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<br />Request for Taxpayer
<br />Give Form to the
<br />Form 1V
<br />(Rev., 201a)
<br />Identification Number and Certification
<br />requester. Do not
<br />Depanmentof the Treasury
<br />send to the IRS.
<br />Intemai
<br />Revenue service
<br />► Go to wwwdrs.gov/FormWa for Instructions and the latest Information.
<br />1 Name (as shown on your Income tax return). Name Is required on this fine; do not leave this line blank.
<br />Loyola Mar mount University
<br />2 Business nameldisregarded entity name, if different from above
<br />LMU Extension
<br />3 Check appropriate box for federal tax classification of the person whose name is entered on line L. Check only one of the
<br />4 Exemptions (codes apply only to
<br />following seven boxes.
<br />certain entities, rot Individuals; see
<br />a.
<br />p
<br />❑ IndlvlduaVsole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trost/estate
<br />Instructions on page 3):
<br />single -member LLC
<br />exempt payee code (if any)
<br />0
<br />❑ Limited liability company. Enter the tax classification (C=C corporation, 9=S corporation, P=Partnership) ►
<br />o
<br />Note: Check the appropriate box in the line above for the lax classification of the single -member owner. Do not check
<br />Exemption from FATCA reporting
<br />�i
<br />LLC If the LLC is classified as a sfngle-member LLC that Is disregarded from the owner unless the owner of the LLC Is
<br />another LLC that IS not disregarded from the owner for U.S. federal tax purposes. Olherwise, a single -member LLC that
<br />code(if any)
<br />u
<br />IE
<br />Is disregarded from the owner should check the appropriate box for the tax classification of its owner.
<br />Y
<br />Other (see Instructions)►
<br />(AaP.:.�asn,,,�rtmwdw,re•m•usJ
<br />Co
<br />5 Address (number, street, and apt. or suite no.) See Instructions.
<br />Requester's name and address (optional
<br />1 LMU Drive, Suite 1840
<br />6 City, slate, and ZIP code
<br />Los Angeles CA, 90045
<br />7 List account number(s) here (optional)
<br />Taxpayer Identification Number (TIN)
<br />Enter your TIN In the appropriate box, The TIN provided must match the name given on line 1 to avoid
<br />Social security number
<br />backup withholding. sole For Individuals, this Is generally your social security number (SSN). However, fora
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
<br />m
<br />entitles, it Is your employer identification number (EIN). If you do not have a number, see How to got a
<br />�LJJ
<br />TIN, later.
<br />or
<br />Note: If the account Is In more then one name, see the instructions for Ilse 1. Also see What Name and I Employer Identification number
<br />Number To Give the Requester for guidelines on whose number to enter. m1 I I I
<br />Bl!•]Cmmmmmmm
<br />Under penalties of perjury, I certify that: _--
<br />1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
<br />2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
<br />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 me that I am
<br />no longer subject to backup withholding; and
<br />3. 1 am a U.S, citizen or other U.S. person (defined below); and
<br />4. The FATCA cade(s) entered on this form (If any) Indicating that 1 am exempt from FATCA reporting Is correct.
<br />Certification Instructions. You must cross out item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because
<br />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,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
<br />other than Interest and dividends, you are note allied to sir the certillcatlon, but you most provide your correct TIN. See the instructions for Part g, later.
<br />Signature of
<br />U.S. person ►
<br />General Instructions
<br />Section references ara to the Internal Revenue Code unless otherwise
<br />noted.
<br />Future developments. For the latest Information about developments
<br />related to Form W-9 and Its instructions, such as legislation enacted
<br />after they were published, go to www,!rs.gov/FormW9.
<br />Purpose of Form
<br />An Individual or entity (Form W-9 requester) who is required to file an
<br />Information return with the IRS must obtain your correct taxpayer
<br />identification number (TIN) which may be your social security number
<br />(SSN), individual taxpayer Identification number (]TIN), adoption
<br />taxpayer identification number (ATIN), or employer Identificalion number
<br />(EIN), to report on an Information return the amount paid to you, or other
<br />amount reportable on an Information return. Examples of information
<br />returns Include, but are not limited to, the following,
<br />• Form 1099-INT (Interest earned or paid)
<br />5
<br />Date► /18122
<br />• Form 1099-DIV (dividends, Including those from stocks or mutual
<br />funds)
<br />• Form 1099•MISC (various types of Income, prizes, awards, or gross
<br />proceeds)
<br />• Form 1099-5 (stack or mutual fund sales and certain other
<br />transactions by brokers)
<br />• Form I099-S (proceeds from real estate transactions)
<br />• Form 1099-K (merchant card and third party network transactions)
<br />• Form 1098 (home mortgage interest), 1098-E (student loan interest),
<br />1098-T (bullion)
<br />• Form 1000-C (canceled debt)
<br />• Form 1099-A (acquisition or abandonment of secured property)
<br />Use Form W-9 only if you are a U.S. person (Including a resident
<br />alien), to provide your correct TIN.
<br />If you do not return Faint W-9 to the requester with a TIN, you might
<br />be subject to backup withholding. See What is backup withholding,
<br />later.
<br />Cat. No. 10231X Form W-9 (Rev.10-2018)
<br />
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