EFTA01374177.pdf

Form W-9 (Rev. 12-2014) Page 3 Line 2 'However. the following payments made to a corporation and reportable on Form If you have a business name, trade name. DOA name. or disregarded entity name, 1099-MISC are not exempt from backup withholding: medical and health care you may enter it on line 2. payments. attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(0, and payments for services paid by a federal executive agency. Une 3 Exemption from FATCA reporting cods. The following codes identify payees Check the appropriate box in fine 3 for the U.S. federal tax classificaticn of the that are exempt from reporting under FATCA. These codes apply to persons person whose name is entered on line 1. Chock only one box in line 3. submitting this form for accounts maintained outside of the United Stales by certain foreign financial institutions. Therefore. if you are only submitting this form Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a for an account you hold in the United States. you may leave this field blank. partnership for U.S. federal tax purposes, check the "Limited Liability Company Consult with the person requesting this form it you are uncertain if the financial box and enter "lo- in the space provided. If the LLC has filed Form 8832 or 2553 to institution is subject to these equ ements. A requester may indicate that a code is be taxed as a corporaticn, check the "Limited Liability Company" box and in the not required by providing you with a Form W-9 with 'Not Applicable' (or any space provided enter -O" for C corporation or '5" for S corporation. Hats a arnier indication) written or printed on the line to a FATCA exemption code. single.member LLC that is a disregarded entity, do not check the 'Limited Liability Company" box: instead check the first box in line 3 "Individual/sole proprietor or A—An organization exempt from tax under section 501(a) or any individual single-member LLC.* retirement plen as defined in section 7701(a)(37) B —The United States or any of its agencies or instrumentalities Line 4, Exemptions C —A state. the District of Columbia. a U.S. commonwealth or possession. or a you are exempt from backup withholding and/or FATCA reporting. enter in the any of their political subdivisions or instrunwntalitles appropriate space in line 4 any code(s) that may apply to you. D—A corporation the stock of which is regularly traded on one or more Exempt payee code. established securities markets. as described in Regulations section • Generally. individuals (including sole proprietors) aro not exempt from backup 1.1472-1(c)(1)(i) withholding. E —A corporation that is a member of the same expanded affiliated group as a • Except as provided below, corporations are exempt from backup withholding corporation described in Regulations section 1.1472-1(O(1)0) for certain pawn/wits, including interest and dividends. F —A dealer in securities, commodities. or derivative financial instruments • Corporations are not exempt from backup withholding for payments made in 6rockiding notional principal contracts. futures, lanyards. and options) that is settlement of payment card or third party network transactions. registered as such under the laws of the United States or any state • Corporations are not exempt kom backup withholding with respect to attorneys' G —A real estate investment trust fees or gross proceeds paid to attorneys, and corporations that provide medical or H —A regulated investment company as defined in section 851 or an entity health care services are not exempt with respect to payments reportable on Form registered at all times during the tax year under the Investment Company Act of 1099-MISC. 1940 The following codes identify payees that are exempt from backup withholding. I —A common trust fund as defined in section 584(a) Enter the appropriate code in the space in line 4. J —A bank as defined in section 581 1—An organization exempt from tax under section 501(a). any IRA or a custodial account under section 403(b)(7) if the account satisfies the requirements K —A broker of section 401(f)(2) L —A trust exempt from tax under section 664 or described in section 4947(a)M 2 —The United States or any of its agencies or instrumentalities M —A tax exempt trust under a section 403(b) plan or section 457(g) plan 3—A state. the District of Columbia. a U.S. commonwealth or possession. or Note. You may wish to consult with the tragical institution requesting this bon to any of thew political subdivisions or instrumentakties determine whether the FATCA code and/or exempt payee code should be 4—A foreign government or any of its political subdivisions, agencies, or completed. intrumentahties Line 5 5—A corporation Enter your address (number, street. and apartment or suite number). This is where 6—A dealer in securities or commodities required to register in the United the requester of this Form W-9 wit mail your information returns. Stales. the District of Columbia, or a U.S. commonwealth or possession 7—A futures commission merchant registered with the Commodity Futures Line 6 Trading Commission Enter your city. state. and ZIP code. 8—A real estate investment trust 9 —An entity registered at all times during the tax year under the Investment Part I. Taxpayer Identification Number (TIN) Company Act of 1940 Enter your TIN in the appropriate box. 11 you are a resident alien and you do not 10—A common trust fund operated by a bank under section 584(a) have and aro not eligible to get an SSN. your TIN is your IRS individual taxpayer identificalicn number (ITN). Enter it in the social security number box. If you do not 11—A financial institution have an ITIN. see How to get a TIN below. 12—A middleman known in the Investment community as a nominee or If you are a sole proprietor and you have an EIN, you may enter either your SSN custodian or EIN. However, the IRS prefers that you use your SSN. 13—A trust exempt from tax under section 664 a described ei section 4947 If you are a single-member LLC that is disregarded as an entity separate from its The following chart shows types of payments that may be exempt from backup owner (see Limited Liability Company (LLC) on this page). enter the owner's SSN withholding. The chart applies to the exempt payees listed above. 1 through 13. la EIN. if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership. enter the entity's EIN. IF the payment is for ... TT1EN the payment is exempt for ... Note. See the chart on page 4 for further clarification of name and TIN combinations. Interest and dividend payments All exempt payees except How to get a TIN. If you do not hare a TIN, apply for one immediately. To apply for 7 for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at WvAv.SSagov. You may also get this form by Broker transactions Exempt payees I through 4 and 6 calling I-800-772-1213. Use Form W-7. Application for IRS Irdividual Taxpayer through 11 and all C corporations. S Identification Number, to apply for an MN, or Fam SS-4. Application for Employer corporations must not enter an exempt Identification Number, to apply for an EIN. You can apply for an EIN online by payee code because they are exempt accessing the IRS website at www.irs.govibusinesses and clicking on Employer only for sales of noncovered securities Identification Number (EIN) under Starting a Business. You can get Forms W-7 and acquied prior to 2012. SS'4 from the IRS by visiting IRS.gov or by calling 14300.TAX-FORM (1-800-829-3676). Barter exchange transactions and Exempt payees 1 through 4 you are asked to complete Form W-9 but do not have a TIN, apply for a T1N patronage dividends and write "Applied For in the space for the TIN, sign and date the form. and give it to the requester. For interest and dividend payments, arid certain payments made Payments over 5600 required to be Generally, exempt payees with respect to readily tradable instruments generally you will have 60 days to get reported and direct sales over $5.000' 1 through 5' a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be Payments made in settlement of Exempt payees 1 through 4 subject to backup withholding on all such payments until you provide your TIN to payment card or third party network the requester. transactions Note. Entering "Applied For' means that you have already applied for a TIN or that you intend to apply for one soon. See Form 1099-MISC. Miscellaneous Income, and its instructions. Caution: A disregarded U.S. entity that has a foreign owner must use the appropnate Form W-8. CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0068744 CONFIDENTIAL SDNY_GM_00214928 EFTA01374177