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efta-01368410DOJ Data Set 10Other

EFTA01368410

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DOJ Data Set 10
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efta-01368410
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EFTA Disclosure
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Form We Feev, Debstrerf 2014 Desrinent anof s itie Many interns ereSenke Request for Taxpayer Identification Number and Certification Give Form to the requester. Oa not send to the IRS. cv . 2,0 a ° 0 g 6 t re :c E • e E i to 0 ' Fr= 7 Nae Its Shown on tae Income lex We nn Mere 4 rogWN onvn ow do not leave 9no blank Southern Trust Company, Inc. 2 Webs nansektbreearded erttny twin, a decant Iron above Southern Financial, LLC a Chick appeconale bat for federal Lot clasedicatbn: shock on' one of the follareba swan busk O C C O IndlySeuela0010 proplifetet Ot orpovoam epcia n O pyityrnyhip K ii stn t rase O unwed Z' ' aC Nycarnpatry. Enter the tee tlieeetatiOn froo° GOIParal tea 5.5 FerPerof we. P•PasentO) Now, Fora s.natelember LLC ;halls c-srogercke, do not cheek LLC; Nock me appropriate Cox b itx tax clessleeoice of the thee member anew. ie r. pow pan IratructkorteN ri L_i flank" .• 4 Exemptions C titian mules bibiNCUOMS Exempt pare bar:oder bode (4 end Vadesseetwensvineaseta (cabs sepir orh 40 not Ircnisekr see on px:64 code (If cw)) kern FATCArtecetb; Pe Me above tor 31 5 Addetre (end.. skeet. led apt oral na) 6100 Red Hook Quarter, 63 Recomtlef a fume and edemas foplkeree 4 City. sole, arc) EP coda St. Thomas, USVI 00802 7 LIst =own menbete)hens Optional) Taxpayer Identification Number(T'IN) Enter your TIN In the appropriate box. The 11N provided must match the name given on Snell° avoid I soda backup witinotrAng. For Individuals. this Is generally your social security number (EISN). However, for a resident alien. sole proprietor, or rEwegarded ondly, See the Part I instructions on page 3. For other entities, It Is yaw employee' Ideintlficatron number (EIN). If you do not have a number, se* Now lo pate TIN on page 3. Or Nolo. If the account Is In more than ono nwno. sea the Instructions for (Inc I end the chart on page 4 for rEmploVerwentireeeen number guldelines on whose number to enter. city nimbi's' -1 Certification Undo, penalties of perjury. I certify that 1. The number shown on this form Is my correct taxpayer identilleadon number (slam walling for a number to be (Med to met and 2. I am not suofect to backup withhoteeng because: (a) I om exempt from backup withholding, cr (b) I have not been notified by the Internal Revenue Service (IRS) that I ern subject to backup wilhhokkng as a mutt ol o railse to repel ell interest or dividends, or (c) the IRS has notified me that I am no longer subject to traekup withholdings and 3. I am a U.S. citizen or caw U.S. person (defined belowt and 4, The FATCA MOEN entered on tNs Ism El any) indicating that I MI exempt from FATCA reporting Is correct. rarefication tnatructlons. You must cross out Item 2 above If you have been notified by the IRS that you No currontly subject to backup eithhoising because you have failed to moon all Interest and dividends on your tax return. For real estate hansactior.s, Item 2 does not appty. For rriOn9a9* Interact paid, acquisition or abanoonmont of secured property. canceletion of debt, contributions tom InckvOnat roparmon arrangement g)uq, end genaraity. payments other than Interest and dividends, you are not requIrea to sign the certification, let you must provide your coact TIN. See the instructions on page 3. Sign Hero u.s. 949neene pormont otThT -••• General Instructions Section islorences em to We Minn Revenue Oxle urge*: Othenvhe noise. FUtute devolopmenta. Infortnatten about developments Meeting Form W-9 (sash as unbutton enacted arts we release it) b la www./ratoWF.S. Purpose of Form Ni neonatal Cr ray (Porn W-9 sane/Mx) wed btogned lo No an Insermetica semi nth its IRS man °Otter, yore Wren taxpayer leent(“ben mambo( (11N) with may to ycur metal seolty mantes ESN), inchnun taxpayer klentbcalbet mrnbor pm, adoption lamer bendlIcetion amber (411.5. or employer canDlIcaeon novbcv(LTM, to egad an en Inkartanan beim theamount pakt to you. or ens amount mortal* on en bloananon Man Emonples d trionnalkm enfant inekdo, bat cm not Writs. to, the follow* • Font 1009-Itir trams swoop or paid) • Fenn 10994W essidrinds. rataing those Iran, stab or mead Von • awn 109%MISC envious types of income. Neon ands. el geese proceed.) • Form 10994 (stock ce infAue fund sake cod conah Wit leamactione by broers) • For, 1079.3 hatoMeat ham real estate trantactIonr4 • Form 1099.K sent= Card had fled party network bansactiOnN oaten ahilfilzio iT • Font 1008 9weno ~ogle trammel 1090-beaten loan Merest/. Eft. (wkion) • Form 1099-C bancelea esker • Form 1095,4(acquieironcesbuwkement of sawed property) Use roan W41 off if you am a U.S. preen Ohtenalel a reakin° dm). le fortroldeyow comxit Prude not Arum Tom W-9 to Om marooneWOa TIN. sou malpht be object as owns aithrooldirp. See Muir bra* nitheato? on pest 2. By spring Me lilled-oul ben Yon 1. Cerny met the Ni you are Ohre la cowed for you era wake tie a orate to be Su* 2. Cattythet you ere not nubby. to beans witbotinte 3. Clem themptIon from baba. p wahholdvo a you teea US. exempt pose. If appacenie, yoa fl ew centri.) that os a U.S. pent.. your Seeable ewe of any brand* beam from a U S, bade or bus rAtil b not sub;ect to Me wlihhotlarg tax on footan partnere' Mare of elfeethefy corrected Isom NC 4. Corley Ink PM CA cockfll entered on Mb Win of any) Indicettre ter you We exempt front the FATCA female, b correct See What is FATC4 neve& an Rao 2 for tether Irecemr&st Cal. S. 10231X Soon W-9 (Rev. l2-20l.) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0060143 SDNY GM_00206327 EFTA01368410

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