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Form W-9 (Rev. 12-2014) Page 2
<br />Note. If you are a LLS. person and a requester dives 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 US.
<br />person if you are:
<br />• An Individual who Is a U.S. citizen or U.S. resident alien;
<br />• A partnership, corporation, company, or association created or organized In the
<br />Untied States or under the laws ofth. United States;
<br />• An estate (ether than aforeign estate); or
<br />• A domestic trust (as defined in Regulations section 301.7701-7).
<br />Special roles for partnerships. Padnerships that conduct a trade or bushman In
<br />the United States ate generally requ trod to pays Withholding tax under section
<br />1,146 an any foreign partners' share of effectively connected taxable income from
<br />such business. Further, In certain cases whore a Form W-9 has not been resolved,
<br />file rules under section '1446 require a partnership to presume that a pad net is a
<br />foreign person, and pay the capitol 1446 withhetdhig tax. Therefore, It you are a
<br />U.S. person that Is a pad net in a pannershlp 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 sec Hon 1446 withholding on your share of partnership income.
<br />In the cases below, the following person must give Form W-9 to the partnership
<br />for purposes of establishing its U.S. status and avoiding withholding on its
<br />allocable share of net Income from the partnership conducting a trade car business
<br />In the United States:
<br />• In the case of a disregarded entity with a U.S. owner, the U.S. owner o1 the
<br />disregarded entity and not the entity;
<br />• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
<br />the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and
<br />• In the case of a U.S, trust (other than a grantor treat), the U.S. trust (other than a
<br />grantor trust) and not the banafictaries of the trust.
<br />Fere tgn person. If you are a foreign person or the U.S. branch of a foreign bank
<br />that has elected to he treated a. a U.S. person, do not use Form W-9. Instead, use
<br />the appropriate Form W-8 or Farm 8233 (see Publication 515. Withholding of Tax
<br />on Nonresld.m Allans and Foreign Entitles),
<br />Nonresident alien who becomes a resident alien. Generally, only a nonresident
<br />alien Individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on
<br />certain types of income. However, most lax treaties contain a provision known as
<br />a "saving clause." Exceptions specified In the saving clause may permit an
<br />exemption from tax to continue for certain types of income even after the payee
<br />has otherwise become a U.S. resident alien for tax purposes.
<br />If you are a U.S. resident alien who Is relying on an exception contained In the
<br />saving clause of a tax treaty to claim an exemption from U.S. lax on regain typal
<br />of Income, you must attsoh a statement to Form W-9 that specifies the following
<br />five Items:
<br />1. The treaty country. Generally, this must be the same treaty under which you
<br />claimed exemption from tax as a nonresident ellen.
<br />2. The treaty crisis addressing the income.
<br />3, The article number (or location) In the tax treaty that contains the saving
<br />clause and Its exceptions.
<br />4. The type and amount of Income that qualifies for the exemption from tax.
<br />5. Sufflcfent facts to justify the exemption from tax under the terms of the treaty
<br />article.
<br />Example. Ad Iola 20 of the U.S.-China Income tax treaty allows an exemption
<br />from tax for scholarship income received by a Chinese student temporarily present
<br />In the United States, Under U.S. law, this stud ant will become a resident alien for
<br />lax purposes If his or her stay In the United Stales exceeds 5 calendar years.
<br />However, paragraph 2 of the first Protocol to the U.S: Chiha treaty (doted April 30,
<br />1984) allows the provisions of Article 20 to continue to apply even after this
<br />Chinese student becomes a resident ellen of the United States. A Chinese student
<br />who qualifies for this exception (under paragraph 2 of first protocol) and is
<br />relying on this exception 10 claim an exemption from tax on his or her scholarship
<br />or fellowship Income would attach to Form W-9 a statement that Includes the
<br />Information described above to support that exempden.
<br />If you are a nonresident alien or a foreign entity, give the requester the
<br />appropriate completed Form W-8 or Form 5233.
<br />Backup Withholding
<br />Win at is backup withholding? Persons making tannin payments to you must
<br />under certain conditions withhold and pay to the IRS 29% of such payments. This
<br />is called "backup withholding." Payments that may be subject to backup
<br />withholding Include Interest, tax-exempt Interest, dividends, broker and barter
<br />exchange transactions, rents, royalties, nonemployee pay, payments made in
<br />settlement of payment card and third party network transactions, and certain
<br />payments from fishing boat operators. Real estate transactions are not subject to
<br />backup withholding.
<br />You will not be subject to backup withholding on payments you receive if you
<br />give the requester your correct TIN, make the proper certifications, and report all
<br />your taxable Interest and dividends on your tax return.
