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Request for Taxpayer
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Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the 'Name line
to avoid backup withholding. For indridualsMN is your social security number (SSN). Hooey, to a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EN). If you do not have a number, see How fo gel a
TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
Rani./ NetilitVranhdr
Employer idenencauen ramnbor
P 1 r II
Certification
Under penalties of pettily. 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 0)) I have not been notified by the Internal Revenue
Service (RS) that I am subject to backup withholdings a result of • 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 6m • U.S. citizen or other U.S. person (defined below).
Crertifketion instructions. You must CFOSs out item 2 above x you have been notified by the IRS that you we currently subject to backup withhokling
because you have tailed to report all interestengsfividende on your tax return. For real estate transactions, horn 2 dorm not apply. For mortgage
Interest paid, acquisition a abandomant of secunid property, cancellation of debt, contributions to an lndMdual retirement arrangement PRA), and
ariefellY. payments other thanyrterest and dividenkle, you are not n u
oelprrthe-cantificstion, but you must provide your correct TIN. Seethe
Instructions on page 4.
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General Instructions
Section references are to the Internal Revenue CAie unless otherwise
noted.
Purpose of Form
A person who is required to file an Information return with the IRS must
obtain your correct taxpayer identification number (TIN) to report. for
example. Income paid to you, real estate transactions, mortgage interest
you paid. acquisition or abandonment of secured property. cancellation
of debt, or contnbuticns you made to an IRA.
Use Form W-9 only t you WO • U.S. person including a resident
alien). to provide your correct TIN to the person requesting it (the
requester) and, when applicable. to
1. Certify that the TIN you are giving is coned (or you are walling for a
number to be issued),
2. Certify that you re not subject to backup withholding, or
3. Claim exemption horn backup withholding If you we • U.S. exempt
payee. If applicable you are also certifying that se a US. person, your
allocable sham of any partnership income from a U.S. trade or business
is not subject to the withholding tax on foreign partners' share of
effectively connected borne
(
Date e
Note. If • requester gives you a form
thanForm W-9 to request
your TIN, you must use the requester's form If It is substantially amity
to this Form W-9.
Definition of a U.S. person. For federal tax mimosa, you are
considered a U.S. person If you re:
• M individual who Is a U.S. citizen or V.S. resident alien,
• A partnership, corporation, company, or association created or
organized In the United States or under the laws of the United States.
• Mn estate (other than • foreign estate), or
• A domestic Met (as defined in Regulations section 301.7701-7).
Special See for partnerships. Partnerships that conduct a trade a
business in the United States are pinerelly required to pay a withholding
tax on any foreign partnere' share of income from such business.
Further, In certain cases where • Form W-9 has not been received, a
partnership's required to presume that • partner Is • foreign person.
and pay the withholding tax. Therefcredf you re • U.S. person that is a
partner in a partnership conducting a trade or business in the United
Slates, provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership income
Cr No. 10231X
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e).
ram W-90ire. 120A1)
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USAO_001084
EFFA_00018994
EFTA00168741