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ATTACHMENT
<br />Form W-9 (Rev. 8-2013) Page 4
<br />What Name and Number To Give the Requester
<br />For lilts type of account:
<br />Give name and SSN of:
<br />1. Individual
<br />The Individual
<br />2. Two or more Individuals(lainl
<br />The actual owner of the account or,
<br />account)
<br />If combined funds, the first
<br />Individual on the account'
<br />3. Custodian account of a minor
<br />The minor'
<br />(Uniform Gift to Minora Act)
<br />4. a. The usual revocable savings
<br />The grantor -trustee'
<br />trust (grantor is also trustee)
<br />b. So-called trust account that le
<br />The actual owner'
<br />not a legal or valid trust under
<br />elate law
<br />6. Soba proprietorship or disregarded
<br />The owner'
<br />entity awned by an individual
<br />0. Grantor twat filing under Optional
<br />The grantor'
<br />Form 1099 Filing Method 1 (see
<br />Regulation section 1.671-4(1b)(2)(I)(A))
<br />For this type of account:
<br />Give name and Efflof:
<br />7, Disregarded entity not owned by an
<br />The owner
<br />Individual
<br />B. A valid twat, estate, or reason trust
<br />Legal entity'
<br />9. Corporation or LLC electing
<br />The corporation
<br />corporate status on Form 8832 or
<br />Form 2663
<br />1O. Association, club, religious,
<br />The organization
<br />charitable, educational, or other
<br />tax-exempt organization
<br />11. Partnership or multi -member LLC
<br />The partnership
<br />12. A broker or registered nominee
<br />The broker or nominee
<br />13. Account with the Department of
<br />The public entity
<br />Agriculture in the name of a public
<br />entity (such and a state or local
<br />government, school district, or
<br />prison) that receives agricultural
<br />program payments
<br />14. Grantor trust filing under the Form
<br />Thetford
<br />1041 Filing Method or the Optional
<br />Farm 1099 Filing Mathnd 2 (see
<br />Regulation seclian 1.671.4(b)(2H0(SI)
<br />' fust first end circle the name of the person whose number you furnish, if only one person on a
<br />joint account has an SSN, that Immune number moat be famished.
<br />e Circlathe mieei s name and furnish the mNm's SSN.
<br />.You must show your Individual roma and you may area enter your entrants of "DSA" mama on
<br />basic cau), bsust the INSencouraged
<br />ncourageo One. You may ase eitheryour SSN cr EIN If you
<br />you to use your 66N.
<br />°fist informed ctega the name of the tract, sal ate, or pension trust, (00 not (win lab To TIN of the
<br />Fewer re mandtoUse or trustee unless the legal entity itself Is utdoximuted In the account
<br />III Iw) Nee see 5peclafmfes rot ,finershlpson page 1.
<br />'No le, (I motor also meet provide a Form W-9 to tested of trust.
<br />Note. If no name Is circled when mare than one name Is listed, the number will be
<br />considered to be that of the first name listed.
<br />Secure Your Tax Records from Identity Theft
<br />Identity then occurs when someone uses your personal information such as your
<br />name, social security number (SSM, or other Idantifying Information, without your
<br />permission, to commit fraud or other crimes. An Identity thief may use your SSN to
<br />get a lob or may Ole a tax return using your SSN to receive a refund.
<br />To reduce your risk:
<br />• Protect your SRN,
<br />• Ensure your employer Is protecting your aSN, and
<br />• Be careful when cheating atax preparer.
<br />If your tax records are affected by Identity theft and you receive a notice from
<br />the IRS, respond right away to the name and phone number printed an the IRS
<br />notice or letter.
<br />If your tax records are not currently effected by Identity theft but you think you
<br />are at had: due to a lost or stolen purse or wallet, questionable credit card activity
<br />or credit report, contact the IRS Identity Theft Hotline at 1-800-908.4480 or submit
<br />Form 14038.
<br />For more Information, see Publication 4535, Identity Theft Prevention and Victim
<br />Assistance.
<br />Victims of Identity theft who are experiencing economic harm or a system
<br />problem, or are seeking help in receiving tax problems that have not been resolved
<br />through normal channels, may be eligible for Taxpayer Advocate Service RAS)
<br />assistance. You can reach TAS by calling the TAS loll -free case Intake line at
<br />1.877-777-4778 or TTY/TDD 1.800-829.4059.
<br />Protect yourself from auspicious smalls or phlshing schemes, Phlshinglsthe
<br />creation and use of anner and websites designed to mimic legigmate business
<br />emails and welselles, The most common act Is sending an email to a user falsely
<br />claiming to be an established legitimate enterprise in an attempt to scam the user
<br />Into surrer,daiing private Information that will be used for identity theft.
<br />The IRS does not Initlate contacts with taxpayers via emails. Also, the IPS does
<br />not rsgmm personal detailed Information through email or ask taxpeyere, for the
<br />PIN numbers, passwords, or similar secret access Information far their credit card,
<br />bank, or other financial accounts.
<br />If you receive an unsolicited email claiming to be from the IRS, forward this
<br />message to phlshing®trs.gov. You may also report misuse of the IRS name, logo,
<br />or other IRS property to the Treasury Inspector General for Tax Administration at
<br />1-808-886-4484. You can forward suspicious smalls to the Federal Trade
<br />Commission at: spam®uco.gov, or contact them at www..fhogovlfdtherf or 1.877
<br />1 DTH EFT (1-877-438-4338).
<br />Visit IRS.gav to learn more abort Identity theft and how to reduce your risk.
<br />Privacy Act Notice
<br />Section 6109 of the Internal Revenue Cade requires you to provide your correc YIN to pers
<br />file IRS to report Interest, dividends, or certain other Income paid to you; mortgage Interest'
<br />of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting th
<br />reporting the above Information. Routine uses of this Information Include giving it to the Dap
<br />of Columbia, end U.S. commonwealths and possessions for use In administering their laws,
<br />federal and state agencies to enforce civil and criminal laws, or to federal law enforcements
<br />whether or not you are required to rile a tax return. Under section 3406, payers must genera
<br />payments to a payee who does not give a TIN to the payer. Certain penalties may also start)
<br />75E-34
<br />s) who are required to file Information returns with
<br />candonmenl of secured property; the cancellation
<br />to the farm to file Information returns with tile IRS,
<br />it criminal litigation and to Gilles, states, the District
<br />disclosed to other countries under a (early, to
<br />)tnbat terrorism. You must provide your TIN
<br />arable Interest, dividend, and certain other
<br />
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