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PROFESSIONAL SERVICES AGREEMENT
<br />ATTACHMENT "F"
<br />Form W-9
<br />Request for Taxpayer Identification Number and Certification
<br />Request for Taxpayer
<br />Identification Number and Certification
<br />Oiw Fonn to ihe
<br />NqUHltw. Do not
<br />NndtothellS.
<br />o,1 hiiiiiimi'iiiiimiiiiijiiitiiici'ocwimyniii;;:,..,...ijmio,,ji','!ci-iiiiiia1iiiiii1rn:miiiiii.,.,iix,iilljj, __________________________ _
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<br />8 D ,.,..,w.,,,._~ D oc.c,,,pc,nmc,n De~ D -., D -'I Blln'fll ........... (11~--.. D un-_., amnpany. B'llllr l'la la __ .., [C-C amp,mmr,. -""'l"'Nlal. P-~• Eoanpll:rl Ian FATCA.np,rlt,g
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<br />Q'Jlll[ )"OU'11N lnVllt ~l:IQlc. 11111 TIN~ rnustrn,Wfl:lt tne ITlllte i,ve,i· Oil 100 'N~· .. e
<br />1011/0t!I m<:1WP~'19. For lndhllelual8, mti. 11 ~11·socl111 ~ fltl'llber ~ HQ'ft,wet'. ror a
<br />m/Olflt af«l. 'llll9 ptipn1t01', or dlln!gan:ll!O omny, iSoN h! Pert I lrt:IINCU:llll ·1111 P8tl& !i. Fa 0111111' ermuea. n II yoir 11mplc,pr ldenUllcalloo m.mtlllr IE1NJ . n 1-'D'i i>o oat nave a ntaT1t>er, &ee How ID gll!l a
<br />TIN on page a.
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<br />runbllrlOldar.
<br />•Gill c.tification
<br />lhW parlllll8B ar parJa.y, I 081111)' tnat
<br />1. 11111 runbllr lll1DWn on 1nB 1'0lm • m,camict IIDpayar ldel1IIIICIIIIDI rlJmDllr {« I am Waatg 1llr a runDar ID I» IIIIIUIIII 1D mat, 8ncl
<br />2. hm n« w:,j~ to baclu.p Wlll!dl~ bll<laUM:fllj I am exempt ll't!ffl b&CIWp wttmcming, « lb) J 118\/9not bOClr1 natt111<1i,y 1nu 1fllmel ~
<br />SIN~ QRS} 11181 I am 11._,.IICI tobactu . .p ~~ u.a l'fl!S 01 a lllhn 10 ,eponaJ ~ or .,._.t!en:19; cr(c) tne ms he nOl!lled l'llll 1llill I 111J1
<br />llQ lofger sul:{iecl 10 bQcllup W1tntl0111ng, illlO
<br />a. 1 am a U.S. cttlzlan or CJlhllr U.S. penon p,nnec1 INIIDW), anr::I
<br />4. 1nll FATCA COCIBC8) antBnld on .. lllrm pr 811)') rdclSlll trwt I am --.pt Win FATCA rapor1lfll lB conact.
<br />Cldlllclban rllR'lll:IIDnL vou fll.lBI C10111 out 1111m 2 aba'1III n you naw tlNn nott t,,,-tn. IRS tnat ~ n ci.n-entty sf.t!ltci 10 tl80kt..p 'IQl)nddhg
<br />bacal.all you nave fllllld b repirt • lnlBnlBl and~ on yDUr 1111 ratum. For reat utam'lranuctl0f'I$; ~ 2 <10119 not apply. RH' rMft1Jllg9
<br />lnhlreUpi!JCI, Eq.ililltlori or a.blnclolmant or NCUllld p,q,ertv, cancaldon or Cld)t, C(!f1tll;l'U!IOflJ 111 an rni:a CSt.191 tDll19111enl ~ (IRA). anc:1
<br />Qellffllly, paymenbl OIi!&' 1111111 ln1BrNl anCI Cl'lldeftCII.. )'CIIJ aJ'I& not ~rad to al!JI lie i:emtauon, b:11 you mU5t p!1)"1dl! 'fOl1I COCN!!:I TJN . ~ Ult ~n=~ Hao ua.,--... _.,.
<br />General Instructions ___ 1o_......,._c..-__ _
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<br />Purpoee of Form
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<br />con-o,cn t.11111-ldoonl!lkll!Dn rvnl>or (IINJ to rqz,t, l>r -~.-p,lld ID
<br />)'Dia, pll)fflO<lm,_11>~111 ~or payil\lW"il.,....andffd ..-,y "'*""""
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<br />Page 18 of 21
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