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<br />l,ll-g Request for Taxpayer
<br />ldentification Number and Certification
<br />) Go to www./rs ,govlFormW9lor instructions and the latest information.
<br />Give Form to the
<br />requester, Do not
<br />send to the lRS.
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<br />Matt Webb
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<br />Number {TlN)
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<br />TlN. later.
<br />Note: lf iiitt rlacaiiIi is r' il'tre iilari Lr're irair{). see llrc {1siiljair:rt's lar i,',t' 1 A;sn see itihiti
<br />^;.nrj'o llt,sr's>i::r Tt C;/t: lhc {1():)ir:::}llr fcr rlu:delines or' lyitose r:ir'}tber lcr ?.rler.
<br />li!filll Certification
<br />lr'rle pur'r,t,..s r ilp'.,r:.,. I it,,11tfi th1!
<br />.rc ir)frqer sribteci to irackitp witllloldirtq: an|i
<br />.t. rarir;i LI.S" ctlizer: er olller i.j.S Oerslr,j idefrne.l Delr\",,i :tnJ
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<br />Cerlification instruclisns, You .riisi cross ort ilem 2 abr:ve I
<br />,lsrj irave iaiie{l t(, fopor all;rrt€rest arlrj dividerds on yolir
<br />:r.(i.r .lir,, . l :lrf {l,,rrr}rrl.l r:l Jrr i[-d
<br />ha,r: t,eer not,iied b'; ihe lli!,i lhal yor: are curenliy sL,bjccl lo backrtp uithhcldirlg Dec^use
<br />Fo rryiil esiale tra!ri,?i{:;:icils rlerl i'doe: rrol apply. FLrr rnorlga!)e ilrle.es1 pa;d,
<br />c.rilliil,!lion:i lu lir tlci,,rairt3l i?lrtvr:31;1 artilr:qe:Icr]l iltiAl
<br />itP{rtt,-'iliior), l'jiil vl1: iitljsl 0ro!;i.jaj v'.1rii :Or;eCt llN See:he rnSollrea 1i1.1il inleresi ard,ii,/;{Ji,iroi req.;i.ed to
<br />;lIi I rjerrer ali'1, pay{ltj11:,
<br />lrrrcilons loi Pi.1 il l:lltf.
<br />$ign
<br />Here
<br />Signature of
<br />U.S. person >-7-72-
<br />General ln
<br />Seclion references ?ire io lhg lr]lernai Br:r,entre Colie !liliesg olheru,,ise
<br />no !c{i.
<br />Fulure developments. trot lhe l.1les! ,ntornlaliolr aboLlt d€velllpnre.ls
<br />rel:ltect iO F{llrr W g ilnil ils JnsirilCtic,ls Suclt as le(jislaliol e'.acte(l
<br />af ter they v",ere E ubiisheil t)a t..\ w'tw.ir:;,goviFatmwg.
<br />Purpose of Form
<br />Atr ilrtjivrrltlti tr enl,ly {Forrrr W-l reqtresler) ilho ls reqirjte,: lo lile ar:
<br />infoillaiton fetufrr r'rilh the lgS iiusl cbta:n your correct taxp:tvct
<br />rdentitrcal:on nurnbsr i-lfl) wh ch rl)ay be you/ s.cral security number
<br />{SSN), rnriividual taxpayer idenlificrtion nut'lber ilTiN) adoptior.l
<br />laxpayer idontiiioili;on nLjtTlber {ATlNi, or r:rnploycr idcrililicatiotr nu.trtlcr
<br />(ElN) to reparl on,:n rnlcanlairon ral.l,n lire itmcunl piilrl to you, 1-.1 olitrt
<br />:la{rurrt rcporiable on al infoantall,lr reli.ltfi. Exarnplus lt irrforrrritiion
<br />retrrns ;nciride, b[i a16 not lirlited kr, lhe tollollir]a-
<br />, Fofin 1t)99-li\jT iir.lterest earoe.j or paic.i)
<br />Date )
<br />. Fonlr 1Oilg-t)lV ldivrrJericis, rlrolrciirrq lhose lil)nr slccKS o|rLrttial
<br />{tl,'6.i
<br />. Forn l (-t99-MISC ivrrrioils lvpes of iilcor're, rr,zes. aw;trrs, or gr.ss
<br />pt oceeds)
<br />. Foilri 1099-B lslock ar''r,jluai il,!r(j sales and cenain other
<br />Ir arrsactiorrs i;y irrr:kers;
<br />. Fornr 1 OJg S illrocceds ircrrt real eslate iransactrans)
<br />r Fonrr l0fi9-l{ i'n8r{:lr:lr1l.ar'(i,ilrc th,r{i pady r)ellvork tr.rrsitclr.n:i)
<br />. Forrn 1096 ihonre rnon(:aoe rrleresl), 1{)1}{t-[ rsi,riierrl lo;]n interesl].
<br />1 3t6-l itu;tioni
<br />r i;eyy;1 lggB-l) iu,Ircek"'ri debti
<br />' f ornl 1()alg.i1 (;ri,-ili,rsiticn or i]hanoonnrent ol ser;rrreri plcpe(v)
<br />{lse Fc}nrl W-9 only i{ yorr are a U.S. person iincluding a fesident
<br />;iiicni, to provi{le your ci).,rct TlN.
<br />ll ,/otj ilc oot ieluri) f-tm W-9 lo ihe lequestct vtith a TlN,
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<br />l,e s.,l)ecr lc\ backup withholciinq See What is irnckup withholdin!.
<br />lalet.
<br />Cr1 No 1C?.i1X rorn W-9 (nev. 1o-torBi
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