Case File
efta-01450272DOJ Data Set 10OtherEFTA01450272
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01450272
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
IV. TAX ELECTION/DECLARATION OF TAX STATUS
This Account Agreement is designed for use by both U.S. Persons and Non-U.S. Persons. Please check the box next to the applicable Item below.
Client certifies that Client will notify DBSI In wilting Immediately If the representation certified to below ceases to be two and correct.
1.0 U.S. Citizen or U.S. Resident Mien
Fenn W9
Request for Taxpayer Identification Number and Certification
Substitute
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i
Namelitrown ont 7 inctip, tax mum)
4
g
if
Business name/dist aidedentity ne e,r
rent from above
check appropriate box for federal tax classification Required)
1 3 Indhridualkole proprietor❑C Corporation ❑SCorporation K
Partnership al'Irth:tri,!Ntate
K
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, Papattnershro) ,
Other ,
Exempt payee
•
Addre
City,
Rot i Taxpayer Identification Number (TIN)
Rut II
agn
Here
EMer your TIN in the appropriate box. The TIN provided must match the name given on the "Name' line
to avoid backup withholding. For Individuals. this is your social security number ISSN). For other
entitles. it is your employer Identification number (EIN).
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be Issued to me), end
2. I am not subject to backup withholding because: (all em exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a falkire to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. parson (defined in the instructions).
Certification instructions. You must cross out Item 2 above II you have been notified by the IRS that you are wrrently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.
ty Numbor
0
-on-ma
Employer 'thentrflcaoon Number
Signature of
person
eDmvu—,L.
2.0 Non-U.S. Person
Date 0
ClfIL 1/ 3
I am not a U.S. person (including a U.S. resident alien). I am submitting the applicable Form W'8 with this form to certify my foreign status and, d applicable,
calm tax treaty benefits.
For example: Client Is not a U.S. parson (Including a U.S. resident alien). Client agrees to provide ()BSI with this application the applicable Internal Revenue
Service (IRS) Form W43 to certify the client's foreign status. W-8 forms and instructions are available on the IRS website at wwwirs.gov.
6
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0105824
CONFIDENTIAL
SONY GM_00252008
EFTA01450272
Technical Artifacts (3)
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wwwirs.govSWIFT/BIC
DECLARATIONSWIFT/BIC
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