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Oct 25 10 10:03a p.12 paps 4 Form W -9 (Rev. 10-2M 3. Heal estate transactions. You must elfin the cer"Hc&tbn- You may cross out item 2 of the certillcatton. 4. Otter payments. You must give You Cotreet '171N, but you do not have to sign the certification unless you have boon notified that you have previously given an incorrect TIN. 'Other payments" include payments made In the course of the requester's trade or business for rents, royalties. goods (other then bills for merchandise), medical and 1OWth care services (including payments to corporations), payments to a nonernployee for services, payments to certain fishing boat crow members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). S. Mortgage Interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualMted tuition program payments (under section &ilk, IRA, Coverdell ESA. Archer MSA or HSA contn'butione or distributions, and pension distributlons. You must give your cornett TIN, but you do not have to sign the oerlifica What Name and Number To Ghre the Requester For this type of account Give reams and Sew ok 1. kx1viduat The Individual 2. Two or more individuals Qoint The ansld owner of the account or, account) It combined funft the 11nt Individual on the 600ount' 3. Custodian soowxrt of a minor The mina ` (Uniform Gift to Minors Act) 4, a. The usual revocable savings The grarttor- truateo' trust (grantor is also trustee) b. So- called trust account that Is The actual owner' not a legal or vend trust order state law 5. Sole proprietorship or disregarded The owner' entity owned by an individual For this "a of account: Give name and EIN oft 6. Disregarded entity not owned by an The owner individual J. A vaad trust, estate, or pension trust Legal entity ' e. Corporate or LLC electing The corporation corporate status on Form 8832 9. Association, club, mOgkw% The organization charitable, educational. or other tax - exempt organization 10. Partnership or mutti- member LLC The partnership 11. A broker or registered norrlknee The broker or nominee 12. Account with the Department of The public entity Agriculture in the name of a public entity tsuch as a state or local government, school cistrict or prison) that receives agricultural program payments 'Ust ra :t and circle the name dew Pusan whops number you Urn4h N arty am pnaon on a joint e6aear has an 35N. that pw%Ws numbs mutt to Itxnhhed. `Circle one ~2 name and furnpsh the mshorb SM YOU must dhow your lndWuv) name and you may also sneer your bLe new or 'DW name on the second name moo. You mW we 9H)w your SSN or f9N ft you haw one). but the M utcomilas you to use your SSN. ' ust first and drdo the name or the oasts estate. or pension tnts6 too not banish are TIN or !M perowar reprsssnmxve or ttvcree urdess the regal enmity scow is rut daienaied N the account rme i Also see Special ndes Awp V"Vslejoe on pays 1. Note. If no name is circled when more than one name Is listed, the number will be considered to be that of the thirst name listed. Privacy Act Notice Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal wonnatbrt such as your nw, social security number p=4. or other identifying Information. without your permission. of � fraud or other crimes. An idenft thief may to re�ur S a refund. a job or may file a taut I0AI using Your SSN To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax Praparer. Call the IRS at 148004829.1040 if you think your Identity has been used inappropriately for tax Purposes. Vld'Srts of identity theft who are experiencing economic harm or a bystem problem, or we sealing help in r*G0Mn9 tax problems that have not been rewkw through normal channels, be You reycWt nt can reach TAS byc�tghe TAS toll-free Cass Intake film at 1- 877- 777 -4778 or T Y/iDD 1-800- 829 -4059. Protect yourself from suspicious snails or phishing schemes. Phishing is the creation and use of email and websltes designed to mimic legitimate business emails and websim. The mod common act is sending an email to a user falsey claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. The IRS does rot initiate contacts with taxpayers via emails. Also, the IRS dose not request personal detailed 'information through email or ask taxpayers for the PIN ntunbers, passwords. or similar secret access information for their credit card. bank, or other financial atxotints. if you rtaceive an unsolicited emmi claiming to be from the iRS, forward this message to phWWjQaffs.gov. You may also report misuse of the IRS name. logo, or other iRS personal property to the Treasury Inspector General for Tax Administration at 1- 800366 -4484. You can forward suspicious emails to the Federal Trade Commission at Vameuce.gov or contact them at www.consunw.govrjd&aft or 1- 877- IDTHEFT(438- 4338). Visit the IRS webelte at www.irsgov to learn more about Identity theft and how to reduce your risk. Section 6109 of the Internal Revenue Code requires you Igo provide your correct TIN to persona who must Gee Information returns ugh the IRS to report interest, dividends, and certain other Income paid to you, mortgage kftr*M you paid, the acquisition or abandorunent of secured property, cancellation of debt, or contributions you made to an IRA, or Archer MSA or HSA The IRS tries the numbers for identification purposes and to boo verify the accuracy of your tax return. The IRS may also Provide this information to the Department of Justice for civil and criminal litigation, and to titles, states, the District of Columbia. and U.S. possesslons to carry out their tax laws. We may also disclose arts sdormation to other cow tries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law entaoemerd and intsrigence agencies b combat lerrodsnn. You must provide your nN whether or not you are required to Rio a tax return. Payers must generaay wHhhold 28% of taxable interest dividend. and certain other Payments to a payee who sloes not give a TIN to a payer. Certain penalties may also apply. s J_ 011161,