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ATTACHMENT
<br />Form W-9 (Rev. 8-2013) Page 3
<br />Exempt payee code. Generally, individuals (including cote proprietors) are not
<br />exempt from backup withholding. Corporations are exempt from backup
<br />withholding for curtain payments, such as Interest and dividends. Corporations are
<br />not exempt from backup withholding for payments made in settlement of payment
<br />card or third party network lransaallons.
<br />Note. If you aro exempt from backup withholding, you should still complete this
<br />form to avoid possible erroneous backup withholding.
<br />The fallowing codas Identify payees that are exempt From backup withholding:
<br />1—An organization exempt from tax under section 601(a), any IRA, or a
<br />custodial account under section 403(b)(7) If the account satisfies the requirements
<br />of section 401(1
<br />2—The United States or any of Its agencies or instrumentalities
<br />3—A state, the District of Columbia, a possession of the United States, or any of
<br />their polltical subdivisions or instrumanlalitles
<br />4—A foreign government wany of its political subdivisions, agencies, or
<br />Instrumentalities
<br />5—A corporation
<br />G—A dealer In securities or commodities required to register In the United
<br />Slates, the Distdct of Columble, or a possesalan of the United States
<br />7--A futures commission merchant registered with the Commodity Futures
<br />Trading Commission
<br />B—A real estate Investment trust
<br />9—An entity registered at all times during the tax year under the Investment
<br />Company Act of 1940
<br />10—A common trust rand operated by a bank under section 584(x)
<br />11—A financial institution
<br />12-A middleman known In the Investment Community as a nominee or
<br />custodian
<br />13—A trust exempt from tax tinder section 664 or described in section 4947
<br />The following chart shows types of payments that may be exempt from backup
<br />withholding. The chart applies to the oxempt payees listed above, l through 13.
<br />IF the payment is for...
<br />THEN ilia payment Is exempt 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, S
<br />corporations must not enter an exempt
<br />payee code because they are exempt
<br />only for sales of noncovered securities
<br />acquired prior to 2012.
<br />Barter exchange transactions and
<br />Exempt payees 1 through 4
<br />patronage dividends
<br />Payments over$600 required to he
<br />Generally, exempt payees
<br />reported and direct sales over $5,0001
<br />1 through 6s
<br />Payments mads in aettlement of
<br />Exempt payees l through
<br />payment card or third party network
<br />transactions
<br />t See Farm 1009-MISO, Miscellaneous Income, and its Instructions.
<br />'However, the following payments made to a corporation and reportable on Form
<br />10ge-MISC are not exempt From hacimp withholding: medical and health care
<br />payments, attorneys' fees, gross proceeds paid to an attorney, and pnymento for
<br />services paid by a federal executive agency.
<br />Exemption from FATCA reporting code. The following codes Identify payees
<br />that are exempt from repo cling under FATCA. These codes apply to persons
<br />submitting this form for accounts maintained outside of the United States by
<br />certain foreign financial Institutions, Therefore, If you are only submitting this form
<br />for an account you hold in the United Stales, you may leave this field blank.
<br />Consult with the person requesting this form If you are uncertain If the Inandal
<br />Institution Is subject to these requirements.
<br />A—An organization exempt from tax under section 501(a) or any Individual
<br />retirement plan as defined in auction 7701(8)(37)
<br />B—The United Stales or any of its agencies or Instrumentalllles
<br />C—A state, the District of Columbia, a possession of the United Stales, or any
<br />of their political subdivisions or Instrumentalities
<br />D—A corporation the stock of which 1s reg ulady traded on one or more
<br />established securllies markets, as described In Reg. auction 1.1472-1(c)(1)(1)
<br />E—A corporation that Is a member of the same expended affiliated group as a
<br />corporation described In Reg. section 1.1472-1(c)(1)(1)
<br />F—A dealer in securities, commodities, or derivative financial Instruments
<br />(Including notional principal contracts, futures, forwards, and options) that Is
<br />registered as such under the Imus of the United States or any state
<br />G—A real estate investment trust
<br />H—A regulated Investment company as defined In section 851 or an entity
<br />registered at all times during the tax year under the Investment Company Act of
<br />1940
<br />I—A common trust fund es defined In section 564(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 4947(a)(1)
<br />M—A tax exempt past under a section 40303) plan or section 457(g) plan
<br />Part I. Taxpayer Identification Number (TIN)
<br />Enter your TIN In the appropriate box. IF you aro a resident alien and you 00 not
<br />have and are not ellglbfe to gel an SSN, your TIN Is your AS Individual taxpayer
<br />Identification number (ITIM. Enter it in the social security number box. If you do not
<br />have an ITIN, see How to gat a TIN below.
