EFTA01282043.pdf

W-9
Farm Request for Taxpayer Give Form to the
Certification
(Rev. December 2011) Identification Number and requester. Do not
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Part I Taxpayer Identification Number (TIN)
Enter your TIN In the appropriate box. The TIN provided must match the name given on the 'Name the Sects epory reerber
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to avoid backup withholding. For Individuals, this Is your social security number (SSN). However. for a ire
resident alien, sole proprietor, or disreganded entity. ere the Part I instructions on page 3. For other yyr
entities, his your employer identification number (EIN). If you do not have a number, see How to get •
TIN on page 3.
Note PI the account is in more than one name, see the chart on page 4 for guidearries on whose Employes kkinescabal number
number to enter.
P II Certification
Under penalties of perjury. I certify that
1. The number shown on this form is my correct taxpayer idendfloatkai number (or I am waiting for a number to be Issued to me), and
2. I am not subject to beat* withholding because: (a) I am exempt from backup withholding. or (b) I have not been notted by the internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividend., or (e) the IRS has notified me that Ian
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below).
Cerlifflostlon inelnialions. You must cross out hem 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 imn divisdends on your tax return. For reel estate transactions item 2 donna! apply. For mortgage
Interest paid, acquisition or abandonment of sear property. cancellation of debt, °attributions to an individual retirement anangement (IRA). and
generallY. Payrnenb other thartinfinest and d' . you are not n u paten the-certification. but you must provide yourconed TIN. Seethe
Instructions on page 4.
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Here us. anent — / Det• e (0412 ,
General Instructions Net*. If a requester gives you a form than form W-9 to request
your sIN, you must use the requester's form If M is substantially similar
Section references are to the Internal Revenue unless otherwise to this Form W-9.
noted.
Definitien of • U.S. person. For federal tax purposes, you are
Purpose of Form considered • U.S. person S you we:
A person who is required to file an information return with the IRS must • An Individual who is • 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 Stales or under the laws or the United States,
you paid, acquisition or abandonment of secured property, cancellation • An estate (other than a foreign estate), or
of debt or contributions you made tow 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
alien), to provide your correct TN to the person requesting it (the Special rules for parkterships. Pannerehips that conduct • trade a
requester) and, when applicable. to business In the United States are generally required to pay • 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 • Form W-9 has not been received, a
number to be issued), partnership is required to presume that • partner Is • foreign person.
2. Certify that you we not subject to backup withholding, or end pay the withholding tax. Therefore, h you are • U.S. person that Is a
3. Claim exemption from backup withholding If you are • U.S. exempt partner in a partnership conducting a trade a business in the United
payee If applicable, you are also certifying that as • U.S. person, your States, provide Form W-9 to the partnershks to establish your U.S.
allocable share of any partnership income from a U.S. trade or business status and avoid withholding on your sham of partnership incase
is not subject to the withholding tax on foreign partners' share of
effectively connected Imams
Cot No. 10231X tam W-OiRev. 12-2011)
R.toNFIDEN-rIAL
SDNY_GM_00037296
CONFIDENTIAL - PURSUANT TO FED. DB-SONY-0000120
EFTA_OO1479O9
EFTA01282043