Account statement (EFTA01402616)

W-9 Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Form (Rev. December 2011) Departmert o( the Treasury Intemal Revenue Service Name (as shown on your Income lax return) Business nama/disrerfarded entity name, if difforent from above e\i Check appropriate box for federal tax classification: y' K Individual/sole proprietor K C Corporation Q^Ctwporation 8 D Partnershp Q Tnist/estate 11 n Exempt payee K Limited lia