EFTA01298083.pdf

Fenn (Rev.~2013) W-9 Request for Taxpayer Gin Porn tott« nagante. Do not Depennwit d tee Tree«, Identification Number and Certification und to th• IRS. lartl Arena Sera« Nuns («ram, on you- Mm kos /am) Southern Financial, LI.0 d ~re rerridolaregerded raw en a drat from to« 1 C Check stiroorate bore fot«dealt« clanikiettor Exempekne (e•• ketrunknak !I .... ° ❑ indocili t y.* ~ea 0 DeGroote.« 0 6 Ciorporellen 0 PØ Chlualeeree Era««Yee otida 01illal Lc' Unit« «Salty corn Enter fa tat deseillandr,fese ~Ica 13.4 capontkn, elsorteereht9 le S Execration Iran FATGA npor.« cod•Of any) I ,.,, C Other twoInoue.") le AA!~ p9Ø,area. end opt- or arena) Ritoparteme rams end salmi (iatkedi . IMO Red Kook Duarte BS 2 ay, nett end ZIP Mal (13 St. Thomas, MI 00802 tat errant «abo(e) tare«ogre. Log Taxpayer tcluntlfication Number (i1N) Enter your TIN In the «prop:ate box. TS, TIN provided mud match the rearm given on the •Name' line Solel «aunty neite to avoid backup withholding. For Individuals, titler is your «del security number ($52). However, for • reeldeM alien, sole proprietor, or diaregarded onlity. me the Pat I Instruction. on page 3. For other omtina it lc your employer kientMcatbn number (Elk4 M you do not have a number, tee How to get • M on page 3. Notre. If the account le in me« than one name, en the chart on peg* 4 for guldeMnres on whose Ens keys Iddinalketkri numb number to enter. tat Centlfization Under penal«« of perjury, I certify that 1. TM number shown on this font, Is my correct taxpayer Identification number (or I am waiting for a number to be Issued lo ins), and 2. I an not subject to beckup withholding bean: (Siam exempt from backup withholding, a (b) I have not been notified by the Internal Revenue &ask* (IRS) that ern subject to backup wlthhoiding as a reouh of • failure to report ail Intr.« or dal:kind& or (c) the URSA,* notified me that I an no longer *object to backup wIthholoing, and & I am • U.S. oØ or othe U.S. person (ddlned below), and 4. The FATCA *Ode(*) entered on this form (M any) Indicating that I an exempt kern FATCA reporting is comer. Cettlfkation katuellons. You must Grose out 2 above if you have boy% «WOW by the IRS that you are currently subject to backup MINIM:NV bemuse you have fined to repot WI Infonaut end Wends on yourjax.return. For real estate tramuctIons. hem 2 does not apply. For mortgage Intend Paid,«par.« or 6nment of secur property ,colloolistIon of debt orthibuttons to an Individual retirement turengentent (IRA). and generally. payment* other ten« and you me not required tosIgn the certification, but you mast provide your correct TIN. See the instructions on page 3. Mfirt Neiel senate es Uxt. preen e. Ø. 9- 3- ( -a General Instructions -- trtheking than berg. pertmes' ton <I~comb,combated indony and 4. Catty.«FATCA«de« eared on«, farerap seie le.oettio «et Wu as cared. tietekn refennom re to te tam] Revere Code mine ahem« noted. stem from the FATCA renatIng, Fa« developments The IRS la created • pep• on Mgr for liontko Note.If you en. • US. parson«deep's.«eat« you • ken «her Men Form ✓aa Fam W-9. et WAN?. if, 4)0064 , «flew «out err Mum ohmelccocente W.9 to recast ~TINy you mat rat nqueeters kern a I le ~flay Shaba Fam (Ouch es aeration emoted ata rearm Neill be posted era« to thia roan W4. mFnpWe- Defrilion stalk& Issess. Fa Went ter pupae, you on~fled • U.& Purpose of Font pre«a you WE A person who le rested to lee at bearnatbn man wi««ale neat «tab wa • An Ørar le • U.& Olken or U.S. ~am an correct noon, idrecrialono MN to Mood, fa eons« hØ pdd to • A perffina. ~conk" compa-y. a ~wan mad a wind h IPA Ku. ~metemodeto you In ealonent of pawners or end JAW party network United Stet« a under the laws of tie Unit« Stet«, eleneerant, red Sete eeneerfons ~Ago* intred young ender«a • An«we (atar Merr a lor~ gag. a dandorlitiont d wowed property.~Son of debt, or csontrbulkne youneeds • A dogmata mat Ose da bal hReguletkra actin $31.2701-1). to en MA. Use Fars W-9 any/ Øre • U.& person (naming •reilder4 Monk to tosokel See lot peirtnerelipe.11ertnenkie «et omduct a tale«buns, h prose yea coma TIN to the «neon requsetina tre rare« end. when the Ur« Sores en generetiy raga« to pay aWBistag lax order «aka eppikatile to 1446 al any foreign pubes' dam of dfactirely ortneded bribes nor« tarn rahburrs. Fortes, hoorah armtante a Form W4 has not been reared. 1. Genie/ tat the 119: wore 0410 M ca red Yre YOU we eating kr • arbor the rules miler earl« 1446 rota« a pertnereNg toran« gig esker le • tot»«mg, foreignper" end pay the section 1446 wit/holdno tex. messes, If you we • 2. Cory Val you ere not«elect to teas. wiltokeng.« U& person Ow Is • partner el • penmet«conducting • «de a huge« has 3. Clem~from ~Sup «Nakano I you ra a u.S. ~pi pay°, a United~ arcade Fonn W-9 to tie ~ere* to«Sabi« yore U.& area eraceb« you re Leo ~Wino that se • U.S. person. your «oat% e/use and avoid doeikil 1446 withholding al your shin of pet~il Ø. pertnen4 inane from • U.S. side or biehoes Is not abject tots Oa N. 10231X Fant W-9 err. S-2013) SCINT_Ghl_00062037 CONFIDENTIAL - PURSUANT TO FED. R.QP .N,FIDENTIAL DB-SDNY-0024862 EFTA 00172547 EFTA01298083