EFTA01295038.pdf

W-9
Request for Taxpayer Give Form to the
Como
requester. Do not
DOCCITIbilf Identification Number and Certification
( D R o e p v. e rnwt of be J b 0 e 1 a 1) uty wind to the IRS.
*tonal Rhona Senn*
Nan,. (aa shown on your mann Written)
The Hen Treat
Wanes nenalchstegmckat entityrime N deferent from above
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Check approptiato box to Waal um crinicas.a:
O InclaicknVaols proprietor • C Corporation O 8 Coperadon O Perbership a Trust/estate
fi rL-j , Limited **Nay company. Enke the tax cioacirnatket (CeC corporallen frr-8 coPerance.Fvertnershlot a' III Excerpt Parse
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.I Acne frernter. street. and we a suite no.) Requesters name end ediress (options,
t City. Said ZIP code
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St. Thomas, U.S.V.I. 00802
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urn
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the 'Name line I social 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 Pat I instructions on page 3. For other
entities, it is your employer identification number (EN). N you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelnes on whose Employs, Itionakkadannurnber
number to enter.
Part II Certification
Under penalties of perjury, I certify that
1. The number shown on this form Is my oorrect taxpayer identification number (orlon waiting for a number to be issued to rne). and
2. lam not sr act to backup withholding because: (a) I arn exempt horn backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) 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 methat 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 we currently subject to backup withholding
because you have failed to report all Interest and dividends on your tax return. For real estate transactions. Item 2 does not apply. For mortgage
interest paid. acquisition or abandonment of secured property, caricelation of debt, contributions to an individual retirement anangement (IRA), and
generally, payments other than Interest and dividends, you ere not required to Wan the certification, but you must provide your correct TIN. See the
instructions on page 4.
Sign
Here
General Instructions Note. If a requester gives you a form other han 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.
Delloiton of a U.B. person. For federal tax purpceee, you are
Purpose of Form considered a U.S. person if you era
A person who is required to file an information return with the IRS must • An ThiNklual who is a U.S. citizen or U.S. resident
obtain your correct taxpayer Identification number (TIN) to report, for • A partnership. corporation, company, or association created or
scamp* 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 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 (ndudr ig a resident
afien), to provide your correct TIN to the person requesting it (the Spoolsl ales for partnerships. 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 budneee.
1. Certify that the TIN you are giving is correct (or you we 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 a foreign person,
2. Certify that you are not subject to backup withholding, or and pay the withholding tax. Therefore. 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 we a U.S. exempt
payee. If applicable, 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 status and avoid withholding on your there of partnership income.
is not subject to the withholding tax on foreign partners' share of
effectively connected income.
Cat No. 10231% Form W-9pittiv. 12.2011)
SDNY_GM_00053732
.NEIDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R.QP DB-SDNY-0016556
EFTA_00164307
EFTA01295038