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Confidential
<br />t,xrn W-9 Request for Taxpayer Give Form to the
<br />t1i rymtINzm,n Identification Number and Certification sends th CIRnot
<br />Yr•t�•tnnr,ic >tric,im,��ar.; send to the IRS.
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<br />I i'l ""zount nuoihra{si irrxo k,f'hcaG +l)
<br />KM Taxpayer Identification Number (TIN)
<br />Ery er your TIN in the appropriate box. The TIN provided must match the name given on the Name tine Sccaai --rity mmber
<br />to avoid backup witlr'nolding. For individuals, this is your social security number (SSNi However, for a
<br />resident alien sole proprietor or disregarded entity, see the Part I instructions on page 3 For other
<br />entities, . it is your employer idenlitication number (EIN) . If YOU do not have a number. see HpµI to stet a
<br />'TiN on page 3
<br />Note, it the account is in more than one name, see the chart on page 4 for guidelines air whose Employer ideM#Kcat. numtwn
<br />number to enter I .,
<br />Under penalties of perjury.. I certify that
<br />1. The number shown on this fern is my correct taxpayer identification number
<br />for I am yearling for a number to be, issued to rne'r. and
<br />2, 1 am not subject to backup withholding because- Qa) I am exempt from backup
<br />„ithhotding, Or (W I have not been notified by the Internal Revenue
<br />Service (IRS) that lam subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that 1 am
<br />no longer subject to backup wahhclding, and
<br />3, Y am a U S citizen or other U.S person (defined below)
<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 failed to report all interest and dividends oil your tax return.
<br />For real estate transactions, item 2 does not spryly. For mortgage
<br />interest paid acquisition or abandonment of secured property, cancellation of debt contributions to an individual retirement arrangement (IRA), and
<br />gor —ally, payrnents other than hriereet and div'dends You are not required to
<br />sign the certification. but you rrfu'u-t proardr. you, convict TIN .See the
<br />instructions on page 4
<br />Sign Signature of
<br />Here U.S. person►
<br />Mile
<br />General Instructions
<br />Note. It a requester gives you a form other than Form W -9 to request
<br />your TIN, you must use the requesters form if it is substantially similar
<br />Section references are to the Internal Revenue Code unless otherwise
<br />to this Form W -g..
<br />noted
<br />Definition of a U.S. person. For federal tax purposes. you are
<br />Purpose of Form
<br />considered a U B person it you are
<br />A person who is required to file an information return with the IRS must
<br />• An individual voho is a U.S. citizen or U.S. resident alien .
<br />obtain your correct taxpayer idemitication number iTIN) to report, for
<br />• A partnership- corporation, company, or asaocfalion created or
<br />example, income paid to you. real estate transactions, mortgage interest
<br />organized in the United States or under the laves of the United States,
<br />you paid, acquisition or abandonment of secured property, cancellation
<br />• An estate tother than a foreign estate), of
<br />of debl, or contributions you made to an IRA.
<br />• A domestic trust !as defined in Regulations section 301 7701-7),
<br />Use Form VV-9 only if you are a U.S. person (including a resident
<br />Special rules for partnerships. Partnerships that conduct a trade or
<br />alien), t provide you careen TIN to the person request ng if (the
<br />requester; and, when applicable, ta.
<br />business in the Untied States are generally required to pay a :withholding
<br />tax of any foreign partnars share of income from such business
<br />1 Certify that 11% TiN you are giving is correct (or you are awaiting for o
<br />Fur. Cher, in certain cases where a Form W' -9 has not beers received. a
<br />number to be issued,),
<br />partnership is required to presume that a partner is a foreign person,
<br />2. Certify that you are not subject to backup withholding, or
<br />and pay the ewthholchng tax. Therefore if you are a U.S. person that is a
<br />3. Claim exemption from backup withholding if you are a U.B. exempt
<br />partner m a partnership conducting a trade or business in the United
<br />payee If applicable, you are also certifying that as a U.S. person, your
<br />States, provide Form W9 to the partnership to establish your U;S.
<br />allocable share of any partnership Income from a U.S. trade or business
<br />status and avoid withholdng on your share of partnership income
<br />is not subject to the withholrkng tax on foreign partners share of
<br />effectively connected income
<br />1,A No. M1311( I'airr W -0 {Rl'- Pe` 701 ij
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