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DocuSign Envelope ID: CB479571-74E8-4DCC-8F07-F71D3249C902
<br />Form W-9 (Rev. 10.2018)
<br />The following chart shows types of payments that may be exemppt
<br />from backup withholding. The chart applies to the exempt payees listed
<br />above,/ through 13.
<br />IF the payment is for...
<br />THEN the payment Is exempt
<br />for...
<br />Interest and dividend payments
<br />All exempt payees except
<br />for 7
<br />Broker transactions
<br />Exempt payees 1 through 4 and 6
<br />through 11 and all C corporations.
<br />S corporations must not enter an
<br />exempt payee code because they
<br />are exempt only for sales of
<br />.
<br />noncovered securities acquired
<br />prior to 2012,
<br />Barter exchange transactions and
<br />Exempt payees 1 through 4
<br />patronage dividends
<br />Payments over $600 required to be
<br />Generally, exempt payees
<br />reported and direct sales over
<br />1 through 52
<br />$5,000r
<br />Payments made in settlement of
<br />Exempt payees 1 through 4
<br />payment card or third party network
<br />transactions
<br />r See Form 1099-MISC, Miscellaneous Income, and Its instructions.
<br />2 However, the following payments made to a corporation and
<br />reportable on Form 1099-MISC are not exempt from backup
<br />withholding: medical and health care payments, attorneys' fees, gross
<br />proceeds paid to an attorney reportable under section 6045(f), and
<br />payments for services paid by a federal executive agency.
<br />Exemption from FATCA reporting code. The following codes identify
<br />payees that are exempt from reporting under FATCA. These codes
<br />apply to persons submitting this form for accounts maintained outside
<br />of the United States by certain foreign financial Institutions. Therefore, If
<br />you are only submitting this form for an account you hold In the United
<br />Slates, you may leavethis field blank. Consult with the person
<br />requesting thig'form if you are uncertain if the financial Institution Is
<br />subject to these requirements. A requester may Indicate that a code Is
<br />not required by providing you with a Form W-9 with "Not Applicable" (or
<br />any similar indicatlon).wrllten or printed on the line for a FATCA
<br />exemption code. -
<br />A —An organization exempt from tax under section 601(a) or any
<br />Individual 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 U.S, commonwealth or
<br />possession, or any of their political subdivisions or instrumentalities
<br />D--A corporation the stock of which Is regularly traded on one or
<br />more established securities markets, as described in Regulations
<br />section 1.1472.1(c)(1)(1)
<br />E—Acorporation that is a member of the same expanded affiliated
<br />group as a corporation described In Regulations section 1,1472-1(0)(1)(1)
<br />F—A.dealer In securities, commodities, or derivative financial
<br />Instruments (Including notional principal contracts, futures, forwards,
<br />and options) that Is registered as such under the laws of the United
<br />States or any state
<br />G—A real estate Investment trust
<br />H—A regulated Investment company as defined In section 851 or an
<br />entity registered at all times during the lax year under the Investment
<br />Company Act of 1940
<br />I —A common trust fund as defined in section 584(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
<br />4947(a)(1)
<br />M—A tax exempt trust under a section 403(b) plan or section 457(g)
<br />plan
<br />Note: You may wish to consult with the financial Institution requesting
<br />this form to determine whether the FATCA code and/or exempt payee
<br />code should be completed.
<br />Line 6
<br />Enter your address (number, street, and apartment or suite number),
<br />This Is where therequester of this Form.W-9 will mall your Information
<br />returns. If this address differs from the one the requester already has on
<br />file, write NEW at the top. If a new address Is provided, there is still a
<br />chance the old address will be used until the payer changes your
<br />address In their records.
<br />Line 6
<br />Enteryour city, state, and ZIP code.
<br />Part I. Taxpayer Identification Number (TIN)
<br />Enter your TIN In the appropriate box. If you are a resident alien and
<br />you do not have and are not eligible to get an SSN, your TIN Is your IRS
<br />Individual taxpayer identification number (ITIN). Enterlt In the social
<br />security number box, If you do not have an ITIN, see How to get a TIN
<br />below.
<br />If you are a sole proprietor and you have an EIN, you may enter either
<br />your SSN or EIN.
<br />If you are a single -member LLC that Is disregarded as an entity,
<br />separate from Its owner, enter the owner's SSN (or EIN, If the owner has
<br />one). Do. not enter the disregarded entity's EIN. If the LLC Is classified as
<br />a corporation or partnership, enter the entity's EIN.
<br />Note: See What Name and Number To Give the Requester, later, for
<br />further clarification of name and TIN combinations.
<br />How to get a TIN. If you do not have a TIN, apply for one Immediately.
<br />To apply for an SSN, get Farm SS-6, Application for a Social Security
<br />Card, from your local SSA office or get this form online at
<br />www.SSA.gov. You may also gat this form by calling 1-800-772-1213,
<br />Use Form W-7, Application for IRS Individual Taxpayer Identification
<br />Number, to apply for an ITIN, or Form 88-4, Application for Employer
<br />Identification Number, to apply for an EIN. You can apply for an EIN
<br />online by accessing the IRS website at wwwlrs.govreua/nesses and . -
<br />clicking on Employer Identification Number (EIN) under Starting a
<br />Business. Go to wwwdrs.gov/Forms to view, download, or print Form
<br />W-7 and/or Form SS-4. Or, you can go to www.lrs.gowOrderForms to
<br />place an order and have Form W-7 and/or SS-4 mailed to you within 10
<br />business days.
<br />If you are asked to complete Form W-9 but do not have a TIN, apply
<br />for a TIN and write "Applied For" In.the apace for the TIN, sign and date
<br />the form, and give It to the requester. For Interest and dividend
<br />payments, and certain payments made with respect to readily tradable
<br />Instruments, generally you will have 60 days to get a TIN and give it to
<br />the requester before you are subject to backup withholding on
<br />payments. The 60-day rule does not apply to other types of payments.
<br />You will be subject to backup withholding on all such payments until
<br />you provide your TIN to the requester.
<br />Note: Entering "Applied For" means that you have already applied for a
<br />TIN or that you Intend to apply for one soon.
<br />Caution: A disregarded U.S, entity that has a foreign owner must use
<br />the appropriate Form W-8,
<br />Part II. Certification
<br />To establish to the withholding agent that you are a U,S, person, or
<br />resident alien, sign Form W-9. You may be requested to sign by the
<br />withholding agent even if Item 1, 4, or 6 below Indicates otherwise.
<br />For a joint account, only the person whose TIN Is shown In Part I
<br />should sign (when required). In the case of a disregarded entity, the
<br />person identified on line 1 must sign, Exempt payees, see Exempt
<br />payee code, earlier.
<br />Signature requirements, Complete the certification as Indicated in
<br />Items 1 through 5 below.
<br />
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