EFTA01295005.pdf

W-9
Request for Taxpayer Give Form to the
Form
requester. Do not
December 2011) Identification Number and Certification
Depramere eie awn sand to the IRS.
trainal Reveentu e STerbs y
Name grceir2war income tehreetan)
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Buenas graded arty nose, ItL ent Worn above
thick appropriate box for federal tax classification:
O hdirldieWole proprietor El CCorpantin gt<tCeceporeficin O Partners/1p O trust/wale
O ISMS Milky cerroew. Erie the Is. desalcalkin ICC ear' wakes. $4 corpontion, Pepertnenho _ O Sankt Mee
O Other (salreburelone aw4e,
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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 'Names line sods security rather
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 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 •
TIN on page 3.
Note. If the account is in more Than one name, see the chart on page 4 for guldekrers on whose
number to enter.
ligu
Certification
Under penalties of satiny. I ossify that
1. The number shown or, this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. tarn not subject to backup withholding because: (idiom exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service ORS) that I am subject to backup withholding as a result of a failure to report all 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).
Certification Instructions. You must cross out item 2 above If you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all intern! and dividends on your tax return. For real *stae transactions. item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of seCUratroperly, cancellation of debt: contributions to an individual retirement arrangement (IRA), and
generally, payments other than Interest and you ars not to sign the certification, but you must provide your correct TIN. See the
instructions on page 4.
Sign Ilignals• of
Here U.S. per•on 0./ Dote a
General Instruations Note. If a requester gives you a loan other than Form W-9 to request
your TIN, you must use the requester's form if It is substantially similar
Section references are to the Internal Revenue Code unless otherwise to this Form W-9.
noted.
Definition of a U.S. person. For federal tax purposes, you are
Purpose of Form considered a U.S. person If you we:
A person who Is required to file an information return with the IRS must • An Inavklual 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 Staters,
you paid. acquisition or abandonment of secured property. cancellation • An estate (other than a foreign estate), or
of debt, or contnbutions you made to an IRA.
• A domestic trust (as defined in Regulations section 301.7701.7),
Use Form W9 only II you are a U.S. person (indudng a resident
alien), to provide your correct TN to the person requesting it (the Special rtes for pertnenplips. Partnerships that conduct a trade a
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 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), partnership is required to presume that a padre is • foreign person,
2. Certify that you we not subject to backup withholding, or and pay the withholding tax. Therefore, if you are a U.S. person that is a
3. Claim exemption from backup withholding if you we a U.S. exempt partner M • partnership conducting a trade or business in the United
payee. if applied:Ile you are also certifying that as a U.S. person, your States, provide Form W4 to the partnereliP to establish your V.S.
allocable share of any partnership income from a U.S. trade or business status and avoid withholding on your share of partnership income.
is not subject to the withholding tax on foreign partners' share of
effecavely connected income.
Col No.10231% Fart W-0 Rev. 12-2011)
SDNY_GM_00053688
.NEIDENTIAL
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CONFIDENTIAL - PURSUANT TO FED. DB-SDNY-0016512
EFTA_00164269
EFTA01295005