<br />Payments you resolve will be seat act to backup withholding If:
<br />1. You do not furnish your TIN to the requester,
<br />2. You do not certify your TIN when required (see the Pert II instructions on page
<br />3 far details),
<br />3. The IRS tells the requester that you furnished an Incorrect TIN,
<br />4. The IRS tells you that you are subjeri to backup withholding because you did
<br />not extent all your murder and dividends on your tax return (far reportable interest
<br />and dividends only), or
<br />5. You do not codify to the requester that you are not subject to backup
<br />withholding under above (for reportable Interest and dividend accounts opened
<br />after 1983 only).
<br />Certain payees and payments are exempt from backup withholding. See Exempt
<br />payee code on page 3 and the separate Instructions for the Requester of Form
<br />W-9 for more Information.
<br />Also see Special rules forpadnerships above.
<br />What is FATCA reporting?
<br />The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign
<br />financial institution to report all United States account holders that are specified
<br />United States persons. Certain payees we exempt from FATCA reporting. See
<br />Exemption from FATCA reporting cede on page 3 and the Instructions for the
<br />Requester of Form W-9 for more information.
<br />Updating Your Information
<br />You must provide updated Information to any person to whom you claimed to be
<br />an exempt payee if you are no longer an exempt payee and anticipate receiving
<br />reportable payments In the future from this person. For example, you may need to
<br />provide updated Information if you are a C corporation that elects to be an S
<br />corporation, or If you no longer are fax exempt, In addition, you must furnish a now
<br />Farm W-9 if the name or TIN changes for the account; for example, If the grantor
<br />of a grantor trust dies.
<br />Penalties
<br />Failure to furnish TIN, If you fall to furnish your correct TIN to a rend cater, you are
<br />subject to a penalty of $50 for each such failure unless your failure is due to
<br />r .... cable cause and net to willful neglect.
<br />Civil penalty for false informa8an with reapepl to withholding. If you make a
<br />false statement with no reasonable basis that results In no backup withholding,
<br />you are subject to a $500 penalty.
<br />Criminal penalty for falsifying Information. Willfully falsifying aediflcatlons or
<br />affirmations may subject you to ofk incl pehalties including fines and/or
<br />Imprisonment.
<br />Misuse of Title. If the requester discloses or uses TINs In violation of federal law,
<br />the requester maybe subject to civil and criminal penalties.
<br />Specific Instructions
<br />Line i
<br />You must enter one of the following on this line; do not leave this line blank. The
<br />name should match the name on your tax return.
<br />If this Form W -e i9 for a lolnt account, list first, and then circle, the name of the
<br />person or entity whose number you entered in Part I of Farm W-9.
<br />a. Individual. Generally, enter the name shown on your tax retum. If you have
<br />changed your last name without Informing the Social Security Administration (SSA)
<br />of the name change, enter your firat name, the last name as shown on your social
<br />security card, and your new last name.
<br />Nate. ITIN applicant: Enter your individual name as It was ant cold on your Form
<br />W-7 application, line ia. This should also be the same as the name you entered on
<br />the Form 10401104CA/1040EZ you filed with your application.
<br />I Sole proprietor or single -member LLC, Enter your individual name as
<br />shown on your 1040/104CAfl 040EZ on line 1. You may enter your business, trade,
<br />or "doing business as" (DBA) name on line 2.
<br />c. Partnership, LLC that is not a single -member LLC, C Corporation, or
<br />Corporation. Enter the entity's name as shown on the entity's tax return on line 1
<br />and any business, trade, or ODA name on line 2.
<br />d. Other entities. Enteryour name as shown on required U.S. federal tax
<br />documents on line 1. This name should match the name shown on the charter or
<br />other legal document creating the entity. You may enter any business, trade, or
<br />DRA name on line 2,
<br />e, Disregarded entity. For U.S. federal tax purposes, an entity that Is
<br />disregarded as an entity separate from its owner Is treated as a "disregarded
<br />entity." Sae Regulations section 301.7701-2(c)(2)(lii). Enter the owner's name on
<br />line 1. The name of the entity entered on line 1 should never be a disregarded
<br />entity. The name on line 1 should be the name shown on the Income tax return on
<br />which the Income should be reported. For example, If a foreign LLC that is treated
<br />ae a disregarded entity for U.S. federal tax purposes has a single owner that Is a
<br />U.S. person, file U.S. owner's name Is required to be provided on line 1. If the
<br />direct owner of the entity Is also a disregarded entity, enter the first owner that is
<br />not disregarded for federal tax purposes. Enter the disregarded entity's name on
<br />line 2, "Business namefdlsrogarded entity name." If the owner of the disregarded
<br />entity is a foreign person, the owner must complete an appropriate Form W-0
<br />Instead of a Farm W-9. This Is the rasa even It the foretgn person has a U.S. TIN.
<br />75P-43
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