EFTA01255109.pdf

Farm W-9 2011) Request for Taxpayer Give Form to the requester. Do not Depsnmert of rho Tinny Identification Number and Certification send to this IRS. Werra RevenueSeMos Pas fas sham on your income UK CetUrie t i P iC ti "tile • WAWA mmerkieroderded way mow I dinereN Iran above Chick appropriate box kg federal tax cleseXicetion: 0 cl Inivkluaktiol• prowistor ❑ C Corporation Gre/ Corporaion ID Penwell.) O TRef/estate O Exempt owes O Limited lability cowpony. Fits the tax clawfication (C=C corporation. S=S cap:rake. n.:pannershio)s rintrai ovtekt. ❑ Other gee istructors) to OW. stets and ZIP code 1106//4, (fly Colcn- 3 R"queet name end wickets (OP6ene0 LW moon numberlaiherektatkref P irt I Taxpayer Identification Number (TIN) Eller year TIN in the appropriate box. The TIN provided must match the name given on the 'Nantes line to avoid backup withholding. For individuals, this Is your social security number (SSN). However, for a resident Men, sole proprietor, or disregarded entity. see the Part 1 instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a 77N on page 3. lamentationnumber Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am writing for a number to be issued to me), and 2. lam not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have riot been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report at Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Cent floefee instructions. You must cross out Item 2 above if you have been notified by the IRS that you we currently subject to backup withholding because you have failed to report all interest and el' ;donde on your tax return. For real estatetransactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of sects *petty, cancellatkin of d orgifributions to an individual retirement arrangement (IRA), and generally, payment other than Interest and dividend'slll you are not the certification, but you must provide your correct TIN. See the Instructions on pease. SISPI Sensture or Here U.S. pitmen oaten General Instructions II a requester gives you • form other than Form W-9 to request your TIN, you must use the requester's tam r it is substantially similar Section references are to the Internal Revenue Code tallies otherwise to this Form W-9. noted. Drifirilon of a U.S. person. For fated tax purposes, you are Purpose of Form considered a U.S. person If you are • M individual who is a U.S. citizen or V.S. resident alien, A person who is required to fie wi information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for • A pannership, corporation. company, or association created or example, income paid to you. real estate transactions mortgage interest organized in the United States or under the laws of the United States, you paid, acquisition or abandonment of secured property, cancellation • An estate (other then a foreign estate), or of debt, or contrbutions you made to an IRA. • A domestic trust (as defined in Regulations section 301.7701.7). Use Form W-9 only if you are a U.S. person (including a resident Special rafts for partnerships. Partnerships that conduct a trade or alien), to provide your correct TIN to the person requesting it (the business in the United States are generally required to pay a withholding requester) and, when applicable, to: tax on any foreign partners' share of income from such business. 1. Certify that the TIN you we giving is correct (or you are waiting for a Further, in certain cases where a Form W4 has not been received, a number to be issued), patnership is required to presume that a partner le a Halo person, 2. Certify that you we not subject to backup withholding, or and pay the withholding tax. Therefore, It you are a U.S. person that is a partner in a partnership conducting a trade or business in the United 3. Claim exemption from backup withholdMg If you are a U.S. exempt States, provide Form W.9 to the partnership to establish your U.S. payee If applicable, you are also certifying that as a U.S. person, your status and avoid withholding on your share of partnership Income. allocable share of any partnership income from a U.S. trade or business Is not subject to the withholding tax on foreign partners' share of afloat* connected income. Cat. No. 10231X Form W-9 pe.12.2011) SDNY_GM_00056795 CONFIDENTIAL - PURSUANT TO FED. R.Q0 NE IDENTIAL DB-SDNY-0019619 EFTA_00167365 EFTA01255109