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Fom w-g
<br />(Rev. November 2017)
<br />Dspartmflt of the Treasury
<br />lnt€mBl Rsvenue Seruice
<br />Request for Taxpayer
<br />ldentificatlon Number and Gertification
<br />) Go to wunrr.irs,govlFormWg lor instuctions and the latest intormation.
<br />Give Form to the
<br />requester. Do not
<br />send to the lRS.
<br />4 Exemptions (codes apply only to
<br />certain entiti€s, not individuals; see
<br />instructions on pag€ 3);
<br />Exempl payeo code (if any)
<br />Exsmptin lrom FATCA repoding
<br />code (il any)
<br />l,6Eplie. lo accounrc mdolainad oulsids ii€ U.S,)
<br />namo and addross (optisral)
<br />cunently subject to backup withholding because
<br />not apply. For mongage intersst paid,
<br />Ooodo"
<br />co.o!,Eo.oFa)
<br />otr2'6
<br />[.o
<br />oq,oo
<br />0o
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<br />1 Name (as shown on your tax relurn). Name is required on this llne; do not laavo this line
<br />AS NTY
<br />2 Busin€ss name, if dilfercnl trom above
<br />EVENT CENTER
<br />accounl
<br />Enter your TIN in tho appropriate box. The TIN provided must match the name given on line 1 to avoid
<br />backup withholding. For individuals, this is generally your social security number (SSN). However, for a
<br />resident alien, sole proprietor, or disragarded entity, see tho instructions for Part l, later. For other
<br />enlities, it is your employer identification number (ElN). lf you do not have a number, see How to get a
<br />I/N, later.
<br />Note: lf the account is in mora than on6 name, sea the instructions for line 1. Also see What Name and
<br />Number To Give the Fequesler for guidelines on whose number to enter.
<br />or
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on lhis form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
<br />2' I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the lntemal Revenue
<br />Service (lRS) that I am subject to backup withholding as a result of a failure to repod all inierest or dividsnds, or (c) the IRS has notified me that I am
<br />no longer sublect to backup withholding; and
<br />3. I am a U.S. citizen or other U.S. person (defined below); and
<br />4' The FATCA code(s) entered on this form {if any) indicating that I am sxempt lrom FATCA reporting is conoct,
<br />Gerlification insbuctions. You must cross out item 2 abovs if you have been notified by the IBS that you ars
<br />you have lailed to report all interest and
<br />acquisition or abandonment of secured
<br />dividends on your tax retum. For real estata transactions,ilem 2 doos
<br />property, cancellation of debt, contributions to an individual retirement arrangement (lRA), and genorally, paymenls
<br />must provide your correct TlN. See the instruclions for Part ll, later.other than interest and dividends, you are not required to sign the certification, but you
<br />Sign
<br />Here
<br />General lnstructions
<br />Section refersnces are to the lnternal Bevenue Code unless otherwise
<br />noted,
<br />Future developments. Forthe Iatest inlormation about developments
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, go lo www.irs.govlFormWg.
<br />Purpose of Form
<br />An individual or enlity (Form W-9 requestor) who is required to file an
<br />infotmation return with the IRS must obtain your correct taxpayer
<br />identification number fflN) which may be your social security number
<br />(SSN), individual taxpayer identification number (lTlN), adoption
<br />taxpay€r identification number (ATIN), or employer identification number
<br />(ElN), to report on an information return the amount paid to you, or other
<br />amount reportable on an information return. Examples of information
<br />returns include, but are not limited to, the following.
<br />. Form 1099-lNT (interest earned or paid)
<br />I
<br />. Form 1 099-DlV (dividends, including thoss from stocks or mutual
<br />funds)
<br />. Form 1099-MISC (various types of income, prizes, awards, or gross
<br />proceeds)
<br />. Form 1 099-8 (stock or mutual fund sales and certain other
<br />transactions by brokers)
<br />. Form 1 099-5 (proceeds from real estate transactions)
<br />. Form 1 099-K (merchant card and third party nelwork transactions)
<br />. Form 1 098 (home mortgage interest), 1 098-E (student loan interest),
<br />1098-T (tuition)
<br />. Form 1099-C (canceled debt)
<br />. Form 1 099-A (acquisition or abandonment of secured properly)
<br />Use Form W-9 only if you are a U.S. person (including a resident
<br />alien), to provide your correct TlN.
<br />lf you do not retum Form W-9 to the requester with a TlN, you might
<br />be subject to backup withholding. See What is backup withholding,
<br />later.
<br />3 Check appropriate box for federal tax classitlcation of the person whose name is enterod on line 1 . Check only one ol the
<br />following seven boxes.
<br />n tndividual/sote propriotor or E c corporatlon I S corporatlon n Parrnership ! Trusvestate
<br />singlB-momber LLC
<br />! t-imnea liability company, Enler the tax classilication (C=C corporation, S=S corporation, P=Parlnership) > _
<br />Notor Check lhe approPriate box in the line above for the tax classilication of ths single-member owner. Do not chgck
<br />LLC if lhe LLC ls classltled as a slngl€-membor LLC thal is disregarded from lhe ownir unless th€ owner of the LLC is
<br />another LLC thal is not disregatded from the own6r foJ U.S. federal lax purposes. Otherwise, a singlo-member LLC
<br />ls dlsregarded from lhe owner should check lhe appropriate box tor lhe tax classification ol lts owner,
<br />Oth€r COUNTY
<br />no.) Soo
<br />AVE, SUITE 1
<br />stre€t, and apt. or
<br />6 City, slale, and zlP code
<br />sscudty number
<br />Part I
<br />id6ntificalion number
<br />I I 6 0 0 1 3 4 I
<br />Part ll
<br />1Slgnaturs ot
<br />U.S. person ) I Date >zL
<br />Cat. No. 10231X Fom W-9 (Rev. 1 1-2017)
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