EFTA01390417.pdf

IV. TM ELECTIOWDECI_ARATION OF TAX STANS AcCouni Atimemsni Is dostaad for sne by batt U.S. Peisens and Nont) 5. Onani Pi.me rima IA0 ai mnd to the &op/kalke hem bekar. trent muna Ul« o Nes vi* nuly oes.1In Nattog InynedatiiIt 11 the ran »nano^ oefliCad to tokiw mass lo be 31(688d [oren. 1.O US. Ciih•n or 12.3. Rakar. Albin fonn W9 _ for Autavor kyeedan ...aquest mber and CortifianII on `tnt*tntrin t-- tnritAn trt 1 b Sihrtit" Namo Na ifttafri at youi Inoom• Tax MI") 6ii&ma. rterfidiOANOCOrcied eat iy itian, l(ddlerentfrmm sbove Mink lepOnadoto box for Masi aix deendllr.ation (inuiten): ri lallvIchialna omatt/torp C Corporetlen • 5 Corporation 0 Pennal/hipp Tnaviuninu 0 Lama peyoe O Lloked %bai" company Eidar the Lx ciaeKketloittet amsciatleal Sed CONXiation. Pope dirrahlol I . .. Car I Ad me, (num," itiost, end apt. Of Ste MI City, Saab end VP onde Pm,diTaxpayer Idontlficatvm Nungmr olm Enror yourlIN In the Oilacipilete bm. The IN prorked mal match tes mme øren on the 'Nam.' line to .vod booka> withhaillno. toe lalMcluals, lob le youi eoctol sauna mumlet( 155N). For odler enkles, II 1.1 yow iimployw 'domino, don nuraid LEIN; imess omm pota • w inri II conitteation linda pontaki af ;ida/y. I onglitv *at I. NN numbei navn on eds tam i• mynorn:clI/amt ithuolkallan numrar (or I amwmkkw for a ntynbei to be Issved to raet, ond 2.1em not *oblat to indup rahniddlno liocatita all un Gamin kom amen wIthitotafifå or (b) I Nava not anm rioakid by the Intimt) korona/ Sendc• tinS) MAI i ØM &tålig:Cl to boa» vatnnokana ese festa d's (blom ID Innen dett 'Minen Indhakniki.a (c) dr.1nSib.. notgen MO 'kall ein no knast sukka tO bakt" wilhhottling, and 3. lem a U.S. capenoahai U.S. paien kledn.dIn the Intucilonal. Crinfiradlon IntitniatiOM. Vant', oss• ' om 2 debove if sov hye been tlf6-K$ ialt yoo are urer" masa to backup Nubba-daa Lanse VOM haw fedal to idiot/inni an. dirkendi on Sir Skratta of Hen U.S. 00~ ► Dr. 2.13 Non.US. temon H • Fall, W-8 wtth tidt form to arlity my tedyn fytut and, n spormsble, I an not 0 U.S. feoson andudng o U V. imIdem eden). I am subilatinli the applicsb dalen ta Ifility benolø. jo( deavne: Gad 4 not • U.S. person (ilciuding e itS. restileM Alen). Plent Nisen to piovitio D1352 %Oh Nit SPPrICIIIIOntb•applIcatite intim& Revenue Senk* gin, form w43 to come tan linie torar aula. W-I3 lama end Indnxtiona are avaltabio on th• IRS trebtno ål wn%V.81430v. 13-AWM 015ii 6 0121(5 032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0094921 CONFIDENTIAL SDNY_GM_00241105 EFTA01390417