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Give Form to the
Form We Request for Taxpayer requester. Oa not
Feev, Debstrerf 2014
anof itie Many
Desrinent
Identification Number and Certification send to the IRS.
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7 NaeIts Shown on tae Income lex Wenn Mere 4 rogWN onvnow do not leave 9no blank
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' St. Thomas, USVI 00802
7 LIst =own menbete)hens Optional)
Fr= Taxpayer Identification Number(T'IN)
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Enter your TIN In the appropriate box. The 11N provided must match the name given on Snell° avoid
backup witinotrAng. For Individuals. this Is generally your social security number (EISN). However, for a
resident alien. sole proprietor, or rEwegarded ondly, See the Part I instructions on page 3. For other -1
entities, It Is yaw employee' Ideintlficatron number (EIN). If you do not have a number, se* Now lo pate
TIN on page 3. Or
rEmploVerwentireeeen number
Nolo. If the account Is In more than ono nwno. sea the Instructions for (Inc I end the chart on page 4 for
guldelines on whose number to enter.
Certification
Undo, penalties of perjury. I certify that
to to met and
1. The number shown on this form Is my correct taxpayer identilleadon number (slam walling for a number be (Med
withholding, cr (b) I have not been notified by the Internal Revenue
2. I am not suofect to backup withhoteeng because: (a) I om exempt from backup
or (c) the IRS has notified me that I am
Service (IRS) that I ern subject to backup wilhhokkng as a mutt ol o railse to repel ell interest or dividends,
no longer subject to traekup withholdings and
3. I am a U.S. citizen or caw U.S. person (defined belowt and
4, The FATCA MOEN entered on tNs Ism El any) indicating that I MI exempt from FATCA reporting Is correct.
to backup eithhoising
rarefication tnatructlons. You must cross out Item 2 above If you have been notified by the IRS that you No currontly subject
have failed to moon all Interest and dividends on your tax return. For real estate hansactior.s, Item 2 does not appty. For rriOn9a9*
because you InckvOnat roparmon arrangement g)uq, end
Interact paid, acquisition or abanoonmont of secured property. canceletion of debt, contributions tom
payments other than Interest and dividends, you are not requIrea to sign the certification, let you must provide your coact TIN. See the
genaraity.
instructions on page 3.
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Section islorences em to We Minn Revenue Oxle urge*: Othenvhe noise. • Form 1099-C bancelea esker
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as unbutton enacted arts we release it) b la www./ratoWF.S. Use roan W41off if you am a U.S. preen Ohtenalel a reakin° dm). le
Purpose of Form fortroldeyow comxit
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with may to ycur metal seolty mantes ESN), inchnun taxpayer klentbcalbet By spring Me lilled-oul ben Yon
mrnbor pm, adoption lamer bendlIcetion amber (411.5. or employer 1. Cerny met theNi you are Ohre la cowed for you era wake tie a orate
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• awn 109%MISC envious types of income. Neon ands. el geese proceed.) wlihhotlarg tax on footan partnere' Mare of elfeethefy correctedIsom NC
• Form 10994 (stock ce infAue fund sake cod conah Wit leamactione by 4. Corley Ink PM CA cockfll entered on Mb Win of any) Indicettre ter you We
broers) exempt front the FATCA female, b correct See What is FATC4 neve& an
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• Form 1099.K sent= Card had fl ed party network bansactiOnN
Cal. S. 10231X Soon W-9 (Rev. l2-20l.)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0060143
CONFIDENTIAL SDNY GM_00206327
EFTA01368410
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EFTA01368410
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