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ATTACHMENT 6 <br />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 Form 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 Form 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 correct TIN, 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 if: <br />1. You do not furnish your 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 />Page 2 <br />3. The IRS tells the requester that you furnished an incorrect 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 Form <br />W-9 for more information. <br />Also see Special rules for partnerships 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 from 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 failure 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 Form 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 Form 1040/1040A/1040EZ you filed with your application. <br />b. Sole proprietor or single -member LLC. Enter your individual name as <br />shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, <br />or "doing business as" (DBA) 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)(iii). Enter the 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 />