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Form W-9 (Rev. 8-2013) Page 3
<br />Exempt payee code. Generally, IndIvlduals (Including sale proprietors) ere not
<br />exempt from backup withholding. Corporations we exempt tram backup
<br />withholding for certain payments, such as Interest and dividends. Corporations are
<br />not exempt from backup withholding for payments made in settlement of payment
<br />card or third party network transactions.
<br />Note. If you are exempt from backup withholding, you should still complete this
<br />farm to avoid possible erroneous backup withholding.
<br />The following codes Identify payees that are exempt from backup withholding:
<br />1—An organization exempt from tax under section 501(a), any IRA, or a
<br />custodial account under section 403(b)(7) if the account satisfies the requirements
<br />of section 401(0(2)
<br />2—The United States or any of its agencies or Instrumentalities
<br />3—A state, the District or Columbia, a possession of the United States, or any of
<br />their political subdivisions a Instrumentalities
<br />4—A foreign government or any of Its political subdivisions, agencies, or
<br />Nstrumentalitles
<br />5—A corporation
<br />6—A dealer In securities or commodities required to register In the United
<br />States, the District of Columbia, or a possession of the United States
<br />7—A futures commission merchant registered with the Commodity Futures
<br />Trading Commission
<br />B—A real estate Investment trust
<br />9—An entity registered at all (Imes during the tax year underthe Investment
<br />Company Act o11940
<br />10—A common trust fund operated by a bank under section 6114(a)
<br />11—A financial Institution
<br />12—A middlemen known in the Investment community as a nominee or
<br />custodian
<br />13—A trust exempt from tax under section 664 or described In section 4947
<br />The following chart shows types of payments that may be exempt from backup
<br />withholding. The chart applies to the exempt payees listed above,( through 13.
<br />IF the payment is far...
<br />THEN the payment is exempt far...
<br />Interest and dividend payments
<br />All exempt payees except
<br />for7
<br />Broker transactions
<br />Exempt payees 1 through 4 and 6
<br />through 11 and all C corporations. S
<br />corporations must not enter an exempt
<br />payee code because they are exempt
<br />only for sales of noncovered securities
<br />acquired plor to 2012.
<br />Barter exchange transactions and
<br />Exempt payees 1 though 4
<br />patronage dividends
<br />Payments over $600 required to be
<br />Generally, exempt payees
<br />reported and direct sales over S5,0001
<br />1 through 5'
<br />Payments made in settlement of
<br />Exempt payees 1 through 4
<br />payment card or third party network
<br />transactions
<br />1 Sea Form 1099-MISC, Miscellaneous Income, and Its Instructions.
<br />'However, the following payments made to a corporation and reportable on Form
<br />1009-MISC are not exempt from backup withholding: medical and health care
<br />payments, attornays' fees, gross proceeds paid to an attorney, and payments for
<br />services paid by a federal executive agency.
<br />Exemption tram FATCA reporting code. The following codes identify payees
<br />that are exempt from reporting under FATCA These codes apply to persons
<br />submitting this form for accounts maintained outside of the United States by
<br />certain foreign financial institutions. Therefore, If you are only submitting this fart
<br />far an account you hold in the United States, you may leave this field blank.
<br />Consult with the person requesting this form If you we uncertain if the financial
<br />Institution is subject to these requirements.
<br />A—An organization exempt from tax under section 501(a) or any Individual
<br />retirement plan as defined in section 7701(a)(37)
<br />B— The United States or any of Its agencies or Instrumentalities
<br />C—A state, the District of Columbia, a possession of the United States, a any
<br />of their polltical subdivisions or Instmmentali8es
<br />D—A corporation the stock of which is regularly traded W one or more
<br />established securldes markets, as described In Reg. section 1.1472-1(c)(1)(1)
<br />E—A corporation that Is a member of the same expanded affiliated group as a
<br />corporation described In Reg. section 1.1472-1(c)(1)(0
<br />F—A dealer In securities, commodltles, or derivative financial Instruments
<br />Qncluding notional principal contracts, futures, forwards, and options) that Is
<br />registered as such under the laws of the United States or any state
<br />G—A real estate Investment trust
<br />H—A regulated Investment company as tle5ned in section 051 or an entity
<br />registered at all times during the tax year under the Investment Company Act of
<br />1940
<br />I—A common trust fund as defined In section 534(a)
<br />J—A bank as defined In section 581
<br />K—A broker
<br />L—A trust exempt from tax under section 664 or described in section 4947(x$1)
<br />M—A tax exempt bust under a section 403p) plan or section 457(8) plan
<br />Part I. Taxpayer Identification Number (TIN)
<br />Enter your TIN In the appropriate box. If you are a resident alien and you do not
<br />have and are not eligible to get an SEN, your TIN is your IRS Individual taxpayer
<br />Identitfcetlon number (TIM• Enter it In the social security number box. If you do not
<br />have an TIN, see How to get a TIN below.
