EFTA01385762.pdf

Form W-9 Request for Taxpayer Give Form to the requester. Do not (Rev. December 2014) Department al the tereary Identification Number and Certification send to the IRS. Wend &minus Service i Name (as shown on your income tax return). Name is required on this eric de rot leave US area tiwtk Southern Trust Company, Inc. 2 Business nerne/Olsregarded entity name, edifiers% from above See Specific Instructions on page 2. 3 Check appropriate box for federal tax Massakation: chock only ono of the following seven boxes: 4 Exemptions (coca apply only to certain entil:es. nel incliv,duals: um 0 Inctridual/sae proprietor or ti CeaPontioft 0 $ Corporation 0 ParloeFahIP 0 TAtatiostala Instruceons on page 3): Print or type sag's-member tic 0 limitedEsbilty company. Enter the ttaxclasaication (C.0 corporation. S•S oorPoriton. Piteartnerehlo) • Exempt payola Cede pat any) Note. For a singlemember US Mat is diweganled, do not check tic: check the appropiate box In the Rasaabove for Exemption from FATCA repeal% the tax classification of the sego-member owner. code at any) 0 Other (se* Instnrctioa) if- Paseo issiewermoicreeserwara Ma S Address (number. street. and apt. a sake no.) Requesters name and address Node* 6100 Red Hook Quarter B3 a City. Ha andZIPcode St Thomas USVI ,00802 7 List account numbar(S) here (opliona0 Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social secu by number back. p withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity. see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do riot have a number, see Now to get TIN on page 3. Of 1 Note. If the account is In more than one name, see the instructions for line 1 and the chart on page 4 for Employer Identification number guidelines on whose number to enter. Part II Certification Under penalties of perjury. I certify that: 1. The number shown can this form Is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Senders (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 longer subject to backup withholding; and 3. I am a V.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form or any) Indicating that I am exempt from FATCA reporting is correct. Certification Instructions. You must cross out item 2 above if you have been notili00 by the IRS that you are currently subject to backup withholding because you have failed to report e Un dividends on your tax re 1R:-FOireal estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or aba Orelleflt of aeZo ed property, 0 °not bt, contributions to an Individual retkement arrangement (IRA), and generally, payments other than terest and divide you required to si n the certification, but you must provide your correct TIN. See the instructions on page 3. I Sign Here Signature of R\ U.S. person Pfli-V Data 4 .2119/.701-9 General Instructions • Form 1098 (home mortgage intereS1), 1098-E (student ban interest). 1093.-T (turban) Section relerences are to the Internal Revenue Code unless otherwise noted. • Form 1099.0 (canceled debt) Future developments. Information about developments affect:1g Form W-9 (such • Form 1039-A (acquisition or abandonment ol secured womb/ as legislation enacted alter we reheat it) is at www.irs.gov/rw9. Use Form tO-9 only if you are a US. person (ncluceng a resider/ ellen). to Purpose of Form provide your correct TIN. If you do riot /own Form W•9 fo file Mt/later with a TW, you night be scet#ect An Movidual or entity (Form W'9 requested who is requited to Me an information return with the p S mast obtain your correct taxpayer Went/batten number (TIN) to bacAvp witiMokling. See West is backup witeholottng? on page 2. %Mich may be your social Stacey number (ESN). Individual taxpayer Identification Sy ragrFng Me bled-out form. you: number OTIN). adoption taxpayer Identlecatkin number (ATINS. or employer 1. Certify that the TIN you ere giving is correct (or you ere wak'ng tor a number identification number (EIN), to report on en infomiation return the amount pat to to be issuedl. you. or other amount reportable on en kdoemetton return. Examples of informtlion returns Include, but me not limited to, the loeowmg: 2. Certify that you are not SUbjett to On* withholding • of • Form 1099.INT Overact earned or pall) 3. Claim exemption from backup withhold/iv If you are a U.S. exempt payee. If • Form 1099.DIV (dividends. Including those from stocks or mutual funds) oppbcable, you ere also ortilyag that as a U.S. person, your allocable share of any partnership income from a U.S. tin or business Is not attest to trio • Form 1090'441SC 044/0U4 types of income. prizes, awards. or gross proceeds) withholding lax on torsion partners' share of effectively CONICCIed income, and • Form 1099-B (stock or mutual fund gala and certain other transectfrans by 4. Certify that FATCA coatis) entered on this form (if any) InecatIng that you are brokers) exempt from the FNMA repotting is correct. See Werth FATCA reporting? on • Form 1099-8 (proceeds from real estate transactions) page 2 for falter Intonation. • Form 1099-K (merchant card and third party network transactions) Cat. No. 10231X Form W-9 (Rev. 12.2014) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0087100 CONFIDENTIAL SDNY GM_00233284 EFTA01385762