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tu.nrW€iFlsv, le$rsl P"ss 5
<br />1, lileFE€t, dlvldend, end barter excliange sccbufiis dpan{#
<br />betol€ 1$&{ €nd broker eccount€ coneldei€d ectlva durino 1963,
<br />You must givs yourcoff€ct TlN, but you do not haw to .sign th€
<br />cFrtification.
<br />I lntere*t, dlvldencl, broke r, snd barter ecchaffie sccounls
<br />operfed qft6i l$de dr*t bfok€r socbunt* con*Hercd lnectlre durhd
<br />1S63, You. m ust sign lhe certificatbn or bac kup withholdtng vrill appF.-lf
<br />)pu erg .Eubjsct lo backuF l(ithholding end you srs m€rsly proliijing
<br />lour coff.€ct TIN t0 th.s r€qusst€r, yo! must,cross out it€m 2 in th€.
<br />csnifibathn bqtor€ signing th€ forrn.
<br />f HEgl €6fsf€ iramactlons. You must sign thc c€nif icetion. You rile.r'
<br />cross oul h€m 2 ot th€ c€rtification.
<br />+ Other peymenls, You mlst Sivs your cor€ct TlN. but you ds not
<br />hale io s&jn fi€ c€nification unhss you hev€ b€€n notif iddlhar you
<br />hsve Fr€viously gimn an incorEctTlN. *Stherpeymsntg't inclu*i
<br />paym€nts msde in th€ cours€ ot th€ ldqu€stsi's trad€ or busin€ss fof
<br />r€ nts, royaltiss, g{rc{Ls [oth€r then bi lh tor m€rc hendh€l, rn€d hel and
<br />hselth cer€ dlrvicei fincluding paymsntE to corporationsl, paym€ntq to
<br />a non€m Fl{I/ae for servicss, Faymsnls mad€ in ,sttl€m€nt of payment
<br />cerd 4rid thhd Fefly mhirbrk liansection.s, paym€nts !o ienAin fishinq
<br />boel cr€w n€mbsrs snd fishermen. and gross pfttc€€ds paid to
<br />attolneys [inc I udin g peyft € nts to csrForation.€I.
<br />f niloilOrage lnreredl pald byyou, ecqulsltlon or abandonm6ntflf
<br />aecurcd piopefly, csncolladonof debrr, quellfled tulrlsn Fro0rempeymefit€ lunder rectlon 5!9], ABLE sccouilts luirder secrlon 52sAi,
<br />lRA, Cor€rdell eBA, Arclror MSA or HSA r,oiltrlbuions or
<br />dbrrlbutlonf, hnd peffilondl€triburloffi. You must giw yourcorr€ct
<br />TlN, brit you do not har/e to iigfi ths csrtificatioB.
<br />What Name and Number To Give the Fequesler
<br />For
<br />nth
<br />Fdhodture In tfF rianrB ofa pilbtc
<br />Fldty € rch # a {tatF ai ts8l
<br />gsi€lnf,rBnt, sclEel detlsl, or
<br />pft sori} lhat Foqvgg agns/tunl
<br />p rtlglaf,l pay ntBnis
<br />l5- Grarior lruetihf, I rnder the Farm
<br />l04l F'lr f, I Helicd sr tnEOfi oll{l
<br />Forrn r0O0 Frl' ng lleltod I
<br />ffiton I A7t-4(
<br />namd EIN ofr
<br />qBp*df,rcit TIE oubl,tr Bo ty
<br />TIE lru6t
<br />t,
<br />FDrThE of sccouilt;GIv€ neme ettd 5€H otr
<br />TtF
<br />TIE actrsl s.JrErci{lhB ffiufit or, rl
<br />cOdlbrn€d fufids. tlEfrrgt rfdrkrdual on
<br />tr€ irtountl
<br />E{*h rEadel of llE nr{ourtt
<br />Tte nrm/
<br />Trc gtantol-t.nt*'
<br />TrB amua uvrmr'
<br />Trp sfnerj
<br />TtE glentof
<br />daaftsl
<br />I*g* enatl{
<br />IIF Erooreloh
<br />TIF o(gsftraton
<br />ThF. partrpr€ht
<br />TIF uret€rqtEnriffi
<br />I Llstiir.stendchclq the name olth€ psr.son whcas numb€ryo! furnlsh.
<br />ItonvOn€ Fsrson on a jilintaccount hdsan $SN, thel psrson'.s numbsf
<br />filust b€ furnish€d.
<br />: Circls ths minorrs name and furnish th€ minor's.S$N.
<br />! You must sha'v/ iiour. indlviduel nam€ and vou mav elso €nt€r vour
<br />busino.ss or DBA iamg on th€ "Busin€-ss neine/dirrbgarded cntity"
<br />nems.lln€. You may Us€ dith€r l'sur.SsN or EIN [if you hevs on€], but th€
<br />lR$encouraqesrlqu to use your $.SN.
