Case File
efta-01450290DOJ Data Set 10OtherEFTA01450290
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01450290
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 writing Immediately if the representation certified to below ceases to be true and correct.
4;0 U.S. Citizen or U.S. Resident Allen
Fenn W9
Request for Taxpayer Identification Number and Certification
Substitute
a
F
i
n
Name (as shown on your income lax return)/
'le (64•0:;yintiv eni Cie rra t‘ent
Itusiness ne
tole above raPPOPtiets borbrletlerel fax daasifaatWn (reeltdred);
I
Exempt payee
❑Individual/sole proprietor Ill C Corporation K S Corporation 0
PannereNp 0
Trust/estate
•
Llmked liability company. Enter the tax classification (C.0 corporation, S.S corporation, P.partnership)
Other 1
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7- korms ti5 V -I , Li Taxpayer den (cation Number (TIN) riterietiatiN 'nibs apPropitate Mi.*. 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
entities. It Is your employer Identification number (EINI.
t 11
Em
identification Number
Ix -MO I DO
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). and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or lb/they° not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure 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. person lc/Wined in the instructions).
-
Certification Instructions. You pest cross out Item above if you have been
11K1 by the IRS that you ere currently subject to backup withholding
erincit because you have failed to wort as all Interest and dry ands on your tax r
p
.
Sign
Here
Signature of.
IJA PIMA;
20 Non•U.S. Person
I am not s U.S. person (including a U.S. resident alien). I am submitting the applicable Form WS with this form to eerily my foreign status and, if applicable,
claim tax treaty benefits.
For example: Client is note U.S. person (including a U.S. resident alien). Client agrees to provide DBSI with this application the applicable Internal Revenue
Service ORS) Fare WA to certify the client's foreign status. WE forms and instructions are available on the IRS website at wvny.irspov.
L>atsft..'t
9/05
(THIS SPACE INTENTIONALLY LEFT BLANK)
12.PWW.-0573
6
012145 011113
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DEkSDNIY-0105842
CONFIDENTIAL
SONY GM_00252026
EFTA01450290
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SWIFT/BIC
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