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Form W-9 (Rev. 12-2014)
<br />Note. If you are a U.S. person and a requester gives you a form other than Form
<br />W-9 to request your TIN, you must use the requester's form if it is substantially
<br />similar to this Form W-9.
<br />Definition of a U.S. person. For federal tax purposes, you are considered a U.S.
<br />person if you are:
<br />• An individual who is a U.S. citizen or U.S. resident alien;
<br />• A partnership, corporation, company, or association created or organized in the
<br />United States or under the laws of the United States;
<br />• An estate (other than a foreign estate); or
<br />• A domestic trust (as defined in Regulations section 301.7701-7).
<br />Special rules for partnerships. Partnerships that conduct a trade or business in
<br />the United States are generally required to pay a withholding tax under section
<br />1446 on any foreign partners' share of effectively connected taxable income from
<br />such business. Further, in certain cases where a Form W-9 has not been received,
<br />the rules under section 1446 require a partnership to presume that a partner is a
<br />foreign person, and pay the section 1446 withholding tax. Therefore, if you are a
<br />U.S. person that Is a partner in a partnership conducting a trade or business in the
<br />United States, provide Form W-9 to the partnership to establish your U.S. status
<br />and avoid section 1446 withholding on your share of partnership Income.
<br />In the cases below, the following person must give Forth W-9 to the partnership
<br />for purposes of establishing its U.S. status and avoiding withholding on its
<br />allocable share of net income from the partnership conducting a trade or business
<br />in the United States:
<br />• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the
<br />disregarded entity and not the entity;
<br />• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
<br />the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and
<br />• In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a
<br />grantor trust) and not the beneficiaries of the trust.
<br />Foreign person. If you are a foreign person or the U.S. branch of a foreign bank
<br />that has elected to be treated as a U.S. person, do not use Forth W-9. Instead, use
<br />the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax
<br />on Nonresident Aliens and Foreign Entities).
<br />Nonresident alien who becomes a resident alien. Generally, only a nonresident
<br />alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on
<br />certain types of Income. However, most tax treaties contain a provision known as
<br />a "saving clause." Exceptions specified in the saving clause may permit an
<br />exemption from tax to continue for certain types of income even after the payee
<br />has otherwise become a U.S. resident alien for tax purposes.
<br />If you are a U.S. resident alien who is relying on an exception contained In the
<br />saving clause of a tax treaty to claim an exemption from U.S. tax on certain types
<br />of Income, you must attach a statement to Form W-9 that specifies the following
<br />five items:
<br />1. The treaty country. Generally, this must be the same treaty under which you
<br />claimed exemption from tax as a nonresident alien.
<br />2. The treaty article addressing the income.
<br />3. The article number (or location) in the tax treaty that contains the saving
<br />clause and its exceptions.
<br />4. The type and amount of income that qualifies for the exemption from tax.
<br />5. Sufficient facts to justify the exemption from tax under the terms of the treaty
<br />article.
<br />Example. Article 20 of the U.S: China Income tax treaty allows an exemption
<br />from tax for scholarship Income received by a Chinese student temporarily present
<br />in the United States. Under U.S. law, this student will become a resident alien for
<br />tax purposes If his or her stay in the United States exceeds 5 calendar years.
<br />However, paragraph 2 of the first Protocol to the U.S: China treaty (dated April 30,
<br />1984) allows the provisions of Article 20 to continue to apply even after the
<br />Chinese student becomes a resident alien of the United States. A Chinese student
<br />who qualifies for this exception (under paragraph 2 of the first protocol) and is
<br />relying on this exception to claim an exemption from tax on his or her scholarship
<br />or fellowship Income would attach to Form W-9 a statement that Includes the
<br />information described above to support that exemption.
<br />If you are a nonresident alien or a foreign entity, give the requester the
<br />appropriate completed Form W-8 or Form 8233.
<br />Backup Withholding
<br />What Is backup withholding? Persons making certain payments to you must
<br />under certain conditions withhold and pay to the IRS 28% of such payments. This
<br />is called "backup withholding." Payments that may be subject to backup
<br />withholding include Interest, tax-exempt Interest, dividends, broker and barter
<br />exchange transactions, rents, royalties, nonemployee pay, payments made in
<br />settlement of payment card and third party network transactions, and certain
<br />payments from fishing boat operators. Real estate transactions are not subject to
<br />backup withholding.
<br />You will not be subject to backup withholding on payments you receive if you
<br />give the requester your correctTIN, make the proper certifications, and report all
<br />your taxable Interest and dividends on your tax return.
