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Form W-9 (Rev. 10-2018)
<br />Page 3
<br />Criminal penalty_for falsifying information, Willfully falsifying
<br />certifications or affirmations may subject you to criminal penalties
<br />including fines andlor imprisonment.
<br />Misuse ol TlNs. lf lhe requester discloses or uses TlNs in violation of
<br />federal law, the requester may be subject to civil and criminal penalties.
<br />Specific lnstructions
<br />Line 1
<br />You must enter one o{ the following on this line; do not leave this line
<br />blank. The name should match the name on your tax return.
<br />lf this Form W-9 is for a joint account (other than an account
<br />maintained by a foreign financial institution (FFl)), list tirst, and then
<br />circle, the name of the person or entity whoie number you entered in
<br />Pad I of Form W-9. i{ you are providing Form W-g to an fft to documentajoint account, each holderofthe account that is a U,S. person muslprovide a Form W-9.
<br />a.. lndividual, Generally, enter the name shown on your tax return. lfyou have changed your last name without informing the Social Security
<br />Administration (SSA) of the name change, enter your first name, the lait
<br />name as shown on your social security card, and your new last name.
<br />Note: lTlN applicant: Enter your individual name as it was entered onyour Form W-7 application, line 1a. This should also be the same as the
<br />name you entered on the Form 104O/1O4ON1O4OEZyou filed with your
<br />application.
<br />b. Sole proprietor or single-member LLC. Enler your individual
<br />name as shown on your 1040/104AN104OEZ on line i, you may enteryout busrness, trade, or "doing business as,' {DBA) name on line 2.
<br />c. Partnership, LLC fhat is not a single-member LLC, Ccorporation, or S corpotation. Enter the entity,s name as shown on theentily's tax return on line 1 and any businoss, tiade, or DBA name on
<br />line 2.
<br />d.. Oiher entities, Enter your name as shown on required U.S. federal
<br />tax documents on line 1. This name should match the name shown on the
<br />charter or other legal document creating the entity. you may enter any
<br />business, trada, or DBA name on line 2.
<br />e. Disregarded entity, For U.S. federal tax purposes, an entity that is
<br />disregarded as an entity separate from its owner is trealed as a'disregarded entity." See Flegulations section 001.7701-2(c)(2)(iii). Enter
<br />the owner's name on line 1. The name of the entity entered on line .l
<br />should never be a disregarded entity. The name on line l should be the
<br />name shown on the income tax return on which the income should be
<br />reported. For example, if a foreign LLC thal is treated as a dlsregarded
<br />entity for U.S. federal tax purposes has a single owner that is a 0.S.person, lhe U-S. owner's naryte is required to be provided on line 1. lf
<br />the direct owner of th6 entity is also a disregarded entity, enter the first
<br />owner that is not disregarded tor tederal tax purposes. Lnier the
<br />disregarded entity's name on line 2, ,,Business name/disregarded entity
<br />name." lf the owner of the disregarded entity is a foreign person, the
<br />owner must complete an appropriate Form W-g instead of a Form W-9.
<br />This is the case even if the foreign person has a U.S. TlN.
<br />Line 2
<br />lf you have a business name, trade name, DBA name, or disregarded
<br />entity name, you may enter it on line 2.
<br />Line 3
<br />Check the appropriate box on line 3 for the U.S. federal tax
<br />classification of the person whose name is entered on line 1. Check only
<br />one box on line 3.
<br />Line 4, Exemptions
<br />lf you are exempt from backup withholding andlor FATCA reporting,
<br />enter in the appropriate space on line 4 any code(s) that may apply to
<br />you.
<br />Exempt payee code.
<br />. Generally, individuals (including sole proprietors) are not exempt from
<br />backup wilhholding.
<br />. Except as provided below, corporations are exempt irom backup
<br />withholding {or certain payments, including inter€st and dividends.. Corporations are not sx€mpt from backup withholding for paymonts
<br />made in settlement of payment card or third pany network transactions.. Corporations are not exempt from backup withholding with respect to
<br />attorneys' fees or gross proceeds paid io attorneys, and corporations
<br />that provide medical or health care services are not exempt with respect
<br />to payments reportable on Form 1ogS-M|SC.
<br />The following codes identify payees lhat are exempt from backup
<br />withholding, Enter the appropriate code in the space in line 4.
<br />1 -An organization exempt from lax under section 501(a), any lRA, or
<br />a custodial account under sectjon 403(bXZ) if the account satisfies the
<br />requir€ments of section 401(0(2)
<br />2-The United States or any of its agencies or instrumentalities
<br />3-A state, the District of Columbia, a U.S. commonwealth or
<br />possession, or any of their political subdivisions or instrumentalities
<br />4-A foreign government or any of its political subdivisions, agencies,
<br />or instrumentalities
<br />5-A corporation
<br />6-A dealer in securities or commodities required to regjster in the
<br />United States, the District of Columbia, or a U.S. commonwealth or
<br />possession
<br />7-A futures commission merchanl registered with the Commodity
<br />Futures Trading Commission
<br />8-A real €state investment trust
<br />9-An entity registered at all times during the tax year under the
<br />lnvestment Company Act of 1 940
<br />10-A common trust fund operated by a bank under section 5g4(a)
<br />1 1 -A financial institution
<br />12-A middleman known in the investment community as a nominee or
<br />custodian
<br />'13-A trust oxempt from tax under section 664 or described in section
<br />4947
<br />lF the enlity/person on line 1 is
<br />a(n).'.THEN check the box for
<br />r Corporalion Corporation
<br />. lndividual
<br />. Sole proprietorship, or. Single-member limited liability
<br />company (LLC) owned by an
<br />individual and disregarded for U.S.
<br />federal tax purposes.
<br />lndividual/sole proprietor or single-
<br />momber LLC
<br />. LLC treated as a partnership for
<br />U.S. federal tax purposes,
<br />. LLC that has filed Form 8832 or
<br />2553 to be taxed as a corporation,
<br />or
<br />. LLC that is disregarded as an
<br />€ntil.y separaio from its olvner but
<br />the owner is another LLC that is
<br />not disregarded for U.S. foderal tax
<br />purposes.
<br />Limited liability company and enter
<br />the appropriate tax classif ication.
<br />(P= Partnership; C= C corporation;
<br />or S= S corporation)
<br />r Partnership Padnership. Trust/estate Trust/estate
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