|
ATTACHMENT
<br />Enter you rTINck inthe appropriate box.idU UN prosyou Moor marchsin Ung bar
<br />r($S ). •„� ,.u,,.- ....- � _L—t--� -
<br />to avoid backup withholding. For Individuals, this is your social securtty number (SSN). However, for a
<br />resident alien, sole proprietor, or dlsregarded entity, see the Part I instructions on page 3. For other
<br />entitles, it Is your employer identification number (EIN), If you do not have a number, see How to get a
<br />TIN on page 3.
<br />M
<br />Nate. If the account is In more than orae name, see the chart on page 4 for guidelines on whose Employer Identification number
<br />I I I
<br />number m enter.
<br />�'me, Po, w,.,o�... r...q...n • __...., ._....
<br />1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting fora number to be Issued to me), and
<br />2. 1 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 or dividends, or (c) the IRS has notified me that I am
<br />no longer subject to backup withholding, and
<br />3. 1 am a US, citizen or other U.S, person (defined below), and
<br />4. The FATCA code(s) 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 dividends on your
<br />of debt, contributiorano6otiono, Item 2 does not ns to an Individual retirement apply.
<br />nFor ot (IRA), and
<br />Interest paid, nentsioth or abandonment of secured property,
<br />nannranv. navmenls other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
<br />on
<br />Here
<br />General Instructions
<br />Section references are to the Internal Revenue Corte unless etherise noted.
<br />Future developments. The IRS has created a page on IRS.gov for information
<br />about Form W-9, at wwwIns .govlwg, Information about any future developments
<br />affecting Form W-9 (such es legislation 6, send after We release 11) will be posted
<br />on that page.
<br />Purpose of Form
<br />A person who Is required to file an Information realm with the IRB must obtain your
<br />correct aid to
<br />you, paymxents; made tlfication number o you In sad ement o)ftpayment cardlot x ndthird party Incomenetwork
<br />transactions, real estate transactions, mortgage Interest you paid, acquisition or
<br />abandonment of secured properly, canoellallon of debt, or contributions you made
<br />to an IRA.
<br />Use Form W-9 only If you ara 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 the TIN you are giving Is correct for you are waiting for a number
<br />to be Issued),
<br />2. CenUy that you ere not subject to backup withholding, or
<br />3. Claim exemption from backup withholding If you are a U.S. exempt payee. II
<br />applhabie, you are also certifying that as a U.3. person, your allocable skate of
<br />env rmm emhln Income from aU,S. bade or business Is not subject to the
<br />Date P
<br />withholding tax on foreign partners' share of effectively connected income, and
<br />4. Cedilythat FATCA codes) entered on this farm (if any) Indicating that you we
<br />exempt from file FATCA reporting, Is oonect.
<br />Note. If you are a U.B. parson and a requester gives you a form other than Form
<br />W-9 to request your"IN, you must use the requester's form if it Is subatantielly
<br />similar to this Form W -e.
<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 ellen,
<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 dellned in Regula Ions section 301.7791-7).
<br />Special rules for partnrships. Partnerships that conduct a trade or business In
<br />the United States are rienerelly required to pay a withholding tax under section
<br />1446 on any foreign Waste' share of effectively connected taxable Income from
<br />such business. Further, in certain cases where a Form W-9 has net been received,
<br />the rules under section 1446 require a partnership to presume that appartner Is a
<br />foreign person, and pay the section 1446 withholding lax. Therefore, If you re a
<br />U.B. person that Is a partner In a partnershlp conducting a trade or business In the
<br />Un0ed States, provide Form W-9 tothe prmershlp to establish your U,S, statue
<br />and avoid section 1446 withholding on your share of pennrehip Income.
<br />Cat. No. 10231X
<br />75F-53
<br />rum,
<br />(Rev, 9-2013)
<br />®
<br />Request for Taxpayer
<br />Give Form to the
<br />Foran
<br />(Rev. August 2013)
<br />identification (dumber and Certification
<br />requester. Do not
<br />send to the IRS.
