HomeMy WebLinkAboutW-9 Form (1) (2)."- W-9
Gev. D€c€irb6f :01a)
Deparhrrn dile TrDart'yht.d,EkrgE Soie
C-tttvl€t?-
Efltgr yorr IlN in lhe apEoprht€ box. Ih6'nN piovldgd must match lhc nam6 ghln on the 1 to avotd
bactep wi$holding. For iidMduals, this iB g6nerally youl' socJal s€curity numb€. (SSNI Howevet, for a
rcsld€ni alkn, sole popdelor, or dlsr€gaded ontlty, s€€ ih€ Pfi I lnskuctions oo pago 3. For other
€ntltl6s, it is l9t, omdoyor identifEallon numb€r (ElN). lf you do rEt havo a rumber, se€ How fo 9€t a
I/N on pago 3.
l,lote- lf lheaoc.our.l ig io mo{glian o.te rlame, a€e U€ lrdrudio'ls lor &161 ald the chart on pagE 4
gdds$ne or lvfroEe nurr66r io enlq.
Under pemltbs of psdury, I cortlfy thal:
instruction$
to sign the cortlflcatlon, bl]t you fiust provide your conect TIN. S6a ths
Heirs
General lnstructions
S€cfon r€furlrEos arB to lhs lntsml B6ven!ts Oode lnle5s oliernd.s not6d,
Futurs d6vd0pmosE- ln oarnadon about ddvalopment6 .ti€cthq Foafi W€ Fuch
as l€gbhion ena<$d Efle. Qo rcl€a$ l0 is d www,iegorfir€.
Purpose of Form
An lrdlvldlJal .r sdry (Form W€ rcqu€st€r, $11o b .€qulrEd to lilo an hlormatlon
.Eium ,rfth tho IBS mr.rs* obtah )rolr 6fi€ot laxpayc'ldodmcalion n$b€r (IN)
lthl* may b€ ltur.oclsl s&ufly nunb€r €SN), lndividsd taxpayt ldoniltlca{on
numb€r 0TlNr, idoplion taxp.yar ldc.ltilbaiion nu(ber (A'flN), or €rrploy6.
id€ntfi,lcatjon rumb€. {ElN), to rEp.rt gn tn lnfoamslioo lElum the ernotrl1t pald to
you, o. otl6[ rnount reportrb6 on 5n lnlorrlEtion rotdin, Exanrphc oi lnforma{or
rctunE lncldo, but al€ not lirnlted lo. l,he foiswlng
. Forrr! 1 @glNT (htdrsr €8rmd o. pdrt)
. Fonn 10€a-Dv (drueidq h.loding those torn stocl(3 or mrtusJ fundsi
. Form 1099-ll SC (v8rlq't3 types c, ln6rne, ptiz's, aw6d9, 6 91063 procoe&)
. Form l0g9-l lstock or.Ildud turlC s6l€6 ad cgtaln otllei lrsn6aclh.E by
. Fofit 10S9-S {proeeds lism rerl 6tate iransacton9}
. Folm 1099-X {mgthrr, card ard ltd.d pert notvio* t€ftactioos)
o*", i I l7
. Farn 1008 {hon$ mortaas€ lil€rerr} i 094{ l6tud€l1i ban ifiterst), 1 098.7
&rI[on]
. Form 1093{ (dn.sld deb0
. Form 10S0.A (acqurlrton !r abardonm€nt of s.cuEd proporty)
lrse Fom W€ only H you are a U.s. percon (ncll,drrg a llstded efi6i), to
provlds yotr co.r€6_t TlN.
lf W do not tetu,,] Fo*n W-g le Io,Eg{re3t6rwltl'. Ilr,,.o, dgrrtbr svqirct
io b!ck& $t1,',01*rl9. S* tl4t]rt h b3ch4o wft *pr*,g? on pa!6 2.
Sy El€FkE the A{.d.ort hrm, you:
1. CerXry that Ap Thl you er€ glving b con€61 (.{ you sro \ieElng tor s nunber
to b€ |rsll6d,
2. Ce{ify that you sr6 rot subiactlo bartup llfthhol&lne, or
3. Chlfl ar€mptlon IrD.r backip wiinhdd g if yft erB a U.S. oxernp{ p6}€e. tt
app,lcabla. you lre 6bo cstlyng liat as s U.S. p&ron, yow aliocabL jiare ot
any pcdnarahb tEorn€ ,ror a lJ.S. tad6 or b!6ln€as b id subjact to th.
withloldn€ rrx otr loftlgn partnas' sh € ot .ff€otlvoly conn€c1€d lncorn6, ard
4. C6nh/ thd FATca c.deF) enti(€d on thb hrm 0l6iy) Inoba{ng tnd ycu E
o(€md horn t\s FATCA r6po.tihg, 16 codEct. 5o6 tafrat E FAICI r.pod:nq? on
pags 2 lEr turus lnformdtion,
g OEck epproprlatr box ld ftds.l t x chllfr.fion: otEt ontyon. of thefoitov/irq ss,$ !oxe€:
Eltndlvtdudisole prorletor or E c cor.por*ron fl soorpo"*ron E pa rerEtp E rnnyeglate' *!do-m€n b€r tl-C
E urnliEd xi6lily compaiy. Ert f iha trx .lslification [o:c corpof€lio.l, +3 cotlordon, p*pE tEr*ipl >
iloto. Fd a slnole-msnb* LJ.c th* t€ dtErE{ltdoo, do rbr cfted( [Iq d!d( lh. apgrpriste U", tn U. fp_G-tq
tt|e to( cl&lciflc'tkM ol tha 8,ng{E-nEmb€r out€r,
( -
cst No. 10231x Fonn W-9 Fev. 12-a14)