|
!t
<br />\
<br />,o,," llll-9
<br />{Rev, Dscembor 2014)
<br />Deoarlment ol ths Tr€asury
<br />lntirnal Revenue Seruico
<br />Request fot TaxPaYet
<br />ldentification Number and Certification
<br />Glve Form to the
<br />requester. Do not
<br />send to the lRS.
<br />does not applY. For modgage
<br />retlrem€nt arrangement (lBA), and
<br />on Iine;llne
<br />{as on your 1Bx
<br />New Suncadia
<br />General lnstructions
<br />, LLC
<br />name, lt dltferent above2cli
<br />d)ort
<br />CL
<br />co
<br />aOrcLoqE
<br />oC
<br />>o
<br />&4E
<br />(,oo,
<br />U'
<br />0){ug,
<br />4 Exemptlons {codas aPPIY only to
<br />certaln dntilies, not Individuals; seo
<br />lnstruotlons on Page 3):
<br />Exempl payee code (if anY)
<br />--*-Fx€mptlon from FATCA rePortlng
<br />code {ir any)
<br />Uppds. lo r.counls fttl^lajnsd oulEldo tte USJ
<br />Requesler's name
<br />Llst account
<br />I/N on page 3.
<br />Nofe. lf the account is in more than one name, see tho lnstruclions for line .l and the chart on page 4 for
<br />guldetlnas on whose number to enter.
<br />Under penaltios of perJury' I certify that:
<br />1 . The number shown on thls form ls my correct taxpayer identlficatlon number (or I am waitlng for a numbor to be issued to meli and
<br />2. I am not subject to backup withholdlng booausel (a) I am oxempt from backup withholdlng, or (b) I have not bean nolifled by tho lnternal Flevenue
<br />sorvtce (lRS) that I am subJoct to backup withhotdrng u" d i.ruii of a faiture to report all inlaresi irr dlvldends, or (c) the IRS has notifled me lhat I am
<br />no longer sublect to backup withholdlng; and
<br />3. lam a U.S. citlzon or oth€r U.S' person (defined below); and
<br />4. The FATCA ooda(s) entered on this form (lf any) Indicatlng that I am exempt from FATCA repoding is correct'
<br />are cunenllY sublect to backuP withholdlng
<br />Certllication instruclions. You must cross out ltom 2 above lf you have been notlfiod bY the
<br />or
<br />IRS that you
<br />transactlons,item 2
<br />bocause You have failod to report all interest and dlvldends on Your tax return, For roal estate
<br />lntelast pald, acqulsltlon or abandonment of secured ProPertY,cancel latlon of debt, contribuilons
<br />other and dividends, You are not required to sign tho certificatlon,but you must provlde your cotrect TlN. S€€ the
<br />3,
<br />Here
<br />(student loan interesl), 10s8-T
<br />to an lndluidual
<br />. Form 1098 (horne mongEge
<br />{tultlon)
<br />Sectlon referenoes ar€ to the lnt6nlal Flevenue Cods unloss otherwlse [oted'
<br />Future developm6nts, lntormatlon about dgvslopm€nts affeotlng Forrn W-s (such
<br />aiiJgtslaUon eiuoted after we release l$ ls at www'irs'gov/frv9'
<br />Purpose of Form
<br />An lndlvldual or antity (Form W-9 requsster) who is requhed.to llle an lnfotmatlon
<br />iii jilir;,,nf iltilnS'niri,t oftatn yourconeci taxpayer ldsntllloatlon number.(IlN)
<br />;#;i; ;;t; 6e vour iooial tu"uritv number (ssNi, i-ndlvldualtaxpsyer identlflcation
<br />il,'.iiiJi rlhr,tl
<br />"a"oiton
<br />tuxpuv"f nentillcation riumber (ATIN), or employer . . .
<br />;d,;;'iiil;iil'ffi-d-;iEri'tf i"'r"pott tn an lnformatlon ioturn lhe.amount pald to
<br />u*.'or-olr"i .*ount iepo'rtaUte bn an inlo/matlon return. Examplas of lnfotmation
<br />ieUlns inolude, but 8/e not Iimlted to, the following:
<br />. Form 1099lNT (lnterest eamed or pald)
<br />. Form 1099-DlV (dlvldends, lncludlng lhose from stock6 or mutual funds)
<br />r Form 1090-Ml$c (various types ol inoome, pflzes' awards, or gtoss prooeeds)
<br />. Form 1099-8 (stock or mutual fund sales and certain other transactlons by
<br />brokers)
<br />o Form 1o99'S (proceeds flom rsal eslate transactlonsl
<br />. Form 1099'K imerchant card and thkd party network transaolions)
<br />. Form 1099-G (canceled debt)
<br />. Form 1 009-A (acqulsition or abandonment of s€cured property)
<br />Use Form W-9 only lf you are a U.S, person (including a resident alien)' to
<br />provlde your eorrect TlN.
<br />tl vou do not telum Fo'm W-g lo ths rcquestet with a TlN, you mlght be subiect
<br />to b'ackup wlthholdtng. SBe Lvhal .ls back,p withholdlng? an page 2'
<br />By slgnlng lhe flll6d-out torm' you:
<br />1, Cerlily that th€ TIN you are glvlng is oorrBot (or you are waltlng lol a number
<br />lo be issued).
<br />2, cedlry ihat you ara not subJect lo backup wilhholding, or
<br />3. Clalm oxempllon from backup wllhholdlng if you aro a U'S' exemptpay6e' lf
<br />".,,-.ii.i6iJ,
<br />uiJ'riieitso certlfving'that as a U.5. parson, your allocable shara ol
<br />.ff i-"ttj,-,jiittlp t.come trom i Uls. trade or buslness ls not sublect to th€
<br />iiit fioiJlni i"i ""
<br />foreign partners' shalo ot offectivoly conneoted lncome, and
<br />4. C€rtitu that FATOA code{s} entared on this form [f any) lndicatlng that you ara
<br />"xumpi
<br />ti.im inu nefCA reporting, ls ooneot. S60 What is FATCA repoding? on
<br />page 2 tor furlher lnformallon.
<br />Other
<br />lndlvldual/sole proprletor
<br />slngle-member LLO
<br />Limlt€d llabllity company'
<br />Note, For a slnqle-member
<br />the lax classilloatlon of the
<br />LLC ihat is disregarded'
<br />slngle-member owner.
<br />box€s:69vgnihsofcheckfollowlngon6forboxtaxlederalclasslficatlonionlyCheck3approprlate
<br />TrusveslatetrsPartnershlponCorporatlonotCotpolationtr
<br />Ps=s P=partnorshlp)taxthe {c=cclasslflcatlon oorpolation,corporatlon,Enter
<br />aboveline lorlnboxlh6cheoknotcheckthedoLLC;appropriate
<br />and apt, or
<br />770 Suncadia Trail
<br />no,)
<br />6 state, and
<br />Cle Elum, WA 98922
<br />social secuilty number
<br />l-t t_ttt
<br />Pad I
<br />number
<br />I 3 1 1 63204
<br />Part ll
<br />Dale >Slgnature ol
<br />U,S. per6on
<br />Cai. No,102S1X FormW-96ev. 1z-2014)
|