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DOJ EFTA Data Set 10 document EFTA01295005

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DOJ EFTA Data Set 10 document EFTA01295005

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EFTA Disclosure
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Form December 2011) Depramere eie awn trainal Revenet ue SeTrbs y W-9 Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not sand to the IRS. Name greicr2war income tehreetan) trrirsci Buenas graded arty nose, It Lent Worn above thick appropriate box for federal tax classification: O hdirldieWole proprietor El CCorpantin gt<t eCceporeficin O Partners/1p O trust/wale O ISMS Milky cerroew. Erie the Is. desalcalkin ICC ear 'wakes. $4 corpontion, Pepertnenho _ O Other (salreburelone Address easier, street. en/Septi mute bid° Ki.egY City. stew, end 2, c57 ?tat Osvi O CC6 0 List account nueberffitere foptichet k aw4e, O Sankt Mee one end seders loPlienst Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on the 'Names line 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 instructions on page 3. For other entities. It is your employer identification number (EIN) If you do not have a number, see How to get • TIN on page 3. Note. If the account is in more Than one name, see the chart on page 4 for guldekrers on whose number to enter. ligu Certification Under penalties of satiny. I ossify that 1. The number shown or, this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. tarn not subject to backup withholding because: (idiom exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service ORS) 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 (defined below). Certification Instructions. You must cross out item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all intern! and dividends on your tax return. For real *stae transactions. item 2 does not apply. For mortgage interest paid, acquisition or abandonment of seCUratroperly, cancellation of debt: contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and you ars not to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Sign Here sods security rather Ilignals• of U.S. per•on 0./ General Instruations Section references are to the Internal Revenue Code 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 contnbutions you made to an IRA. Use Form W9 only II you are a U.S. person (indudng a resident alien), to provide your correct TN to the person requesting it (the requester) and. when applicable. to: 1. Certify that the TIN you we 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 we a U.S. exempt payee. if applied:Ile 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 effecavely connected income. Dote a Note. If a requester gives you a loan other than Form W-9 to request your TIN, you must use the requester's form if It is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person If you we: • An Inavklual 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 Staters, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701.7), Special rtes for pertnenplips. Partnerships that conduct a trade a 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 W4 has not been received, a partnership is required to presume that a padre is • foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner M • partnership conducting a trade or business in the United States, provide Form W4 to the partnereliP to establish your V.S. status and avoid withholding on your share of partnership income. Col No.10231% Fart W-0 Rev. 12-2011) SDNY_GM_00053688 CONFIDENTIAL - PURSUANT TO FED. „QC) .NEIDENTIAL DB-SDNY-0016512 EFTA_00164269 EFTA01295005

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