EFTA01390389.pdf

IV. TAX ELECTION/DFCLARA I ION OF TAX STATUS Res Account Agreement is designed for use by both U.S. Persons and Non-US. Persons. Ploese check the box next to the applicable item below. Client certifies that Client veil notify DBSI in writing Immediately il the representation certified to below ceases to be we and correct. Form W9 Request for Taxpayer Idaatification Number and Certifioation Substitute 1.4eMart~rtiOnM 1lIrMetrill e - (4 RustriettstWinaardeSZIMY neiattrintsfillSbefft »Over r. h..ePr4f.dirrhl.ht:.1 .8Ierkir..ter~ratireSerrelliShSkfirSetlinira./ Lk Itlairsole proprietor IIIII C CorpOretion El S CerporatIon El Pettnershipp Trustrestine Ei Exempt Perin B ❑ Limited liability company. Enter the tax classification (C.0 corporation. S=5 Corporation, Pepartnerahlp) iii Other D MSBISSEkYr..ltbhk . ent4410.514WISOBS, &id° ei) Abut 'PM.. ':a4X8(isaff. rit.004/15, USVI P. i , I Taxpayer Identification Number (TIN) ritli(allnithriarixo~iat The TIN provided must match the name given on the "Name tine to avoid bacimp withholding:F& individuals, this is your soda) security number ISSN). For other entities. it Is your employer identificabon number WIN). mptpypr tdeetrl.cat.on RUm DO-MO I DO Certification Under penalties of perjury. I certify that: 1. The number shown on this lem, is my correct tamsyer Identification number (or I am waiting for a number lo be Issued to me). and 2. I am not subject to backup withholding because: lal lan, 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 talk» to report all interest or divIdinds. or kith& IRS has notified me that I am no longer sublet* to backup withholding. and 3.1am a U.S. citizen or other U.S. pen in the instructions). Certification instructions. You st cross out earn above if you have been by the IRS the' you ale cwamdy subject to backup wilhhelifing because you have failed to rt all interest and d nde on your tax t Sign Here 2.0 Non.US. Person I am not e U.S. person Including a U.S. resident alien). I am submitting the applicable Form W-8Ø this form to paddy my toregn status and. if applicable, claim tax treaty benefits. For example. Client is not a LIS. person (including a U.S. resident skenl. Client agrees to provide DBSI with this application the applicable Internal Revenue Service (IRS) Form W.8 to certify the darts foreign status. W-8 forms and instructions am available on the IRS website at www.irs.gov. (THIS SPACE INTENTIONALLY LEFT BLANK] 12.PWSA-0573 e 012145 011113 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0094882 CONFIDENTIAL SDNY_GM_00241066 EFTA01390389