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Form W.9
<br />(Rev Nlarch 2C24)
<br />D<,padmont of theTrnasury
<br />lritemal R@venue Seryic8
<br />ATTACHMENT"E"
<br />!Request for Taxpayer
<br />ldentification Number and Gertification
<br />Go to www.irs.gou/Formvw fot instructions and the latest info'rmat'ion.
<br />Give form to the
<br />requester. Do not
<br />send to the lRS.
<br />Before For of see ol below.
<br />Nanleofentfylindividual..ADenlryisrequired-iforaso.eproplielorordsregardederll r.enterlhemimefsirameonlillel,andenterlhebusiness/disregarded
<br />entrty's rrme on ine2
<br />2 Business name/disrigardedl0l 1tM: y .ame. ifdiffBrirlt:rom above.
<br />4 Exompiror,s (codGSapply onlyto
<br />.ertain enlities, nol n-dYvidll ais
<br />see lnstroctkms on page 3)
<br />Exenpl payee oode (ii any)
<br />et
<br />0r
<br />oi
<br />CL
<br />c
<br />0
<br />tfii
<br />t.
<br />cLo
<br />4
<br />Exemplionfr.onl
<br />Compliance Acl
<br />code (if any)
<br />Forergr Account Tax
<br />(FATCA) roporting
<br />(t\pCli s ta.ac6i Jk nainln! _!n cJ
<br />oulside lhe Unied States.)
<br />Reqresie/s name \Iel address (optionaii
<br />Enter your TIN in the appropriate box. The ilNI provided must rnatclh tihe 1 l ame grvel 1on line 1 to avoid
<br />backup withholding. For individuals, lhrs !s generally your social security number (SSN). However, for a
<br />resident alien, sole proprieto: r, or disregarded ent,ty, see the instruclions for Pa. rt l, I at-'r For oiher
<br />entlties, ( is your employer identification number (ElN). lf you do not have a nuinber, see How lo get a
<br />I/ /. Iater.
<br />Notg: ;f the account is il l more than one name, see the instructions for limi 1 . See also What A/afie and
<br />Number To Gile the Requesterfor guidelines on whose number to enler.
<br />Social number
<br />fl@ certification
<br />Under penalties of perjury, I certiiry thai:
<br />1. The number shown on th,s form is my correct iaxpayer .dentiflcation number (or I am wal ting lor a numberto be issued to me); and
<br />2 I am not sub,jcct to backup withholding because (a) I am exempt from backup withholding, or (b) I have not beer, notified by ihe lnternal Revenue
<br />Seruice (lRS) that I am subject to backup withholding as a resull of a failure to report all inierest or dividend s, or (o) the iRS has notified me that I am
<br />no longer subject to backup withholding; atld
<br />3. I am a U.S citizen or other U.S. person (deNned beiow) and
<br />4 The Fr'\TCA code(s) entered on ihis forn Ql any) indicating that I am exempt from FATCA reporting :s corocl.
<br />Certilication inslructiions. You rnust cross out :tern 2 above if you have been noiified by the IRS thal you are currently sublect to backup wilhholding
<br />because you have failed to report ali interest and div!dends on your tax return. For reai estate transactions, ilem 2 does not apply. For mortg1 age Interest paid,
<br />acquisilionorabandonmentofsecuredproperty,cancellationofdebt.contribulionsioanindividualretiremenlarrangemellt(lRA).and,generally payments
<br />.other than interest and dividends vou are nol reouirnd io sion lhe certific.tion hut vori mrrst nrovide vour correct TIN Soothe lnstructions for Part ll. iater'
<br />Signatur<> of
<br />u s, porson
<br />7 l. jsl accourt.>cBloor (s)heleioptionaij
<br />lffi
<br />Sign
<br />Here Dal
<br />3a Check ihe appropriate box lor iederaltax classili€1ion of the en ryiindl\adoal whosen e is errlered on line 1 Check
<br />only one oftrn. fQ!lowlng seven boxes.
<br />! nrdividiuallsorepropriotor ! Gcorpor:iior1 ! Scorporation ! l.artoorstrip n Trusueslate
<br />! LLC. Enlerlhelr'ucclassifical;oniC- Coorporatlon,s= Scarporation,P" Parlrershrp)
<br />Note : Check tl,e "LLC" box above and, ln I ha entry space, enter rhe anpronriate cod e lC S, o. Pr iDrllia 'ay
<br />classilimtionofttlel-i C,unlessilisadiwegardedbntitv.Adisregard entityshouldinsteadchcckiheS.i)proprlate
<br />box lbrflrelax classificationof ;ts oMler.
<br />h
<br />Sb lf on llne 3a you checked " PartnershEp, or "Tx rsuestate." oa chedked,/rLlc ' a!!d eDtered P' as lts tax tlassiilcatioJ 1
<br />arl{l youl nr. pfoviclirrg ihis fo to a padnership. lrusl or es.tale n whiclr yor! have an ownership interest, llieck
<br />U.ls box i'f :or haveanv foreiqn parlnels, cwners. or beneticislies. See lnsiructions !
<br />5 Adcl,es, (nLmbe,streei,i\ldapl or uitenc).Seeinstruclions
<br />6 City, stale anrl zlP code
<br />General lnstructions
<br />Section refererices are to the lnternal Revenue Code unless otheMise
<br />no.led
<br />Future developments. For the latest information about d'eve'lopments
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />aiter they were published, golo ww.irs.gov/Formvw,
<br />What's New
<br />L-rne 3a has been modified to clarify how a disregarded entity completes
<br />thrs line. An LLC thai is a drsregarded entily should check the
<br />appropriate bo x for the tax classification of lts owner. Othemise, it
<br />should check the "LLC"'box and enter lts appropriate tax classification.
<br />New iine 3b has been addedl to this form. A flow-through entity is
<br />required to complete this li e 10 indicate that it has direcl orindirect
<br />foreign pa(ners, owners, or beneflcia ies when rt provides lhe Form W-9
<br />to another tlow thrm, gh e 1 l ily :n which rt has an ownersh, ip inte,rest This
<br />chang,e s intended to provide a flow{hrough entity wilh nformation
<br />regardrng the slatus of tts i direct !or.eign partners, owners, or
<br />beneficiaries, so lhat it can satisfy any applicable reporting
<br />requirements. For example, a partnership thai has any indirect foreign
<br />partners may be required to complete Schedules K- 2 and K-3, See the
<br />Partnership lnsbructions for Schedules K 2 and K 3 ,(Form 1 065).
<br />Purpose of Form
<br />An indivl duai o.e lily (Form W-9 reque$ler) who is required to file an
<br />'nformation rettl m with lhe IRS is giving you this form because they
<br />rom W-9 icev 3'2024)
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