<br />{ Llgt tirst end ckcls the name of th€ trust, €stat€. or trsnsion trust. tD+
<br />nol lurnish th€ TIN ofth€ p€rscnal r€Fr€.s€ntatiw ot trusl€€ unlq.ss ih€
<br />lsgelsntiry ih{ilf ir notdssidnet€d in the eccount titl€.1 Alsos€s Speeial
<br />riJ,bs.fal p|lr0lefshiilq sarlis r.
<br />lNct$ Th€ grantor also m ust provld€ e Form W-g to trust€€ ol lrust,
<br />Itlole; lf no nem€ GciFrlsdr#hsn mors than cn€ nam€ E listsd, th€
<br />null1bar will b0 considsred to bs thal of ths f irEt nane li+ed.
<br />Secure Your Tax Hecords From ldentity Theft
<br />ldantity thett cccurs whe n somqons usss your p{rsonal lnlormetion
<br />€uc h ,as you r fi enis. $Slr,l, or 6ther ids ntif yin g intormethfl , without you r
<br />Fsrml4slon, to commit faud or oth€r crim€s. An ldanthy thkf rnay use
<br />your ggN to g€t e lob or m4V fih a tsx rstlrn usi[{ lrlour$SN lo rscsivs
<br />a rsfund.
<br />To reduce your rigkr
<br />' Frotect your SgM.
<br />; Ensurs your smphryer k protecting pur 93N, and
<br />. Ee carslul when chcosing a ar Freper€r.
<br />!!yourtix rscdriJgers affect€d try lienthyth€ftandyou r,scgiw a
<br />notic€ ffom th€ lRg, fqspond ihht ewer to thE name and phone number
<br />print€d $n th€ IRS fiotic€ or htt€r,
<br />ll yourtax rscord,E aje not cur€nt[/ eff€cted by ldentitg thelt but.you
<br />think yeu ar€ et fEk due to a hst or giolsn Furbe df well€l, qqsslionablil
<br />credit card aciivity or crsdil r€ Fort, contect th€ IRS ld€ntity Th€it Hotiine
<br />st 1 .800.909.44S0 or .!1lbmil Form 14419.
<br />F5r mdr€ infoimetion. s6e Fub. 5fl27, ld6ntity Th€ft lntormation lor
<br />Texpeyers.
<br />Victims of identhythsft who are experkncing economic herm or a
<br />systemk Frabls#, orer€.ss€king h€lp in r€solving tax problsms$at
<br />helE not bsen'r€soh€d through.normel channsls, may bs.€l'E ibh for.:
<br />Taxpaysr Adlgcats $orvice ffASI "ssistarrce. You cari'r€ach TAS h/
<br />celling ths TAS tall.freecaE€ intek€ lins et {.9??.7??.-+??8 oTTTYfTDD
<br />1 "8fl0.829.4.05s.
<br />Frolect yo urueli f ro m cusp lcloul €melld o r phlshl ng echem€*,
<br />Fhi$hing isthe creatian end use of'emailgnd u*bsitesdesigned to.
<br />nimic lsgitimat€ busin€qs smsils end luqbsitss. Th€ mosl common act
<br />i,s,s€nding en emeil to e ussrlatssly chiming to be en €s'tabihh€d
<br />lcgitimsts €nt€rprEs in an att€mptto scgm ih€ u€€i intosurbndsring
<br />prlvet€ informstion that will b€ ussd for iJsntit/ thAft.
<br />2 frjo qr ntore rndvrddals (tq fit
<br />sE|oufit dtl€r lh4h en airo dnt
<br />nnntarrxd by. an FFI
<br />{ TriDor f,raB U.T. peEoffi
<br />qom€E{odflt nrarit*rEd B an FF0
<br />4: Ci€tldral acmunt sl * n\tfrl
<br />iudftrnl 6ft to Mrrbra,!c9
<br />g a. T16 'Jtual iEtoffibl€ saurEs trdt
<br />{gJanbrrs €lso tfHl*)
<br />b. S+aallEd iiuit'ataour|tthet is
<br />4 lqtl or ldrd ttudt drdBf staie laVJ
<br />A Sds pbprarior€h g o. dteGgd,d€d
<br />€rtlt grarEd by enrrd't/rdlJ|,l
<br />T,.Sltnlor trdt tl'ng lnd€r Oatonal
<br />Forir U€6Fhrg MetH I Fes
<br />El€gudtorB €*toft .l .g/r -d(blq0)
<br />FDr thh ol
<br />an
<br />rrdvrdrral
<br />4A lald trml, €sti.i6, or F€ffirgn trrEt
<br />10. Coigoreton ar LLC dstrE
<br />mrporatestetu on Fornr €842 or
<br />Fornr't553
<br />I t, Aglo(rsnbfl, ddn, ta'go'JE,
<br />ChaitadB, edHioffl. or otlE. tilr-
<br />s€nr0t oq+nraton
<br />12. FafiffiEllp or fidt-f,ref,rbEr LLC
<br />13. A blol(Fi ot €ltstE€d mtrrrF6
<br />Professional Services Agreement
<br />Page25
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