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For W-9 (Rev. 12-2014)
<br />Line 2
<br />If you have a business name, trade name, DBA name, or disregarded entity name,
<br />you may enter It on line 2.
<br />Line 3
<br />Check the appropriate box in line 3 for the U,S. federal tax classification of the
<br />person whose name Is entered on line 1. Check only one box in line S.
<br />Limited Liability Company (LLC). I1 the name on line 1 Is an LLC treated as a
<br />partnership for U,S, federal tax purposes, check the "Limited Liability Company"
<br />box and enter "P" In the space provided. If the LLC has Ned Form 8832 or 2553 to
<br />be taxed as a corporation, check the "Limited Liability Company" box and In the
<br />space provided enter "C" for C corporation or "S" fors corporation. If It is a
<br />single -member LLC that Is a disregarded entity, do not check the "Limited Liability
<br />Company" box; Instead check the first box in line 3 "Individual/sole proprietor or
<br />single-membar LIC."
<br />Line 4, Exemptions
<br />If you are exempt from backup withholding and/or FATCA reporting, enter in the
<br />appropriate space In line 4 any code(s) that may apply to you.
<br />Exempt payee coda.
<br />Generally. Individuals (Including sole proprietors) are not exempt from backup
<br />withholding.
<br />4 Except as provided below, corporations are exempt from backup withholding
<br />for certain payments, Including Interest and dividends.
<br />. Corporations are not exempt from backup withholding for payments made In
<br />settlement of payment card or third party network transactions.
<br />Pace 3
<br />'However, the following payments made to a corporation and reportable on Form
<br />MD-MISC are not exempt from backup withholding; medical and healthcare
<br />payments, attorneys' fees, gross proceeds paid to an attorney reportable under'
<br />section 6046(f), and payments for servlcas paid by a federal executive agency.
<br />Exemption from FATCA reporting code. The following codes identify payees
<br />that are exempt from reporting 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 farm
<br />for an account you hold In the United States, you may leave this field blank.
<br />Consult with the person requesting this form If you are premium if the financial
<br />Institution Is subject to these requirements. A requester may indicate that a code is
<br />not required by providing you with a Form W-9 with "Not Applicable" (or any
<br />similar indication) written or printed on the line for a FATCA exemption code.
<br />A—An organization exempt from tax under section 501(a) or any Indl i
<br />retirement plan as defined In section 7701(a)(37)
<br />S—Tire United States or any of its agencies or Instrumentalities
<br />C—A stale, the District of Columbia, a U,S. commonwealth or possession, or
<br />any of their political subdivisions or Instrumentalities
<br />D—A corporation the stock of which Is regularly traded on one or more
<br />established securities markets, as described In Regulations section
<br />11472-1(c)(1)(I)
<br />E—A corporation that Is a member of the same expanded affillated group as a
<br />corporation described in Regulation. section 1.1472,1(c)(1)(1)
<br />F—A dealer In securities, commodities, or derivative 1lnanci.l Instruments
<br />(Including notional principal contracts, futures, forwards, and options) that Is
<br />registered as such under the laws of the United States or any state
<br />e investment trust
<br />Investment company as defined In section 051 or an entity
<br />mes during the tat year underthe Investment Company Act of
<br />• Corporations are not exempt from backup withholding with respect to attorneys' Q—A real estat
<br />fees or grass proceeds paid to attorneys, and corporations that provide medical or Hlale
<br />health care services are not exempt with re—Aregud
<br />ritegistered spect to payments reportable on Form —Ane all
<br />1099-MISC. 140
<br />The following codes Identity payees that are exempt from backup withholding.
<br />Enter the appropriate code in the space In line 4.