<br />If you are a sole propdetar and you have an EIN, you may enter either your SSN
<br />or EIN. However, the IRS prefers that you use your SSN.
<br />If you are a single -member LLC that Is disregarded as an entity separate from Its
<br />owner (sue Limited Llatu ify Company (LLC) on page 2), enter the owners SSN (or
<br />EIN, If the owner has one). Do not enter the disregarded entity's FIN. if the LLC Is
<br />cleselfled as a corporation or partnership, enter the entity's BIN.
<br />Note. See the chart on page 4 for further clarificallon of name and TIN
<br />combinations.
<br />How to get a TI N. If you do not have a TIN, apply for one Immediately. To apply
<br />for an SSN, get Form 55-5, Application for a Social Security Card, from your local
<br />Social Security Administration office or get this form online at www.ssa,gov. You
<br />may also gel this form by calling 1-000-772-1213. Use Form W-7, Application for
<br />IRS Individual Taxpayer Identificntlon Number, to apply for an ITIN, or Form 88-4,
<br />Application for Employer Identification Number, to apply for on EIN. You can Oppty
<br />for an EIN online by accessing the IRS websita at wua0ro.9ov7bushoesses and
<br />clicking on Employer identification Number (EIN) under Starting a Business. You
<br />can get Forms Wd and SS4 from the IRS by visiting IRS.gov or by calling 1 -800 -
<br />TAX -FORM (1.800.829-3676).
<br />If you unasked to complete Form W-9 but do not have aTIN, apply for a TIN
<br />and write "Applied For" In the space for the TIN, sign and date the fano, and give It
<br />to the requester. For Interest and dividend payments, and certain payments made
<br />with respect to readily tradable instruments, generally you will have 60 days to get
<br />a TIN and give it to the requester before you are subject to backup withholding on
<br />payments. The 60 -day rule does not apply to other types of payments. You will be
<br />subject to backup withholding on all such payments until you provide your TIN to
<br />the requester.
<br />Note. Entering "Applied Far" means that you have already applied fora TIN or that
<br />you Intend to apply for one soon.
<br />Caution: Adfsregardsd U.S, entity that has a foreign owner must use the
<br />appropriate Form W -e,
<br />Part II. Certification
<br />To establish to the withholding agent that you are a U,S, person, or resident alien,
<br />sign Form W-9. You may be requested to sign by the withholding agent even If
<br />Items 1, 4, or below Indicate otherwise.
<br />For ajolnt account, Only the person whose TIN Is shown In Part I should sign
<br />(when required), In the case of a disregarded entity, the person identified on the
<br />"Name" tine must sign. Exempt payees, see Exemptpayee coda earlier.
<br />Signature requirements. Complote the cergflcatlon as Indicated In Items'I
<br />through 5 below.
<br />1. Inlsrss4 dividend, and barter exchange accounts opened before 1984
<br />and broker accounts considered active daring 1983. You must give your
<br />correct TIN, but you de not have to sign the certification.
<br />2. Interest, dividend, broker, and barter exchange accounts opened after
<br />1983 and Is raiser accounts considered Inactive during 1983. You must sign the
<br />cedihoaticn or backup withholding will apply. If you are subject to backup
<br />withholding and you are merely providing your correct TIN to the requester, you
<br />must cross out Item 2 in the certification before signing the form.
<br />3, Real estate Iruminations. You must sign the oedlfication. You may cross out
<br />Item 2 of the certification.
<br />4.0ther payments. You must give your correct TIN, bre you de not have to sign
<br />the certiffcaflon unless you have been notified that you have previously given an
<br />Incorrect TIN. "Other payments" Include payments made In the course of the
<br />requester's trade or business for rents, royalties, goods (other than hills for
<br />merchandise), medical and health core services (Including payments to
<br />corporations), payments to a nonemployee for services, payments made in
<br />settlement of payment card and third party network transactions, payments to
<br />certain fishing boat crew members and fisherman, and gross proceeds paid to
<br />attorneys Including payments to corporations).
<br />8. Mortgage Interest paid by you, scarlet lion or abandonment of secured
<br />property, cancellation of deb I. qualified tuition program payments (under
<br />section 629), IRA, Covert ESA, Archer MSA or HSA contributions or
<br />distributions, and pension distributions. You must give your correct TIN, but you
<br />do not have to sign the certification.
<br />75E-33
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