|
PERSONAL SERVICES AGREEMENT
<br />w-g
<br />ATTACHMENT ''F''
<br />Form W-9
<br />Request for Taxpayer ldentification Number and Certification
<br />Requert for Texpayer
<br />ldentlf, catlon Hu,mber snd Cerfffl catlnn
<br />F hflmttir*rnl
<br />me.
<br />;L
<br />6
<br />EE
<br />:Tfi
<br />!I
<br />.St
<br />ffif,
<br />{iEr- *rgullslE
<br />OEdtwnqafEEsy
<br />Hqdtlffi3d6
<br />H'LH
<br />*.Edt
<br />gh!-rwsl
<br />UAi pnod!,
<br />{lsnera| lnctructlotw
<br />Sodtbc nlgcE alD AE hls[, ftsrH ft(tc [a5r oaffltc ndhd
<br />RlLE dtrhFrfr, nn lrl€l tEm# r FryEq El€G tr hh{ffit-ftltqr Fsn tY-O, rt 'w.Gop!r*!. tritsril-G &d m nFrc ffiEbdtEliE Frm rY-C |ldr G &glrl-Eh m*t aner ffi trlD q dt bri F.lDdqfl-tryn
<br />9rgpwof Foon
<br />A Fm *p IrE |lE k lt fi ffimdJ[r rdra It$ tE ffiA Elrt obfr FdEd lrFlE rt$lllcdbr ruH (nt{le reFcrl b Erpb, lm F b
<br />Frr F mdtr rrlb b Fr rr t ftnnl ol F nlrtt{ct rd*rtd Fty ifF*t[rttm, m, Elh Frmn+ ffilglgq tirn- tou Forcl. r$daim srFr.tfli5t.ll Hrd F€psfy, ryt€Cl|lrr oadrta. { Eqir&rataE Ft iltsio- lFl*-
<br />{,letum l|l! qttl trumr U-g psEl tnd.drE r rlds* !E* to
<br />Fo'ir3 yil, Effil Tll| to lF Fsm rqtathg I |rp EFstrl rld, *mrFdlalal lo:
<br />L ecrilfid t*ntlr Fr trgil.lgbdrr F yurc fllq k! rrrff
<br />tc bs hrdl.
<br />a Csl'y nra F., and r-Ctsd b lcbtF rril$oEhg. tr
<br />I Ctn dndoG nrr t-ls rfifr-p il EIrc. t,,a wEt M Iryg*r. puir rro sul.lg-lllt r I Ud l*wr,
<br />'ur
<br />.GoUri *rii arrt p-nE*+ !ffis llw I l},g. t{tn { trrfE| : mt drtlEt b ItE
<br />trqrdcr. Do rrct
<br />snd ioths' n8.
<br />EnmFatrE ls hdtnllr4
<br />E rE,rry.odsff-d_
<br />eleplh.i to.fl FAttnA rsforthg
<br />lqts Fnyl
<br />lltr F
<br />xitfaEadlqti u EE€n FrtlEl' frola DtFn$nrysr5tE{t lEqtrs, nct
<br />4. gstry trl F,qtcAc€de(* slqt ffi lhlr hc fififl ncirg ttrl Fr m.fldF fqr lEFAlg!.mFrlngr lrffiL
<br />15ts- lf yal ffi [ U-A- psEftrltl r EqJrb glE lst a tEEf, d*E tE FffifC{ b n+rd Fr Tl{ t@el. wtE EqEHr kn a lt k xJbtr'ltafdif lotrrlFmWJr.
<br />It-d6afi oi r U.t Ftrm FE HGI Ee F poa4 F.r mffiddrEd. {l9.
