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... W-9
(Res Deeenter 201i)
Doennore el the Teen
Netelliew
Salo
Request for Taxpayer
Identification Number and Certification
give ronn to the
-equester. Do not
;and to rho IRS.
nia
Print er tape
Seo Specific Inspections on page 2.
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6100 Red Hook Quarter, B3
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St. Thomas, U.S.V.I.
code
00602
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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 rine
to avoid backup wahholding. For individuals, this is your social security number (SSN). However, to a
resident *hen, sole proprietor, or disregarded entity, see the Part I instnichons on page 3. For other
entities, it is your empkwee identifioation number (EIN). If you do not have a ns,mber, see How to pet a
Tiei 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.
Certification
Part II
Social salty nurnb
IEMPIOSS idellbfiCatio n numbs
Under pens Ms of penury. I certify that:
1. The number shown on this form is my correct taxpayer identification number (orlon waiting for a number to be issued to nx v and
2. I ern not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by . he 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 RS h; c notWird me that I an
no longer abject to backup withholdrva. and
3. I ant a U.S. Sayan or other U.S. person (defined below).
Certification inathintions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject 1 ) backup Wrthholding
because you hive faked to report an wittiest and dividend; on your tax return. For real estate transactions. item 2 does not appl For mortgage
interest paid, acquisition or abandonment of secured poverty. cancellation of debt. auntributions to an individual retirement am Iceman (IRA). and
generally, payments other than interest and dividends, you are not required to sign the certification, but you most provide your c :nal TIN. See the
instructions on page 4.
Sign
Here
Sienna*
t jeN
US. person to
General Instructions
Section references am to the Internal Revenue Code unlit= otherwise
noted.
Purpose of Form
A person who is required to file on information return with the IRS must
obtain your correct taxpayer identification number (TIN) to report, for
example. income paid to you, nod estate bane-lotions, mortgage interest
you pald, acquisition or abandonment of secured property. cancellation
of debt, or contributions you made to an IRA.
Use Form W-9 only if you are a 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 k correct (or you we waning for a
number to be Issued).
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee. It applicable, you are also certifying that as a U.S. Person, your
allocable share of any partnership income from a U.S. trade or business
is not subject to the withholding tax onloreign partners' share of
effectively convected income.
Deret R I -so I V.
Note. t a requester gives you
other than
on W-1 to request
your TIN, you must use the requester's form it it
substantia/iy rimibr
to this Form W-9.
Definition of a U.S. person. For federal tax pup; doss. you are
considered a U.S. person it you we:
• An individual who is a U.S citizen or U.S. residi ot then,
• A partnership. corporation. company, or osa0Cli 'ion en steal or
organized in the Untied States or under the L7.15 r ' the United States,
• An estate (other than a foreign emote), or
• A domestic trust (as defined in Regulations sad on 301.7701.71.
Special rules for partnerships. Partnerships nut' .:onduct a trade or
business in the United Stake are generally raged. :I to pay a withholding
tax on any foreign partners' share of income from Ouch business.
Further, in certain cases where a Form W-9 has it :I beenuecewed, a
partnership is requi'ed to presume that a partneri r a forego person.
and pay the vdthholchrog lax. Theater., I you are 5 U.S. p aeon that is a
partner in a partnership conducting a trade or but inns in the United
States. provide Form W-9 to the partnership top :thlish your U.S.
°talus and avoid withholding on your share of par unship income.
Cat No. 10231%
f
W-9 (Rev. 122011)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
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