EFTA01295008.pdf

Form W - 9 Request for Taxpayer Give Form to the
(Rev. Decade 20tt) Identification Number and Certification requester. Do not
Depethent d the tray send to the IRS.
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Pad I Taxpayer Identification Number (TIN)
Enter your TIN In the appropriate box. The TIN provided must match the name given on the 'Nos' line l Social soCurill nil/1w
to avoid backup withholding. For individuals, this is your social security number (SSN). However, for •
resident alien sole proprietor. or disregarded entity, see the Pat I instructions on page 3. For other
entities, it Is your employer identification number (ELM If you do not have a number, see How to get a
TIN on page 3.
Note. It the account Is In more than one name, see the chart on page 4 for guidelines on whose Employer Ide C ntif ier:fon nitro*.
number to enter.
7 I
Part II Certification
Under penalties of perjury, I certify that
1. The number shown on this foam Is my correct taxpayer Identification number (orient waiting for a number to be Issued to me), and
2. lam not subject to backup withholding because: (a) I am exempt from backup withholding, or (b)1 have not been notified by the Internal Revenue
Service (IRS) that I ant 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 ern
no longer subject to backup withholding, and
a I am a U.S. chase, or other U.S. person (defined below).
Cerlifleation Instructions. You must cross out itent2 Cove it you have been notified by the IRS that you arecurrently subject to backup withholding
because you have failed to report a• intereiderirldwi on your tax return. Format estate transactions, hem 2 does not apply. For mortgage
interest paid. acquisition or abandonMentof secured , ea:collation-ardent. contributions to an Individual retirement rurarcement ORA), and
9enotelth PeYrnente other than interW and dividends. owe .ragred to is the certification, but you must provide your convect TIN. See the
Instructions on page 4.
Sign fageseare
Hem U.S. personI .
General Instructi0ns Note. If a requester gives you a form 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 Cods 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 are
A person who Is required to file an information return 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, cancellatkm • An estate (other than a foreign estate), or
of debt, or contributions you made to an IRA.
• A domestic trust (as defined in Regulations section 301.7701.7).
Use Form W-9 only if you are a U.S. person (indud rig a resident
alien), to provide your correct TIN to the person requesting it (the Special flies for partnerships. Partnerships that conduct a trade or
requeeter) 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. Croft 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 is required to presume that a partner 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 in a partnership conducting a trade or business In the United
payee. If appficable, 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. 10231X Rem W-9 pw. t2-2011)
SDNY_GM_00053695
IDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R.QP DB-SDNY-0016519
EFTA_00164276
EFTA01295008