<br />Payments you receive will be subject to backup withholding Ih
<br />1. You do not furnish you(TIN to the requester,
<br />2. You do not certify your TIN when required (see the Part II instructions on page
<br />3 for details),
<br />3. The IRS tells the requester that you furnished an inconect TIN,
<br />4. The IRS tells you that you are subject to backup withholding because you did
<br />not report all your Interest and dividends on your tax return (for reportable Interest
<br />and dividends only), or
<br />5. You do not certify to the requester that you are not subject to backup
<br />withholding under 4 above (for reportable interest and dividend accounts opened
<br />after 1983 only),
<br />Certain payees and payments are exempt from backup withholding. See Exempt
<br />payee code on page 3 and the separate Instructions for the Requester of Forth
<br />W-9 for more information.
<br />Also see Special rules lorparfnerships above.
<br />What is FATCA reporting?
<br />The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign
<br />financial Institution to report all United States account holders that are specified
<br />United States persons. Certain payees are exempt from FATCA reporting. See
<br />Exemption Imm FATCA reporting code on page 3 and the Instructions for the
<br />Requester of Form W-9 for more Information.
<br />Updating Your Information
<br />You must provide updated information to any person to whom you claimed to be
<br />an exempt payee if you are no longer an exempt payee and anticipate receiving
<br />reportable payments in the future from this person. For example, you may need to
<br />provide updated Information if you are a C corporation that elects to be an S
<br />corporation, or if you no longer are tax exempt. In addition, you must furnish a new
<br />Form W-9 if the name or TIN changes for the account; for example, if the grantor
<br />of a grantor trust dies.
<br />Penalties
<br />Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are
<br />subject to a penalty of $50 for each such failure unless your fallure is due to
<br />reasonable cause and not to willful neglect.
<br />Civil penalty for false information with respect to withholding. If you make a
<br />false statement with no reasonable basis that results in no backup withholding,
<br />you are subject to a $500 penalty.
<br />Criminal penalty for falsifying Information. Willfully falsifying certifications or
<br />affirmations may subject you to criminal penalties Including fines and/or
<br />Imprisonment.
<br />Misuse of TINS. If the requester discloses or uses TINS in violation of federal law,
<br />the requester may be subject to civil and criminal penalties.
<br />Specific Instructions
<br />Line 1
<br />You must enter one of the following on this line; do not leave this line blank. The
<br />name should match the name on your tax return.
<br />If this Form W-9 is for a joint account, list first, and then circle, the name of the
<br />person or entity whose number you entered in Part I of Forth W-9.
<br />a. Individual. Generally, enter the name shown on your tax return. If you have
<br />changed your last name without informing the Social Security Administration (SSA)
<br />of the name change, enter your first name, the last name as shown on your social
<br />security card, and your new last name.
<br />Note. ITIN applicant: Enter your individual name as it was entered on your Form
<br />W-7 application, line 1 a. This should also be the same as the name you entered on
<br />the Forth 1040/1040Ar1040EZ you filed with your application.
<br />b. Sole proprietor or single -member LLC. Enter your individual name as
<br />shown on your 1040/1040AII040EZ on line 1. You may enter your business, trade,
<br />or "doing business as" (DSA) name on line 2.
<br />c. Partnership, LLC that Is not a single -member LLC, C Corporation, or S
<br />Corporation. Enter the entity's name as shown on the entity's tax return on line 1
<br />and any business, trade, or DBA name on line 2.
<br />d. Other entities. Enter your name as shown on required U.S. federal tax
<br />documents on line 1. This name should match the name shown on the charter or
<br />other legal document creating the entity. You may enter any business, trade, or
<br />DBA name on line 2.
<br />e. Disregarded entity. For U.S. federal tax purposes, an entity that is
<br />disregarded as an entity separate from its owner is treated as a "disregarded
<br />entity." See Regulations section 301.7701-2(c)(2)(ii). Enterthe owner's name on
<br />line 1. The name of the entity entered on line 1 should never be a disregarded
<br />entity. The name on line 1 should be the name shown on the income tax return on
<br />which the Income should be reported. For example, if a foreign LLC that is treated
<br />as a disregarded entity for U.S. federal tax purposes has a single owner that is a
<br />U.S. person, the U.S. owner's name is required to be provided on line 1. If the
<br />direct owner of the entity is also a disregarded entity, enter the first owner that is
<br />not disregarded for federal tax purposes. Enter the disregarded entity's name on
<br />line 2, "Business name/disregarded entity name." If the owner of the disregarded
<br />entity is a foreign person, the owner must complete an appropriate Form W-8
<br />Instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN.
<br />25C-15
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