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DocuSign Envelope ID: CB479571-74E8-4DCC-8F07-F71D3249C902
<br />Form W-9 (Rev. 10-2018) Page 3
<br />Criminal penally for falsifying information. Willfully falsifying
<br />certifications or affirmations may subject you to criminal penalties
<br />Including fines andlor imprisonment.
<br />Misuse of TINs. If the requester discloses or uses TINS in violation of
<br />federal law, 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
<br />blank. The name should match the name on your tax return.
<br />If this Form W-9 is for a joint account (other than an account
<br />maintained by a foreign financial Institution (FFI)), list first, and then
<br />circle, the name of the person or entity whose number you entered In
<br />Part I of Form W-9. If you are providing Form W-9 to an FFI to document
<br />a joint account, each holder of the account that Is a U.S. person must
<br />provide a Form W-9.
<br />a. Individual. Generally, enter the name shown on your tax return. If
<br />you have changed your last name without Informing the Social Security
<br />Administration (SSA) of the name change, enter your first name, the last
<br />name as shown on your social security card, and your new last name.
<br />Note: ITIN applicant: Enter your Individual name as It was entered on
<br />your Form W-7 application, line la. This should also be the same as the
<br />name you entered on the Form 1040/1040AI1040EZ you filed with your
<br />application.
<br />b. Sole proprietor or single -member LLC, Enter your Individual
<br />name as shown on your 1040/1040A/1040EZ on line 1. You may enter
<br />your business, trade, or "doing business as" (DBA) name on line 2.
<br />c. Partnership, LLC that Is not a single-mombor LLC, C
<br />corporation, or S corporation, Enter the entity's name as shown on the
<br />entity's tax return on line 1 and any business, trade, or DSA name on
<br />line 2.
<br />d. Otherentlties. Enteryour name as shown on required U.S, federal
<br />tax documents on line 1. This name should match the name shown on the
<br />charter or other legal document creating the entity. You may enter any
<br />business, trade, or DBA name online 2.
<br />A. 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
<br />"disregarded entity." See Regulatlons section 301,7701-2(c)(2)(111). Enter
<br />the owner's name on line 1. The name of the entity entered on line 1
<br />should never be a disregarded entity. The name on line 1 should be the
<br />name shown on the Income tax return on which the Income should be
<br />reported, For example, if a foreign LLC that Is treated as a disregarded
<br />entity for U.S. federal tax purposes has a single owner that is a U.S.
<br />person, the U.S, owner's name Is required to be provided on line 1. If
<br />the direct owner of the entity Is also a disregarded entity, enter the first
<br />owner that is not disregarded for federal tax purposes. Enter the
<br />disregarded entity's name on line 2, "Business name/disregarded entity
<br />name." If the owner of the disregarded entity Is a foreign person, the
<br />owner must complete an appropriate Farm W-8 Instead of a Form W-9.
<br />This is the case even if the foreign person has a U.S. TIN,
<br />Line 2
<br />If you have a business name, trade name, DBA name, or disregarded
<br />entity name, you may enter It an line 2.
<br />Line 3
<br />Check the appropriate box on line 3 for the U.S. federal tax
<br />classification of the person whose name Is entered on line 1. Check only
<br />one box on line 3.
<br />IF the entitylperson on line 1 Is
<br />THEN check the box for...
<br />a(n)...
<br />• Corporation
<br />Corporation
<br />• Individual
<br />Indivlduallsole proprietor or single-
<br />• Sole proprietorship, or
<br />member LLC
<br />• Single -member limited liability
<br />company (LLC) owned by an
<br />Individual and disregarded for U.S.
<br />federal tax purposes.
<br />• LLC treated as a partnership for
<br />Limited liability company and enter
<br />U.S. federal tax purposes,
<br />the appropriate tax classification.
<br />• LLC that has filed Form 8832 or
<br />(P=Partnership; C= C corporation;
<br />2553 to be taxed as a corporation,
<br />or S= S corporation)
<br />or
<br />• LLC that is disregarded as an
<br />entity separate from Its owner but
<br />the owner is another LLC that Is
<br />not disregarded for U.S. federal lax
<br />purposes,
<br />• Partnership
<br />Partnership
<br />• Trust/estate
<br />Trust/estate
<br />Line 4, Exemptions
<br />If you are exempt from backup withholding and/or FATCA reporting,
<br />enter in the appropriate space on line 4 any code($) that may apply to
<br />you.
<br />Exempt payee code.
<br />• Generally, Individuals (Including sole proprietors) are not exempt from
<br />backup withholding.
<br />• Except as provided below, corporations are exempt from backup
<br />withholding for certain payments, Including interest and dividends.
<br />• Corporations are not exempt from backup withholding for payments
<br />made In settlement of payment card or third party network transactions.
<br />• Corporations are not exempt from backup withholding with respect to
<br />attorneys' fees or gross proceeds paid to attorneys, and corporations
<br />that provide medical or health care services are not exempt with respect
<br />to payments reportable on Form 1099•MISC.
<br />The following codes Identify payees that are exempt from backup
<br />withholding. Enter the appropriate code in the space In line 4.
<br />1—An organization exempt from tax under section 601(a), any IRA, or
<br />a custodial account under section 403(b)(7) if the account satisfies the
<br />requirements of section 401(f)(2)
<br />2—The United States or any of its agencies or instmmenlallties
<br />3—A state, the District of Columbia, a U.S. commonwealth or
<br />possession, or any of their political subdivisions or instrumentalities
<br />4—Aforelgn government or any of Its political subdivisions, agencies,
<br />or Instrumentalities
<br />8—A corporatlon
<br />8—A dealer in securities or commodities required to register In the
<br />United Stales, the District of Columbia, or a U.S,. commonwealth or
<br />possession
<br />7—A futures commission merchant registered with the Commodity
<br />Futures Trading Commission
<br />8—A real estate Investment trust
<br />9---An entity reglstered at all times during the tax year under the
<br />Investment Company Act of 1940
<br />10—A common trust fund operated by a bank under section 884(a)
<br />11--AManclal institution
<br />12—A middleman known In the Investment community as a nominee or
<br />custodian
<br />13—A trust exempt from tax under section 884 or described In section
<br />4947
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