EFTA01298044.pdf

W-9
Request for Taxpayer Give Form to the
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(Rey Docents 2011) Identification Number and Certification requester. Do not
Departed at the Tansy send to the IRS.
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Check ansteltaile boa for lederel tax claestatatico:
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Taxpayer Identification Number (TIN)
Enter yow TIN in the appropriate box. The TIN provided must match the mama given on the 'Name lire Social wiewity number
to avoid backup withholding. For individuals, this le your social security number (SSW However, for •
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 •
11N on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guldelnes on whose
number to enter.
Part II Codification
Under penalties of penury, I ostrty that:
1. The number shown on this form is my correct taxpayer identification number (orient waning for a number to be issued to me). and
2. I am not subject to backup withholding because: (a) I fern exempt from backup withholding, a (b) I have not bean notified by the Internal Revenue
Service (ES) that I am subject to backup withholding as a result of a faiure to report all interest or dividends, or (c) the IRS has notified me Matt 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 it• 2 above It you have been notified by the IRS that you are currently subject to baokup withholding
because you have tailed to report all interest and i3tt Cent on your tax m. For real estate transactions, hem 2 does not apply. Fa mortgage
interest paid. acquisition or abandonment of secu property. of debt, contributions to an hxlividual retirement anangernent (IRA), and
generally, payments other then interest and dividerxis. not required 10 sir the certification, but you must provide your correct TIN. See the
instructions cn paps 4. /
Sign Signature et 7 9// /5
Here U.S. person. bailee
General Instructions Note. if a requester gives you a form other than Form W-9 to mount
your TIN, you must use the requester's form If It is ellbetantittly almlw
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 at
A person who is required to file an Information return with the IRS must • An individual who lea 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 lime 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 It you area U.S. person (including a resident
alien), to provide your correct TIN to the person requesting it (the Special nabs for partneralips. Partnerships that conduct a trade or
requester) and, whin applicable, to business in the United States are genersty required to pay a withholding
tax on any foreign partnere' share of Income from such bud:seas
1. Certify that the TIN you we giving is correct (or you are waitng 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 withhoiding, 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 applicable, you are also certifying that as a V.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 share of partnership inane.
is not subject to the withholding tax on foreign partners' share of
effectively connected Income.
Cat No 10231X Form IN-9 (Roy. 12.2011)
SDNY_GIvl_00061 850
.NE
R.QP I DENTIAL
CONFIDENTIAL - PURSUANT TO FED- DB-SDNY-0024675
EFTA_00172362
EFTA01298044