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— I <br />Form <br />Request for Taxpayer <br />Give Form to the <br />(Rev. August <br />Identification Number and Certification <br />requester. Do not <br />in. T <br />Cteinal not of the Treasury <br />Internal Revenue Served <br />SErld fO the IRS. <br />MlmelllaIi the W,7,r youri3O/l�l,C tax retnln) <br />—' � <br />Business name/disregarded entity name If different from above <br />m <br />m <br />n <br />Check appropriate box for federal tax p eificatlon: <br />5 <br />Exemptions (see Instructions)', <br />a <br />❑ Individual/sole proprietor C oration <br />p p p ❑ S Corporation ❑ Partnership ❑ Trust/estate <br />a c <br />o <br />Exempt payee code (if any) <br />oL <br />❑ Limited liability company. Enter the tax classifleation (C=C corporation, S=S corporation, P=partnership) P <br />Exemption from FATCA reporting <br />c <br />code (if any) <br />Q. <br />❑ Other (sae instructions) <br />;r <br />Addrress��s (number, street, and apt. or suite no.) <br />Requester's name and address (optional) <br />Cityyate, and ZIP code <br />>.'�y'� <br />List account numbers) here (optional) <br />• . <br />Taxpayer Identification Number (TIN) <br />Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line <br />Social security number <br />avoid backup withholding. For individuals, this is your social security numberHowever, for a <br />re <br />resident alien, sole proprietor, or disregarded entity, see the Part I instructions onn page 3. For other <br />-m <br />�n <br />entities, it is your employer identification number FIN). If you do not have a number, see How to gate <br />TIN on page 3. <br />Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose <br />Employer identification number <br />number to enter. <br />/ICI <br />rx <br />mil <br />®.... <br />Under penalties of perjury, I certify that: <br />1. The number shown on this form is my correct taxpayer identification number for I am waiting for a 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 lb) 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 to) 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 coddle) 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 failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage <br />interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and <br />generally, payments 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 3Z--"'-~ ,_ <br />Sign Signature of <br />Here I U.S. person Ir <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, at www.irs.gov/uv9. Information about any future developments <br />affecting Form W-9 (such as legislation enacted after we release it) will be posted <br />on that page. <br />Purpose of Form <br />A person who is required to his an information return with the IRS must obtain your <br />correct taxpayer identification number (TIN) to report, for example, income paid to <br />you, payments made to you in settlement of payment card and third party network <br />transactions, real estate transactions, mortgage interest you paid, acquisition or <br />abandonment of secured property, cancellation of debt, or contributions 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 the TIN you are giving Is correct (or you are. waiting for a number <br />to be issued), <br />2. Cattily that you are not subject to backup withholding, or <br />3. Claim exemption from backup withholding if you are a U.S. exempt payee. If <br />applicable, you are also certifying that as a U.S. person, your allocable share of <br />any partnership income from a U.S. trade or business is not subject to the <br />Date li� t) L..) _. 770 `MV I !;— <br />withholding tax on foreign partners' share of effectively connected income, and <br />4. Certify that FATCA coasts) entered on this form (if any) Indicating that you are <br />exempt from the FATCA reporting, is correct. <br />Note. If you are a U.S. 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-9. <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 la a U.S. citizen or U.S. resident alien, <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 defined In Regulations section 301.7701-7). <br />Special rules for partnerships. Partnerships that conduct a trade or business In <br />the United States are generally required to pay a withholding tax under section <br />1446 on any foreign partners' share of effectively connected taxable income from <br />such business. Further, 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 tax. Therefore, if you are a <br />U.S. person that Is a partner in a partnership 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 withholding on your share of partnership income. <br />Car. No. 10231X Form W-9 (Rev. 8-2013) <br />