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<br /> Form W-9(Rev.10-2018) Page 4
<br /> The following chart shows types of payments that may be exempt M—A tax exempt trust under a section 403(b)plan or section 457(g)
<br /> from backup withholding.The chart applies to the exempt payees listed plan
<br /> above,1 through 13. Note:You may wish to consult with the financial institution requesting
<br /> IF the payment is for... THEN the payment is exempt this form to determine whether the FATCA code and/or exempt payee
<br /> for... code should be completed.
<br /> Interest and dividend payments All exempt payees except Line 5
<br /> for 7 Enter your address(number,street,and apartment or suite number).
<br /> Broker transactions Exempt payees 1 through 4 and 6 This is where the requester of this Form W-9 will mail your information
<br /> through 11 and all C corporations. returns.If this address differs from the one the requester already has on
<br /> S corporations must not enter an file,write NEW at the top.If a new address is provided,there is still a
<br /> exempt payee code because they chance the old address will be used until the payor changes your
<br /> are exempt only for sales of address in their records.
<br /> noncovered securities acquired Line 6
<br /> prior to 2012.
<br /> Barter exchange transactions and Exempt payees 1 through 4 Enter your city,state,and ZIP code.
<br /> patronage dividends Part 1. Taxpayer Identification Number (TIN)
<br /> Payments over$600 required to be Generally,exempt payees Enter your TIN in the appropriate box.If you are a resident alien and
<br /> reported and direct sales over 1 through 52 you do not have and are not eligible to get an SSN,your TIN is your IRS
<br /> $5,0001 individual taxpayer identification number(]TIN).Enter it in the social
<br /> security number box. If you do not have an ITIN,see How to get a TIN
<br /> Payments made in settlement of Exempt payees 1 through 4 below.
<br /> payment card or third party network If you are a sole proprietor and you have an EIN,you may enter either
<br /> transactions your SSN or EIN.
<br /> 1 See Form 1099-MISC,Miscellaneous Income,and its instructions. If you are a single-member LLC that is disregarded as an entity
<br /> separate from its owner,enter the owner's SSN(or EIN,if the owner has
<br /> z However,the following payments made to a corporation and one).Do not enter the disregarded entity's EIN.If the LLC is classified as
<br /> reportable on Form 1099-MISC are not exempt from backup a corporation or partnership,enter the entity's EIN.
<br /> withholding:medical and health care payments,attorneys'fees,gross Note:See What Name and Number To Give the Requester, later,for
<br /> proceeds paid to an attorney reportable under section 6045(f),and further clarification m name and TIN combinations.
<br /> payments for services paid by a federal executive agency.
<br /> Exemption from FATCA reporting code.The following codes identify How to get a TIN.If you do not have a TIN,apply for one immediately.
<br /> payees that are exempt from reporting under FATCA.These codes To apply for an SSN,get Form SS-5,Application for a Social Security
<br /> apply to persons submitting this form for accounts maintained outside Card,from your local SSA office or get this form online at
<br /> of the United States by certain foreign financial Institutions.Therefore,if www.SSA.gov.You may also get this form by calling 1-800-772-1213.
<br /> you are only submitting this form for an account you hold in the United Use Form W-7,Application for IRS Individual Taxpayer Identification
<br /> States,you may leave this field blank.Consult with the person Number,to apply for an ITIN,or Form SS-4,Application for Employer
<br /> requesting this form if you are uncertain if the financial institution is Identification Number,to apply for an EIN.You can apply for an EIN
<br /> subject to these requirements.A requester may indicate that a code is online by accessing the IRS website at www.irs.gov/Businesses and
<br /> not required by providing you with a Form W-9 with"Not Applicable"(or clicking on Employer Identification Number(EIN)under Starting a
<br /> any similar indication)written or printed on the line for a FATCA Business.Go to www.irs.gov/Forms to view,download,or print Form
<br /> exemption code. W-7 and/or Form SS-4. Or,you can go to www.irs.gov/OrderForms to
<br /> place an order and have Form W-7 and/or SS-4 mailed to you within 10
<br /> A—An organization exempt from tax under section 501(a)or any business days.
<br /> individual retirement plan as defined in section 7701(a)(37) If you are asked to complete Form W-9 but do not have a TIN,apply
<br /> B—The United States or any of its agencies or instrumentalities for a TIN and write"Applied For"in the space for the TIN,sign and date
<br /> C—A state,the District of Columbia,a U.S.commonwealth or the form,and give it to the requester.For interest and dividend
<br /> possession,or any of their political subdivisions or instrumentalities payments,and certain payments made with respect to readily tradable
<br /> D—A corporation the stock of which is regularly traded on one or instruments,generally you will have 60 days to get a TIN and give it to
<br /> more established securities markets,as described in Regulations the requester before you are subject to backup withholding on
<br /> section 1.1472-1(c)(1)(1) payments.The 60-day rule does not apply to other types of payments.
<br /> You will be subject to backup withholding on all such payments until
<br /> E—A corporation that is a member of the same expanded affiliated you provide your TIN to the requester.
<br /> group as a corporation described in Regulations section 1.1472-1(c)(1)(i) Note:Entering"Applied For"means that you have already applied for a
<br /> F—A dealer in securities,commodities,or derivative financial TIN or that you intend to apply for one soon.
<br /> instruments(including notional principal contracts,futures,forwards,
<br /> and options)that is registered as such under the laws of the United Caution:A disregarded U.S.entity that has a foreign owner must use
<br /> States or any state the appropriate Form W-8.
<br /> G—A real estate investment trust Part II. Certification
<br /> H—A regulated investment company as defined in section 851 or an To establish to the withholding agent that you are a U.S.person,or
<br /> entity registered at all times during the tax year under the Investment resident alien,sign Form W-9.You may be requested to sign by the
<br /> Company Act of 1940 withholding agent even if item 1,4,or 5 below indicates otherwise.
<br /> I—A common trust fund as defined in section 584(a) For a joint account,only the person whose TIN is shown in Part I
<br /> J—A bank as defined in section 581 should sign(when required). In the case of a disregarded entity,the
<br /> K—A broker person identified on line 1 must sign.Exempt payees,see Exempt payee
<br /> L—A trust exempt from tax under section 664 or described in section
<br /> code, earlier.
<br /> 4947(a)(1) Signature requirements.Complete the certification as indicated in
<br /> items 1 through 5 below.
<br />
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