<br />1—An organization exempt from tax under section 501(a), any IRA, or a
<br />custodial account under section 403(b)(7) if the account sallsfioe The requirements
<br />of section 401 (6(2)
<br />2—The United States or any of Its agencies or Instrumentalities
<br />3—A state, the DhArim of Coklmbla, a U.S. commonwealth or possessloa, or
<br />any of their political subdivisions or Instrumentalities
<br />4—A foreign government or any of its political subdivisions, agencies, or
<br />Instrumantalltton
<br />5—A corporation
<br />6—A dealer In securities orwmmodltles required to registerin the United
<br />Stales, the District of Columbia, or a U.S, commonwealth or possession
<br />7--A futures commission merchant registered with the Commodity Futures
<br />Trading Commission
<br />S—A real estate Investment trust
<br />9—An entity registered at all times during the tax year under the Investment
<br />Company Act of 1640
<br />10—A common trust fund operated by bank under section 584(a)
<br />'Ii —A financial hatit"fl ri
<br />12—A middleman known In the investment community as a nominee or
<br />custodian
<br />13—A trust exempt from tax under section 664 or described in section 4847
<br />The following chat shows types of payments that may be exempt from backup
<br />withholding- The chart applies to the exempt payees listed above, 1 through 13.
<br />IF the payment is for...
<br />THEN the payment is exempt far...
<br />Interest and dividend payments
<br />All exempt payees except
<br />for?
<br />Broker transactions
<br />Exempt payees 1 through 4 and e
<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 t through 4
<br />patronage dividends
<br />Payments river $600 required to be
<br />Generally, exempt payees
<br />reported and direct sales over$6,000t
<br />1 through 5'
<br />Payments made In settlement of
<br />Exempt payees i through 4
<br />payment card orthil'd party network
<br />fiewsactlWS
<br />I Sao Form 1800-MISO, Miscollaneous Income, and its instructions.
<br />I—A common trust fund as defined In section 584(a)
<br />J—A bank as defined In section 581
<br />K—A broker
<br />L—A trust exempt from tax under aection 664 or described in section 4947(a)(1)
<br />M—A tax exempt trust under a section 403(b) plan or section 457(g) plan
<br />Note. You may wish to consult with the financial institution requesting this form to
<br />determine whether the FATCA code and/or exempt payee code should be
<br />completed.
<br />Line 5
<br />Enter your address (number, atreei, and apartment or suite number). This Is where
<br />the requester at this Form W-9 will mall your Information returns.
<br />Line 6
<br />Enter your city, state, and ZIP code,
<br />Part I. Taxpayer Identification Number (TIN)
<br />Enter your TIN in the appropriate box. If you are a resident alien and you do not
<br />have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer
<br />identification number (ITIN). Enter it in the social security number box. If you do not
<br />have an TIN, see How to gets TIN below.
<br />If you are a sole proprietor and you have an FIN, you may enter either your SSN
<br />or EIN. However, the IRS prefers that you use your SSN.
<br />Tryon are a single -member LLC that Is disregarded as an entity separate from its
<br />owner (see Limited Llabiltty Company (LLC) on this page), enter the owner's SSN
<br />(or EIN, If the owner has one). Do not enter the disregarded entity's FIN, if the LLC
<br />Is classifisd as a corporation or partnership, enter the entity's EN.
<br />Note. See the chart on page 4 for further clariflcatlen of name and TIN
<br />combinations.
<br />How to get a TIN. If you do not have a TIN, apply for one immediately. To apply
<br />for an SSN, get Farm 55-6, Application for a Social Security Card, from your local
<br />SSA offfco or get this form online at wwwasegov. You may also get this to" by
<br />tailing 1 -Boa -7721213. Use Form W-7, Application for IRS Individual Taxpayer
<br />Identification Number, to apply for an ITIN, or Form SSA, Application for Employer
<br />Identifleatlon Number, to apply for an EIN. You can apply for an FIN online by
<br />accessing the IRS website at www.hp.gov/bmbhesaoa and clicking on Cmployer
<br />Identification Number (Elf undo)Starting a Business. You car, gat Forms W-7 and
<br />SS -4 from the IRS by visiting IRS.gov or by calling 1 -800 -TAX -FORM
<br />(1-000-829-3676),
<br />If you are asked to complete Form W-9 but do not have a TIN, apply for aTIN
<br />and write "Applied For" In the space for the TIN, sign and data the form, 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 />aTIN and give it to the requester haforo you aro subject to backup withholding on
<br />payments. The 60 -day ITi does not apply to other types of payments. You will he
<br />subject to backup withholding on all such payments until you provide your TIN to
<br />the requester,
<br />Note. Entering "Applied For" means that you have already applied far aTIN or that
<br />you intend to apply for ane soon.
<br />Caution: A disregarded U,S, artily that has a foreign owner must use file
<br />appropdato Form W -g.
<br />75L-60
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