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Request for Taxpayer Give Form to the
<br />(Rev. December 2011:\) Identification Number and Certification requester. Do not
<br />Department of Iha Trea sury send to the IRS. htemal Revenue Se 1vice
<br />1 Name {as shown on your income tax return). Name is required on this l!ne; do not leave this llne blank.
<br />Ecolane USA, Inc.
<br />2 Business name/disregarded entity name, if different from above
<br />3 Check appropriate box for federal tax classification; check only one of the following sovon boxes: 4 Exemptions (codes apply only to
<br />Individual/sole proprietor or (Z] C Corporation S Corporation Partnership TrusVestato certain entities, not individuals; see Instructions on page 3): single-member LLC Exempt payee code (ll any! Limited liability company. Enter the tax classification (C=C corporation, S=S corporation. P=partnership) ►
<br />0 � Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for Exemption from FATCA reporting
<br />tho lax classification of the single-member owner. code Of any)
<br />Other (see Instructions)► �pfu lo •=nt, ma.'n/1/I IBdoul:.lt!• rt,e U.S.} C. u 5 Address (number, s1reet, and apt. or suite no.) Requester's name and address {optionaij
<br />2601 Navistar Drive � m 6 City, state, and ZIP code
<br />Lisle, IL 60532
<br />7 List account number(s) here {optional)
<br />1 Soclal security number I Enter your TIN In the approwi_ate box. !h,e TIN provided must_ match t�e name given on line 1 lo avoid
<br />backup wlthholdlng. For Individuals, this is generally your social secunty number (SSN). However, for a
<br />resident alien, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other
<br />entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
<br />TIN on page 3. or
<br />Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for I Employer Identification number
<br />guidelines on whose number to enter. 26 -1890678
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this form is my correct taxpayer identification number (or I am walling for a number to be issued to me); and
<br />2. I am not subjecl to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by !he Internal Revenue
<br />Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the !RS has notified me that I am
<br />no longersubject to backup withholding; and
<br />3. I am a U.S. citizen or other U.S. person (defined below); and
<br />4. The FAICAcode(s) entered on this form (if any) indicating that I am exempt from FATCA reporting ls correct.
<br />Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
<br />because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage
<br />interest paid, acquisltlon abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
<br />generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the·
<br />instructions oo page 3.
<br />Signature of
<br />U.S. porson ► "'1" . Date►
<br />General Instructions
<br />Section references are to the Internal Revenue Code unress otherwise noted.
<br />Future developments. Information about developments affecting Form W-9 (such as legislation enacted after wa release ii) is at www.lrs.gov/tw9.
<br />An individual or entity (Form W-9 requester) who Is i-equired to file an lnrom,atlon return with the IRS must obla!n your correct taxpayer identification number (TIN) which may be your social seC\Jrity number (SSN), tndividua( taxpayer identification number (ITIN), adoption taxpayer identifica1Ion number (ATJN), or employer ldonlification number (EIN), 10 report on an Information return the amount paid to you, or other amount reportable on an information roturn. Examples of information returns include, but are not limited to, t)ie following:
<br />• Form 1099•1NT 0nterest earned or paid)
<br />• Form t 099-DIV (dividends, including those from stocks or mutual funds)
<br />• Form 1099-MSC (various types of income, prizes, awards, or gross proceeds)
<br />• Form 1099-8 (stock or mutual fund sales and certain other transactions by brokers)
<br />• Form 1099-S (procoeds from roa1 ostate lransacllons)
<br />• Form 1099-K {merchant card and third party nolwork transactions)
<br />• Form 1098 (homo mortgage interest) (tui11on)
<br />• Form 1099-C (canceled debt)
<br />• Form 1099·A (acquisition or abandonmenl of secured property)
<br />Use Form W-9 only if you are a U.S. person (including a res!denl alien), to provide your correct TIN.
<br />If you do not re tum Form w.g to the requester with a TIN, you might be subject to bacf,up w/lh ho!din9. See What is backup withholding? on page 2.
<br />By signing lhe lllled•out fom,, you:
<br />1. Certify th al tho TIN you are giving Is correct (or you are wafting for a number to be Issued).
<br />2. Certify lhal you are not subject to backup withholding, or
<br />3. Claim exemption from backup withholding ir you are a U.S. exompt payee. If applicable, you are also certifying that as a U.S. person, your allocabte share of arr; partnership Income from a U.S. trade or business is not subject to the withholding tax on roraign partners' share of effectively connected Income, and
<br />4. Certiry that FAT CAcode(s)enteredon this form Df any) indicating that you are exempt from the FATCA reporting, 1s correct. See What is FA TCA reporting? on page 2 for further information.
<br />Cnt. No. 10231X Form (Rev. 12·2014)
<br />Docusign Envelope ID: 30116525-3CA0-44BF-A300-567E64354BC7
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