EFTA01282042.pdf

W-9
Request for Taxpayer Give Form to the
Form
requester. Do not
(Flea December 2011) Identification Number and Certification
Dapaimea tithe Treason send to the IRS.
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6100 Red Hook Quarter B3
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St. Biomes, U.S.V.I. 00902
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Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the 'Name* fine Social @abaft number
to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I bonnie-lions on page 3. For other
entities, it is your employer Identification number (am. If you do not have a number, see How to get a
77N an page 3.
Note. if the account is in more than one name, see the chart on page 4 for guidanee on whose Employer Identafication raertte
number to enter.
Part II Certification
Under penalties of perdulY. I certify that:
1. The number shown on this form Is my correct taxpayer identification number (or I an, waiting for a number to be issued to me). and
2. I an, not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I ern subject to backup withholding as a result of a failure to report all interest or dividend; or (o) the IRS has notified me that I an
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below).
Certification 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 dividends on your tax return. For real estate transaction; hem 2 does not apply. For mortgage
interest paid, acquisition or abandonment of seciared property. cancellation of debt contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page 4.
Sign &gnawed
H... US. person e / Date a
General Instructions Note. If a requester gives you a form other than Form W-9 to request
your TIN, you must use the requests?. form Nit is substantially similar
Section references are to the Internal Revenue Code unless otherwise to this Form W4.
noted.
Definition of a U.S. person. For federal tax purposes, you are
Purpose of Form considered a U.S. person tf you art
A person who Is required to file an Information Mum with the IRS must • An individual who Is a U.S. citizen or U.S. resident alien.
obtain your correct taxpayer identification number (TIN) to report, for • A partnership, 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 than a foreign estate), or
of debt or antrbutions you made to an IRA.
• A domestic trust (as defined in Regulations section 301.7701-7).
Use Form W-9 only rf you are a U.S. person (including a resident
alien), to provide your correct TIN to the person requesting it (the Special rules for partnereNps. Partnerships that conduct a trade or
requester) and, when applicable, to: business In the United States are generally required to pay a withholding
tax on any foreign partners' share of income from such business.
1. Certify that the TIN you are giving is correct (or you are waiting for a Further, in certain cases where a Form W-9 has not been received, a
number to be issued), partnership b required to presume that a partner is a foreign pinion,
2. Certify that you we not subject to backup withholding, or and pay the withholding tax. Therefor; If 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 withholding if you are a U.S. exempt
payee. N appicable. you are also certifying that as a U.S. person, your States, provide Form W-9 to the partnership to establish your U.S.
allocable share of any partnership income from a U.S. trade or business statue and avoid withholding on your share of partnership income.
is not subject to the withholding tax on foreign partners' share of
effectively connected income.
Cat No. 1023IX Form W-9 (Rev. 12.2011)
tcyNFIDENTIAL
SDNY_GM_00037294
CONFIDENTIAL - PURSUANT TO FED. DI3-SDNY-0000118
EFTA_00 I 47907
EFTA01282042