form W-9 !es not been reCeNel 1 Certify that the TIN you are rang is correct (or you we waiting for a further the rues inoer section 1446 require a partnership to presume !isotope:Met is a to be issued). foreign person, and pay the section 1446 erthhOkleb tax. Therefore. if you se a 2 Certify dial you are not subject to backup wallesefing, US person that is a partner n a ormersno conducting a trade or business in the United States. provide Form W.9 to the demesne to establish your US. status 3. claim exemption from backup wahhoeng a you me a ti S exempt payee If and avoid SOCbon 1346 withholding on your snare of partnership income. sefocable. you are to certifying that as a U.S. person. yese allocable share of Pannenno income tram a u S trade or business is not SUOteC110 the Car No 10231x Form W-9 'Pe, B.2013) EFTA00301200