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Form W-9

DOJ EFTA Data Set 10 document EFTA01282042

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DOJ EFTA Data Set 10 document EFTA01282042

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EFTA Disclosure
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Form W-9 (Flea December 2011) Dapaimea tithe Treason ham. Revenue Sena Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type Sete Specific Instmotions on Pact 2. Name has shown on your beano tax rattan) Jeffrey E. Epstein Sanaa nemekrareatreded Cray norm r dflerent from above Check ebpropriete 0 irdi,kk.v.,k, Listed iablay El Caw On trabuctionst box for fadaral tax ciessticaoon. e Exempt ayes wow., D C Corporation 0 s Corporation E paten* 0 Tonuestate company. Enter the tax citaacelkn (C-C corpOratka S S ccorporation.Pawannerehip) a Ill AddisWeber, stet and apt or s ito no) 6100 Red Hook Quarter B3 Requesters name and address (optional City. ZIP code 00902 state. end St. Biomes, U.S.V.I. List NM scoant ntenbab) k9t10440 tag Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the 'Name* fine to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I bonnie-lions on page 3. For other entities, it is your employer Identification number (am. If you do not have a number, see How to get a 77N an page 3. Note. if the account is in more than one name, see the chart on page 4 for guidanee on whose number to enter. Social @abaft number Employer Identafication raertte Part II Certification Under penalties of perdulY. I certify that: 1. The number shown on this form Is my correct taxpayer identification number (or I an, waiting for a number to be issued to me). and 2. I an, not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I ern subject to backup withholding as a result of a failure to report all interest or dividend; or (o) the IRS has notified me that I an no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you we currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transaction; hem 2 does not apply. For mortgage interest paid, acquisition or abandonment of seciared property. cancellation of debt contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Sign &gnawe d H... US. person e / General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who Is required to file an Information Mum 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 antrbutions you made to an IRA. Use Form W-9 only rf 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 is correct (or you are waiting for a number to be issued), 2. Certify that you we not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. N appicable. 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 on foreign partners' share of effectively connected income. Date a Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requests?. form Nit is substantially similar to this Form W4. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person tf you art • An individual who Is a U.S. citizen or U.S. resident alien. • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States. • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnereNps. Partnerships that conduct a trade or business In the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership b required to presume that a partner is a foreign pinion, and pay the withholding tax. Therefor; If you are a U.S. person that Is a partner in a partnership conducting a trade or business In the United States, provide Form W-9 to the partnership to establish your U.S. statue and avoid withholding on your share of partnership income. Cat No. 1023IX CONFIDENTIAL - PURSUANT TO FED. tcyNFIDENTIAL Form W-9 (Rev. 12.2011) SDNY_GM_00037294 DI3-SDNY-0000118 EFTA_00 I 47907 EFTA01282042

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