<br />If you was a sole proprietor and you have an EIN, you may enter either your SSN
<br />or EIN. However, the IRS prefers that you use your SSN.
<br />If you are a shine -member LLC that Is disregarded as an entity separate from Its
<br />owner (see Limited Llablifty Company (LLC) on page 2), enter the owner's SSN (or
<br />EIN, If the owner has one). Do not enter the disregarded entity's EIN. If the LLC Is
<br />classified as a corporation or partnership, enter the ent8y's EIN.
<br />Note. Seethe chart on page 4 for further clarification of two and TIN
<br />combinations.
<br />How to get a TIN. If you do not have a TIN, apply for one immediately. To
<br />may also get this form by calling 1-B00-772-1213. Use Form W-7, Application for
<br />IRS Individual Taxpayer Identification Number, to apply for an TIN, or Form SS -4,
<br />Application for Employer Identification Number, to apply far an EIN. You can appll
<br />for an EIN online by accessing the IRS website at www.irs.gowbuslnesses and
<br />all on Employer Identification Number (EIN under Starting a Business. You
<br />can get Forms W-7 and SS -4 from the IRS by visiting IRS.gov or by calling 1 -800 -
<br />if you are asked to complete Form W-9 but do not have a TIN, apply for a TIN
<br />and write "Applied Far" In the space for the TIN, sign and date the farm, and give It
<br />to the requester. For Interest and dividend payments, and certain payments made
<br />win respect to really tradable Instruments, generally you will have 60 days to get
<br />a TIN and give it to the requester betas you are subject to backup whhhelding on
<br />payments. The 60 -day rule dcas not apply to other types of payments. You will be
<br />subject to backup withholding on all such payments until you provide your TIN to
<br />the requester.
<br />Note. Entering "Applied Fa" means that you have already applied for a TIN a that
<br />you Intend to apply for one soon.
<br />Caution: A disregarded U.S. entity that bas a fomfgn owner must use the
<br />appropriate Fonn W-8.
<br />Part II. Certification
<br />To establish to the withholding agent that you am a U.S. person, a resident alien,
<br />sign Farm W-9. You may be requested to sign by the withholding agent even ti
<br />Items 1, 4, or 5 below Indicate otherwise.
<br />For ajolm account, only the person whose TIN Is shown In Part I should sign
<br />(when required). In the vaso of a disregarded witty, the person Identified on the
<br />'Name' line must sign. Exempt payees, see Exempt payee code earlier.
<br />Signature requirements. Complete the certification as Indicated In hems 1
<br />through 5 below.
<br />1. Interest, dividend, and barter exchange accounts opened before 1984
<br />and broker accounts considered active during 1983. You must give your
<br />correct TIN, but you do not have to sign the certification.
<br />2. Interest, dividend, broker, and barter exchange accounts opened after
<br />1883 and broker accounts considered Inactive during 1983. You must sign the
<br />certification or backup withholding will apply. ti you are subject to backup
<br />withholding and you are merely providing your correct TIN to the requester, you
<br />must awes out Item 2 I the certification before signing the form.
<br />3. Real estate transactions. You must sign the certification. You may crass out
<br />Rem 2 of the certilkattlon.
<br />4. Other payments. You must give your correct TIN, but you do not have to sign
<br />the certification unless you have been notified that you have previously given an
<br />Incorrect TIN. "Other payments" Include payments made In the course of the
<br />requester's trade or business for rents, royalties, goods (other than bilis for
<br />merchandise), medical and health care services (Including payments to
<br />corporations), payments to a nonemployee for services, payments made In
<br />settlement of payment card and third party network trensactiens, payments to
<br />certain fishing boat crew members and fishermen, and gross proceeds paid to
<br />attorneys Oncluding payments to corporations).
<br />6. Mortgage Interest paid by you, acquisition or abandonment of secured
<br />property, cancellation of debt, qualified tuition program payments (under
<br />section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or
<br />distributions, and pension distributions. You must give your correct TIN, but you
<br />do not have to sign the certification.
<br />25C-73
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