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10
<br />Form W-9 (Rev. 30-2007) Page 4
<br />3. Real estate transactions. Yau must sign the ct:rtificatfon.
<br />You may cross out item 2 of the certificat€on.
<br />4. Other payments. You must give your correct TIN, but you
<br />do not have to sign the certification unless you have been
<br />notified that you have previously given an incorrect TIN. ^t]ther
<br />payments" include payments made in the course of the
<br />requester`s trade or business for rents, royalties, goods {other
<br />than bills for merchandise), medical and health care services
<br />(including payments to corporations), payments to a
<br />nanemptoyee for services, payments to certain fishing boaf crew
<br />members and fishermen, and grass proceeds paid to attorneys
<br />(including payments to corporations).
<br />5. Mortgage interest paid by you, acquisition or
<br />abandonment of secured property, canceitation of debt,
<br />qualified tuition program payments (under section 529), 1RA,
<br />Coverdell ESA, Archer MSA or HSA contributions or
<br />distributions, and pension distributions. You must give your
<br />corcect TIN, bui you do not have to sign the certification.
<br />What Name and Number To Give the Requester
<br />For this type of account: Give name and SSN of:
<br />1. tndiviriuai The Indivkrual
<br />2. Two or more individuals (ioini The actual owner of the account of,
<br />account) if combined funds, the test
<br /> IndNtdual on the account
<br />3. Custodian account of a minor The minor
<br />(Uniform Gift to Minors Act)
<br />4. a. The usual revocable savings The grantor-Trustee'
<br />trust (grantor is also trustee)
<br />'
<br />b. So-called frost account Thai Is The actual owner
<br />not a legal w varid trust under
<br />state !aw
<br />5. Sole proprietorship or disregazded The owner'
<br />entity owned by an individual
<br />For this type of account: QNe name and EIN of:
<br />6. Disregarded entity not owned by an The owner
<br />Individual
<br />7. A vafad Trust, estate, or pension trust Legal entdy
<br />8. Corporate or LLC electing 'The corporation
<br />corporato status on Form 8832
<br />9. Assocfatbn, club, religious, The organizaton
<br />charitable, educadona{, or other
<br />tax-exempt organization
<br />30. partnership or multi-member t1C The partnership
<br />1 i. A broker or registered nominee The broker or rwminee
<br />12. Account with the Department of 'The pubMc entity
<br />Agriculture in the name of a public
<br />entity (such as a state or beat
<br />government, school district, or
<br />prison) chat recehres agricultural
<br />program payments
<br />'Ust lust and code the name of rho Person vrFrosa number you famish If orrty one person
<br />on a (dnt accaxK has an SSN. that persons ntmber must he furnfsrtad.
<br />=Cirda the m4>o~s reme and lwnish the mimr's SSN.
<br />sYou must show yar individual name and you may also enter your business or °aeA'
<br />name on itra second name Me. You may use etlhet your SSN a EtN (tt you have one),
<br />Fwl fhe IRS encourages you to use yow SSN.
<br />` List first and circle the name d the trust, estate. or pensbn bust (tb rwt famish the TIN
<br />of the personal representellve a bastes ureess iha legal entity itself h rwt designated in
<br />the account title.) Afso see Spedat roles for partrlaratdAs on page 1.
<br />Note. if no name is circled when mare than one name is listed,
<br />The number will be considered to be that of the frrst name listed.
<br />Secure Your Tax Records from Identify Theft
<br />Identity theft occurs when someone uses your personal
<br />information such as your name, social security number {SSNJ, or
<br />other identifying Information, without your permission, to commit
<br />fraud or other crimes. An idenflty thief may use your SSN #o get
<br />a job or may file a tax return using your SSN to receive a refund.
<br />To reduce your risk:
<br />Protect your SSN,
<br />Ensure your employer Is protecting your SSN, and
<br />i3e careful when choosing a tax preparer.
<br />Call the tRS at 1-800-829-1040 if you think your identity has
<br />been used inappropriately for tax purposes.
<br />Vtetims of identity theft who are experiencing economic harm
<br />or a system problem, or are seeking help in resolving tax
<br />problems that have not been resolved through normat channels,
<br />may be eUgible for Taxpayer Advocate Service (TAS) assistance,
<br />You can reach TAS by caning the TAS toll-free case intake line
<br />at 1-877-777-4778 or lTY/TDD 1-800-829-4059.
<br />Protect yourself from suspicious emails or phishing
<br />schemes. Phishing is the creation and use of email and
<br />websites designed to mimic iegit}mate business emails and
<br />websltes. The most common act [s sending an small to a user
<br />falsely claiming to be an established legitimate enterprise in an
<br />attempt to seam the user info surrendering private information
<br />that will be used for identity theft.
<br />The iRS does not initiate contacts with taxpayers via emails.
<br />Also, the IRS does not request personal detailed information
<br />through small or ask taxpayers for the P!N numbers, passwords,
<br />or similar secret access information for their credit card, bank, or
<br />other. financial accounts.
<br />If you receive an unsolicited email claiming to be from the IRS,
<br />forward this mt3ssage to phfshing~lrs.gov. You may also report
<br />misuse of the tR5 name, logo, or other IRS persanaf property to
<br />the Treasury Inspector General for Tax Administration at
<br />1-B00-366-4484. You can forward suspicious emails to the
<br />Federal Trade Commission af: spam~uce.gov or contact them at
<br />www.consumergov/idfheft or 1-877-iDTHEFT(43B-4338).
<br />Visit the IRS websife at ivww.lrs.gov to team mare about
<br />identity theft and how to reduce your risk.
<br />Privacy Act Notice
<br />Section 6109 of The internal Revenue Code requires you to provide your correct TIN to persons who must foe informatbn returns with the IRS to report kiterest,
<br />dfvktands, and certain other income paid to you, mortgage Interest you paid, the acqulsifkxi or abandonment of secured property, canceilatbn of debt, or
<br />contrilwtions you made to an 1RA, or Archer MSA or HSA. The IRS uses the numbers for Iderttitication purposes and to help verify the accuracy of Your tax return.
<br />The iRS may also provide this information is the Department of Justice for civet and criminal litlgallan, arxf to cities, slates, the Distrbt of Columbia, and U.S.
<br />possessxutS to carry out ihek tax laws. We may also discbse the iniarmarron to other countries under a tax treaty, to federal and state agencf~ to enforoe federal
<br />norttax criminal taws, w to federal law enfaroement and lnteftigence agencies to combat terrorism.
<br />You must provide your TfN whether or not you are required to ilia a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other
<br />payments to a payee who does not gNe a TiN to a payer. Certain penalties may also apply.
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