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DocuSign Envelope ID: 2954802F-3DF9-4C1C-80A2-A507C762EF80
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<br />Form W-9 (Rev. 8-2013)
<br />Page
<br />Generally, individuals (including sole proprietors) are not GÄA real estate investment trust
<br />Exempt payee code.
<br />exempt from backup withholding. Corporations are exempt from bac
<br />HÄA regulated investment company as defined in section 851 or an
<br />withholding for certain payments, such as interest and dividends
<br />registered at all times during the tax year under the Investment
<br />not exempt from backup withholding for payments made in settleme
<br />1940
<br />card or third party network transactions.
<br />IÄA common trust fund as defined in section 584(a)
<br />If you are exempt from backup withholding, you shouldstill complete this
<br />Note.
<br />JÄA bank as defined in section 581
<br />form to avoid possible erroneous backupwithholding.
<br />
<br />KÄA broker
<br />The following codes identify payees that are exempt from backup
<br />LÄA trust exempt from tax under section 664 or described in sect
<br />1ÄAn organization exempt from tax under section 501(a), any IRA,
<br />custodial account under section 403(b)(7) if the account satisfi
<br />MÄA tax exempt trust under a section 403(b) plan or section 457(
<br />of section 401(f)(2)
<br />Part I. Taxpayer Identification Number (TIN)
<br />2ÄThe United States or any of its agencies or instrumentalities
<br />If you are a residentalien and you do not
<br />3ÄA state, the District of Columbia, a possession of the United
<br />Enter your TIN in the appropriate box.
<br />have and are not eligible to get an SSN,your TIN is your IRS individual taxpayer
<br />their political subdivisions or instrumentalities
<br />
<br />identification number(ITIN). Enter it in the social security number box. If you do no
<br />
<br />4ÄA foreign government or any of its political subdivisions, age
<br />have an ITIN, seebelow.
<br /> How to get a TIN
<br />instrumentalities
<br />If you are a sole proprietor and you have an EIN, you may enter
<br />5ÄA corporation
<br />or EIN. However, the IRS prefers that you use your SSN.
<br />6ÄA dealer in securities or commodities required to register in
<br />If you are a single-member LLC that is disregarded as an entity
<br />States, the District of Columbia, or a possession of the United
<br />owner (see on page 2), enter the ownerÈs SSN (or
<br />Limited Liability Company(LLC)
<br />7ÄA futures commission merchant registered with the Commodity Fu
<br />EIN, if the owner has one). Do not enter the disregarded entityÈ
<br />Trading Commission
<br />classified as a corporation or partnership, enter the entityÈs E
<br />8ÄA real estate investment trust
<br />See the chart on page 4 for further clarification of nameand TIN
<br />Note.
<br />combinations.
<br />9ÄAn entity registered at all times during the tax year under th
<br />Company Act of 1940
<br />If you do not have a TIN, apply for oneimmediately. To apply
<br />How to get a TIN.
<br />for an SSN, get Form SS-5, Applicationfor a Social Security Card, from your local
<br />
<br />10ÄA common trust fund operated by a bank under section 584(a)
<br />Social SecurityAdministration office or get this form online at . You
<br /> www.ssa.gov
<br />11ÄA financial institution
<br />may also get this form by calling 1-800-772-1213. Use FormW-7, Application for
<br />
<br />12ÄA middleman known in the investment community as a nominee orIRS Individual Taxpayer IdentificationNumber, to apply for an ITIN, or Form SS-4,
<br />
<br />custodian
<br />Application forEmployer Identification Number, to apply for an EIN. You canapply
<br />
<br />for an EIN online by accessing the IRS website atand
<br /> www.irs.gov/businesses
<br />13ÄA trust exempt from tax under section 664 or described in sec
<br />clicking on Employer IdentificationNumber (EIN) under Starting a Business. You
<br />
<br />The following chart shows types of payments that may be exempt f
<br />can get Forms W-7and SS-4 from the IRS by visiting IRS.govor by calling1-800-
<br />
<br />withholding. The chart applies to the exempt payees listed above
<br />TAX-FORM (1-800-829-3676).
<br />If you are asked to complete Form W-9 but do not have a TIN, app
<br />IF the payment is for . . .THEN the payment is exempt for . . .
<br />and write ÅApplied ForÆ in the space for the TIN, sign and date
<br />to the requester. For interest and dividend payments, and certai
<br />with respect to readily tradable instruments, generally you will
<br />Interest and dividend paymentsAll exempt payees except
<br />a TIN and give it to the requester before you are subject to bac
<br />for 7
<br />payments. The 60-day rule does not apply to other types of payme
<br />subject to backup withholding on all such payments until you pro
<br />Broker transactionsExempt payees 1 through 4 and 6
<br />the requester.