<br />Department of the Treasury
<br />Internal Revenue Service
<br />Name (as shown on your Income iaz rehun)
<br />Business name/dlsregarded entity name, if dl rarenlfrom above
<br />m
<br />Exemptions (see lnstnlCllons:
<br />°
<br />o
<br />Check appropriate box for federal tax classiticatlon:
<br />❑ IndMdual/sole proprietor ❑ C Corporation ❑ S Corporation 0 Parimushlp ❑ TrusUestatu
<br />y
<br />Exempt payee code Qf any)
<br />0
<br />'�
<br />❑ Limited liability company. Enter the tax classification (0=0 comorellon,S=B corporation, P=padnership)>
<br />Exemption from FATCA reporting
<br />a
<br />code (if any)
<br />a a
<br />;�
<br />❑Other (see instruollona)►
<br />Address (number, street, end epi, orauIto a0J Requesters room, and address (optional)
<br />v
<br />City, state, and 21P code
<br />m
<br />List account namber(s) here (optional
<br />•
<br />Taxpayer Identification Number TIN)
<br />„•___„„ social
<br />armadillo, number
<br />Enter you rTINck inthe appropriate box.idU UN prosyou Moor marchsin Ung bar
<br />r($S ). •„� ,.u,,.- ....- � _L—t--� -
<br />to avoid backup withholding. For Individuals, this is your social securtty number (SSN). However, for a
<br />resident alien, sole proprietor, or dlsregarded entity, see the Part I instructions on page 3. For other
<br />entitles, it Is your employer identification number (EIN), If you do not have a number, see How to get a
<br />TIN on page 3.
<br />M
<br />Nate. If the account is In more than orae name, see the chart on page 4 for guidelines on whose Employer Identification number
<br />I I I
<br />number m enter.
<br />�'me, Po, w,.,o�... r...q...n • __...., ._....
<br />1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting fora number to be Issued to me), and
<br />2. 1 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 or dividends, or (c) the IRS has notified me that I am
<br />no longer subject to backup withholding, and
<br />3. 1 am a US, citizen or other U.S, person (defined below), and
<br />4. The FATCA code(s) 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 dividends on your
<br />of debt, contributiorano6otiono, Item 2 does not ns to an Individual retirement apply.
<br />nFor ot (IRA), and
<br />Interest paid, nentsioth or abandonment of secured property,
<br />nannranv. navmenls other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
<br />on
<br />Here
<br />General Instructions
<br />Section references are to the Internal Revenue Corte unless etherise noted.
<br />Future developments. The IRS has created a page on IRS.gov for information
<br />about Form W-9, at wwwIns .govlwg, Information about any future developments
<br />affecting Form W-9 (such es legislation 6, send after We release 11) will be posted
<br />on that page.
<br />Purpose of Form
<br />A person who Is required to file an Information realm with the IRB must obtain your
<br />correct aid to
<br />you, paymxents; made tlfication number o you In sad ement o)ftpayment cardlot x ndthird party Incomenetwork
<br />transactions, real estate transactions, mortgage Interest you paid, acquisition or
<br />abandonment of secured properly, canoellallon of debt, or contributions you made
<br />to an IRA.
<br />Use Form W-9 only If you ara 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 the TIN you are giving Is correct for you are waiting for a number
<br />to be Issued),
<br />2. CenUy that you ere not subject to backup withholding, or
<br />3. Claim exemption from backup withholding If you are a U.S. exempt payee. II
<br />applhabie, you are also certifying that as a U.3. person, your allocable skate of
<br />env rmm emhln Income from aU,S. bade or business Is not subject to the
<br />Date P
<br />withholding tax on foreign partners' share of effectively connected income, and
<br />4. Cedilythat FATCA codes) entered on this farm (if any) Indicating that you we
<br />exempt from file FATCA reporting, Is oonect.
<br />Note. If you are a U.B. parson and a requester gives you a form other than Form
<br />W-9 to request your"IN, you must use the requester's form if it Is subatantielly
<br />similar to this Form W -e.
<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 ellen,
<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 dellned in Regula Ions section 301.7791-7).
<br />Special rules for partnrships. Partnerships that conduct a trade or business In
<br />the United States are rienerelly required to pay a withholding tax under section
<br />1446 on any foreign Waste' share of effectively connected taxable Income from
<br />such business. Further, in certain cases where a Form W-9 has net been received,
<br />the rules under section 1446 require a partnership to presume that appartner Is a
<br />foreign person, and pay the section 1446 withholding lax. Therefore, If you re a
<br />U.B. person that Is a partner In a partnershlp conducting a trade or business In the
<br />Un0ed States, provide Form W-9 tothe prmershlp to establish your U,S, statue
<br />and avoid section 1446 withholding on your share of pennrehip Income.
<br />Cat. No. 10231X
<br />75F-53
<br />rum,
<br />(Rev, 9-2013)
<br />
|