ATTACHMENT
<br />to ter your TINavoid back p the appropriate Forhex. The ls, t is Is you muss mann int mote gw SN). H ,� ' -
<br />to avoid backup withholding. For Individuals, this Is your social seeudfy number (SSNJ. However, for a
<br />disregarded entity, see the Part I Instructions on page 3. Forother
<br />®
<br />Request for Taxpayer
<br />Give Form to the
<br />Form
<br />fill August 2013)
<br />identification Number and Certification
<br />requester. Da not
<br />send to the IRS.
<br />Department of the Treasury
<br />Internal Revanue Ssruice
<br />Identification number
<br />I
<br />mEmployer
<br />I
<br />I
<br />Name (as shown on your Income tax return)
<br />Suslness name/disre9erded entity name, if different from above
<br />m
<br />°-
<br />Check appropride box for federal tax classlflcation:
<br />Exemptions (sae instructions):
<br />O
<br />❑ Individual/sola proprietor ❑ C Corporation ❑ 3 Corporation EJ partnership ❑ TmsVestate
<br />y o
<br />Exempt payee code Of any)
<br />t�
<br />F-1 Limited liability company. Aller the tax classification (C=C corporation, 8=3 corporation, P=pednerehlp)>
<br />Exemption from FATCA reporting
<br />`o L
<br />code (if any)
<br />y❑
<br />Other (see instructlons)►
<br />address (options))
<br />AUdress (number, alreet, end apt. arsons an.)
<br />a,
<br />]-F�eq�uooer'8and
<br />Cfly, state, and ZIP code
<br />m
<br />N
<br />List account numbor(s) hero (optional)
<br />•
<br />Tax oyer Identification Number (TIN)
<br />to ter your TINavoid back p the appropriate Forhex. The ls, t is Is you muss mann int mote gw SN). H ,� ' -
<br />to avoid backup withholding. For Individuals, this Is your social seeudfy number (SSNJ. However, for a
<br />disregarded entity, see the Part I Instructions on page 3. Forother
<br />_ m _
<br />resident alien, solo proprietor, or
<br />entities, it Is your employer Identification number (EIN). If you do not have a number, see How to get e
<br />LJJ--f—f
<br />TW on page 3.
<br />Nate. If the account is in more than one name, sae the chart on page 4 for guidelines on whose
<br />number to enter.
<br />Identification number
<br />I
<br />mEmployer
<br />I
<br />I
<br />Under penaites 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. [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 ordlvidends, 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 code(a) entered on this form (if any) Indicating that I 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
<br />because you have felled to report all Interest and divired property,
<br />on cncellationreturn,
<br />of debt, contributions to an individual retirement em 2 does not apply.
<br />arrangement (IFor RA), and
<br />Interest paid, mantoioth or abandonment of secured property,
<br />nanarally. navmenls other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
<br />Instructions on page 3.
<br />Sign Signature of
<br />Here U.S. person 0,
<br />General Instructions
<br />Section references are to the Internal Revenue Code unless otherwise noted.
<br />Future developments. The IRS has created a page on IRS.gov for information
<br />about Form W-9, atuAVW IM40VAV9. [marination about any future developments
<br />affecting Form W-9 (such as legislation enacted after we release Ii will be posted
<br />on that page.
<br />Purpose of Form
<br />A person who Is required to Its an Information return with the IRS must obtain your
<br />correct taxpayer Identification number (11N) to report, for example, Income paid to
<br />you, payments made to you in settlement of payment card and third party no twork
<br />transactions, real estate transactions, mortgage interest you paid, acquisition or
<br />abandonment of secured property, cancellation of debt, orconldbutton6 you made
<br />to an IRA.
<br />Use, Form W-9 only If you are a U.S. person Including, a resident alien), to
<br />provide your correct TIN to the person requesting It (the requester) and, when
<br />applicable, to:
<br />1. Certify that lheTIN you are giving Is correct (or you are waiting for a number
<br />to be issued),
<br />2. Certify that you are not subject to backup withholding, or
<br />3. Claim exemption from backup withholding if you are a Ui exempt payee. If
<br />applicable, you are also certifying that as a U.S. person, your allocable share of
<br />env oadnamhlo Income from a U.S. trade or business Is not subject to the
<br />Data P
<br />withholding tax on foreign partners' share of effectively connected Income, and
<br />4. Ca1IWhet FATCA code($) entered on this form (if any) Indicating that you We
<br />exempt from the FATCA reporting, is Centel.
<br />Note. If you are a US, 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 -g.
<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 to a U.S. citizen or U.S, resident alien,
<br />A parn irship, corporation, company, aassociation created or organized in the
<br />United States or under the laws of the United Slates,
<br />• An "late (other than a foreign social, 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 />tha United Stales are generally required to pay a withholding tax under station
<br />1446 on any foreign parmase' share of effectively connected taxable Income from
<br />such business. Fudher, 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 lax. Therefore. If you are a
<br />U.S. person that Is a partner In a padnemhip 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 Wihholding on your there of partnership Income.
<br />Cat. No. 102SIX
<br />75E-31
<br />Form
<br />B-2013)
<br />
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