<br />through 11 and all C corporations. S
<br />corporations must not enter an exempt
<br />Entering ÅApplied ForÆ means that you have alreadyapplied for a TIN or that
<br />Note.
<br />payee code because they are exempt
<br />you intend to apply for one soon.
<br />only for sales of noncovered securities
<br />Caution: A disregarded U.S. entity that has a foreign owner must use the
<br />acquired prior to 2012.
<br />appropriate Form W-8.
<br />Barter exchange transactions and Exempt payees 1 through 4
<br />Part II. Certification
<br />patronage dividends
<br />To establish to the withholding agent that you are a U.S. person
<br />Payments over $600 required to be Generally, exempt payees
<br />sign Form W-9. You may be requested to sign by the withholding a
<br />12
<br />reported and direct sales over $5,0001 through 5
<br />items 1, 4, or 5 below indicate otherwise.
<br />For a joint account, only the person whose TIN is shown in Part
<br />Payments made in settlement of Exempt payees 1 through 4
<br />(when required). In the case of a disregarded entity, the person
<br />payment card or third party network
<br />ÅNameÆ line must sign. Exempt payees, see earlier.
<br />
<br />transactions
<br />Complete the certification as indicatedin items 1
<br />Signature requirements.
<br />1
<br />through 5 below.
<br />
<br />See Form 1099-MISC, Miscellaneous Income, and its instructions.
<br />2
<br />1. Interest, dividend, and barter exchange accounts opened befor
<br />However, the following payments made to a corporation and report
<br />You must give your
<br />and broker accounts considered active during 1983.
<br />1099-MISC are not exempt from backup withholding: medical and he
<br />correct TIN, but you do nothave to sign the certification.
<br />
<br />payments, attorneys' fees, gross proceeds paid to an attorney, a
<br />services paid by a federal executive agency.
<br />2. Interest, dividend, broker, and barter exchange accounts open
<br />You must sign the
<br />1983 and broker accounts considered inactive during 1983.
<br />The following codes identify payees
<br />Exemption from FATCA reporting code.
<br />certification or backupwithholding will apply. If you are subject to backup
<br />
<br />that are exempt from reporting under FATCA. These codes apply to
<br />withholdingand you are merely providing your correct TIN to the requester,you
<br />
<br />submitting this form for accounts maintained outside of the Unit
<br />must cross out item 2 in the certification before signing theform.
<br />
<br />certain foreign financial institutions. Therefore, if you are on
<br />for an account you hold in the United States, you may leave this
<br />You must sign the certification.You may cross out
<br />3. Real estate transactions.
<br />Consult with the person requesting this form if you are uncertai
<br />item 2 of the certification.
<br />institution is subject to these requirements.
<br />You must give your correct TIN, but youdo not have to sign
<br />4. Other payments.
<br />AÄAn organization exempt from tax under section 501(a) or any in
<br />the certification unless you have beennotified that you have previously given an
<br />
<br />retirement plan as defined in section 7701(a)(37)
<br />incorrect TIN. ÅOtherpaymentsÆ include payments made in the course of the
<br />
<br />requesterÈs trade or business for rents, royalties, goods (otherthan bills for
<br />
<br />BÄThe United States or any of its agencies or instrumentalities
<br />merchandise), medical and health care services(including payments to
<br />
<br />CÄA state, the District of Columbia, a possession of the United
<br />corporations), payments to anonemployee for services, payments made in
<br />
<br />of their political subdivisions or instrumentalities
<br />settlement of payment card and third party network transactions,
<br />certain fishing boat crewmembers and fishermen, and gross proceeds paid to
<br />
<br />DÄA corporation the stock of which is regularly traded on one or
<br />attorneys(including payments to corporations).
<br />
<br />established securities markets, as described in Reg. section 1.1
<br />5. Mortgage interest paid by you, acquisition or abandonment of
<br />EÄA corporation that is a member of the same expanded affiliated
<br />property, cancellation of debt, qualified tuition program paymen
<br />corporation described in Reg. section 1.1472-1(c)(1)(i)
<br />section 529), IRA, Coverdell ESA, Archer MSA or HSA contribution
<br />FÄA dealer in securities, commodities, or derivative financial i
<br />You must give yourcorrect TIN, but you
<br />distributions, and pension distributions.
<br />(including notional principal contracts, futures, forwards, and
<br />do not have to sign the certification.
<br />registered as such under the laws of the United States or any st
<br />
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