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Form W-9
Mar. Decernber 2011)
Request for Taxpayer Give Form to the
requester. Do not
Dopelnwe of the Treaty Identification Number and Certification send to the IRS-
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Part I Taxpayer Identification Number (TIN) •
Enter your TIN In the appropriate box. The TIN provided must match the nas' glee« on the 'Name fine Soda wanly numb*
to avoid backup withholding. For individued, this b you eocial security number (SSW). HOWIN0f, for a
mordent Oen, sole proprietor, or diaregamed entity, see ere Pert I instruct:ens on page 3. Fur other
entities, it is your employer identification number (EIN). If you do not have a numt*CileeHow to get a
nN on page 3.
Note. R the account ie ti more thm one none, see the that on page 4 for guidelines on.h
ivives
number to enter. •
Ulan Certification
Under penuties of penury. I certify that.
1. The number shown on this form is taxpayer Identioation «ober (or I ern waiting fora ranter to be Issued to me), end
2- lam not subject to backup withholding became: (a) 1 anketempt Merit backup withholding, a (b) I have not been notified by the Internal Revenue
SeMoe (IRS) that tam subject to backup withholding se Italia of a *lure to report all Interest or dividends, or (c) the IRS has notified me that I Mn,
no longer abject to backup withholding, and
3. I ern a U.S. citizen or other U.S. peon (defined 1:4frlori).
Canso bon inetruatena You meet crosspdilim . "2•above M You have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report WI altered* dMdentle on your tax nsturn. For real estate transactions, Item 2 doos net apply. For mortgage
interestpaid, aequishion or abandonment of s probily.eincellatIon of debt, cootributions to an individual telinerneint amingernint (IRA). and
generally, payments other than interest end dividd you ire not required to lignite certification, but you mot provide yaw Smoot TN. See the
Instruction* on Pege 4.
Sign
Here
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General Instrudtions ,. Note. If a requester pleas you a fano other than Forrn W-9 to raped
your TIN, you must use the requester's torn It It is substantalty diner
Section re trances are to the Internal Revenue Code ides Othenda to thle Form W-9.
noted.
Definition of a U.S. parson. For federal tax purposes, you an
Purpose of Form considered a U.S. person Ill you art
A anon who le roared to the an information return with the IRS mutt • All hid/vides/ who le a U.S. citizen or V.S. resident alien,
obtain your come« taxpayer Modification number (TIN) Ic report, for • A partnership, corporabon. company, or associabon crested a
exempla income paid to you, real estate traneactione mortgage interest organized In the United States cr under thelaws of the United Stake,
you paid. acquisition or abamkoment id saved pntparty. cancellation • An estate (othor than a foreign estate), «
of debt, or contributions you made ton RA.
• A domestic bust (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 preside your oorrect TN to the Demon requesting h (the Special mks for partner•Nps.Partnertifilpe that conduct a bade a
requester) and, when applicable. to: buckle« in the United Stable are generally required to pay a withholding
lax on any foreign pertness share of income horn such business.
1. Certify that the TN you we 0vong is correct (or you are waiting for a Further, in certain cases when a Fonts W-9 has nee been received, a
number to be isstra), partnership o required to presume that • partner is a foreign person.
2. Certify that you are not subloct to backup withholding. or and pay the withholding tax. Therefore, h you are a U.S. person that ito a
partner h a partnenthlp conducting a trade or business in the Unified
3. Claim exempton from backup withholding it you are a U.S. exempt
payee. If applicable. you are alto carrying that as a U.S. pe•5011, your States. provide Form Wi9 to the pertneNhip to establish your U.S;
amide ahem of any partnership Inonme from a U.S. trade or wanes, (status and avoid withlsoklaig on your share of partnee-ship income
is not (abject to the withholding tax on foreign partners' share
effectivety connected Income.
Ca No 1023IX Form W-9 Rev 12-2011)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0098178
CONFIDENTIAL SDNY_GM_00244362
EFTA01392882
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