<br />FEo.r I lil G:
<br />. gft lrll{Erl *E l! {-Lg, lltgtq U.A, rr*Fa ttb.l
<br />. A Ftlfir{p, wF.llldr, E Fqi * rEltlcn crdxtq qErldt h ne
<br />LFrll !d AE { ur&lfp bcdlt3 thld Etlds.,
<br />r *r e.*r lbCE iulr ta!€n ube$ tr
<br />r I asmlg lr.ld lu lts.tFd ri FrEqd|iif, sltm t[}'!.mfi-ry
<br />+rfl flrr ls prtr*jltsa ftfis*rFcfid sdst r txb B :rrlEr tr
<br />Ele traE gErrc qflqr EEr.|d to rlt flat+Ellat4 rxlsEdqt!.# o rry brqn FiEr -ilb d clHtr64f srltdtffi lm rrn
<br />xnh lltfEa Flrltnr. ,t E{lilm *fr a Fdm lf,*O trt not bst rtorfild,
<br />grE Fr.r TIH lE tfE ryprogpte boc- Tn€ TlH Frstd(bd nHat llrstEh ffE rEn€ gtrEn ofi lfF 'Hrfls' lh6
<br />tB ed6 beclc+ *hhoklhg. Fsf llsilutfttsls. thl* ta rotr eoctet E€srlt? nrrb€f [39{lr Hs*E$$, fif Erglent eHr, qole FfuFrFtq, or frBrsgsrd$ emry. ss ta Pel I lnrflrc&fE trl FEga s. trtr srlsr
<br />sflHiles" 8t ts !0r slIrpoyBf frlefilmaflot nl''tbrf IE|HJ. tf yaru cto r€t tErE .e nsflbsr. s* r*a* lb lEl erinlo.!FqF3-
<br />t{tr" ft the ecotnt b Fl msq lfien ofE nEl?F. BFs s}€ E Bil! rn Fry { 60f grukts&le6 fi! utsss
<br />rx.rrE€r tB snlsf.
<br />trl{l6r F€lfff or F€rtlry, I cfftly lllEE
<br />l TIE trJmb€r ETFHE Ofi fl.3 lbnft E lnf ffirEct ExpEiEr lclrfiltllcslloc mm*a {H I srn rrffiE lE E rxrnbsr b bB, tsE{.Ed to 1'lr , 8no
<br />s. t_sl'l nor lg*t b Eeclo+ riftholdlrg b€Bi8s: F$ | sfn ffirnpt ksn baslorF utlmtrryl tr {bJ I h8lB rEt bsl nstn€d by 8ts *lbfrat Fgtltrr.sgtrrrce 0tr1 tEt I sm el{sct !o baEl{r* *?,thrFft$rE eB €l ErglrE st 8 EllI'? b
<br />'EFo{t
<br />ar fuE6t or {lrlcl€frE, s llBl Ele ns! '!r€a nsilkcl Ele lflat { em
<br />nG hfEs sfttsct tE bsdcF glrrrFldng!. erd
<br />g. l€Ilr a u-s. E$18!of slfEf u_s. psxosFslradF€b$4.8r*l
<br />{. lE r'lifCA {FtFtsl onHE(l oe ltl* ErT{ 0t IrqX hctc8lfrg fiEt I sm wnFd Eurn FATtrA rEforflr€ te eo{tKt.
<br />Cwtltcrtlolr lll.tucUnllr. You r'rlBl ffca flJt lhn s shocB if tfrr Il&lE b8€n rFxfEd by f* lHa tE! ysj cE sr{E r8y,sllqsct !o s*klry iltfihddklgyqrf til rsbfii. Ftr rg sstalc fEnEffifE ltem 2 {h6o nd +Fry- FEf rrltrtorys
<br />e3EE€alEloft d {ft|}t, Eontrt{Jtoas b trr EI'l/ttrral tgflr8rts.lt srsngefrn'rl {Rlt, s,Id
<br />nst rBqdEd to slgR ltE c€r8l'cslsr. ill ym mus,t F.Eyfds !flr Ds!*t TIH- g€a ths
<br />a
<br />[Ft-!5.srbt FdE
<br />lrd m*l rllll!
<br />€tEt lFFEFfb bor lEr b.tnl tlr !5$tar!qt:
<br />E lttclrarrr*r"p*frfo* E cc*p".*.r E ao-p**n E *tr*rp I rnra,ldrro
<br />f] l.:ntE l-lllt ffiFltf. gfir ?E br ohilGrf!.r lc-C dFrdbr\ B€ ffiporf,tr rL p-Fdtstrli:
<br />'Ei*6fi[rl$-, *E*, !E !F- s *b F-]
<br />Clly, !lr-, rd AF oqle
<br />H H
<br />Pail I
<br />tr*rt ll
<br />tt. l{d. l&9?I
<br />'ll!l5 d*!*thg e ydrrfqc oa
<br />Page 17 of 20
<br />F*E W-ll.Fs-g-rct.E
|