EPSTEIN
page 2 / 1356 . OCR, unverified
entities, it is your employer Identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. if the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
Seder security
Employer lemberbon number
Clifin
Certification
Under penalties of perjury, I certify that:
1. The number shown an this form is my correct taxpayer identification number (or I am waiting to a number to be *sued to me), and
2. lam not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a faiure to report all interest or drvklends or (o) the RS has notified me that I an,
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below).
Calf cation instructions. You must cross out item 2 above If you have been notified by the IRS that you we current/ subject to backup withholding
because you have failed to report all Internet and dividends on your tax return. For real estate transactions, item 2 dose not apply. For mortgage
interest paid, acquisition or abandontent of securgproperty, cancellation of debt. contributions to an individual retirement arrangement (IRA), and
generally, payments other then interest and divides, you are not requked to sign the certification, but you must provide your cornet TIN. See the
instructions on page 4.
Sign
Here
remetur of
U.S. person e
General Instructions
Section references are to the Internal Revenue Code unless othe
noted.
Purpose of Form
A person who is required to file an information return with the IRS must
obtain your correct taxpayer identification number (TIN) to report, for
wean** income paid to you, real estate transactions, mortgage Interest
you paid, acquisition or abandonment of secured property. cancellation
of debt, or contributions you made to an IRA
Use Form W-9 only W you are a U.S. carbon (nduding a resident
alien), to provide your correct TIN to the person requesting it (the
requester) and, when applicable, to
1. Certify that the TIN you we giving is correct (or you are waiting for a
number to be issued).
2. Certify that you we not subject to backup withholding, or
3. Claim exemption from backup withholding If you we a U.S. exempt
payee if applicable, you are also certifying that as a U.S. person, your
alkcable share of any partriership income from a U.S. trade or business
is not subject to the withholding tax on foreign partners' share of
effectively connected inoome.
se
Dale e
Note. If a requester gives you a form other then Fonn W-9 to request
your TIN, you must use the requester's tarn If it a substantially similar
to this Form W-9.
Dellnkion of a U.S. person. For federal tax PUrPosons you are
ooneidered a U.S. person d you we:
• An inervidual who is a U.S. citizen or U.S. resident
• A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States.
• An estate (other than a foreign estate), or
• A domestic Matt (as defined in Regulations section 301.7701-7).
Special Min for partnerships. Partnerships that conduct a trade or
business In the United States are generally required to pay a wkhholding
tax on any foreign partners' share of income from such business.
Further, in certain cases where a Form W-9 has not been received, a
partnership is required to presume that a partner is a foreign person.
and pay the withholding tax. Therefore, if you we a U.S. person that Is a
partner in a partnership conducting a trade or business in the United
States, provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership Some
Cat. No. 10231)(
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(0).
Fan) W-9 (Res 12-2011)
DB-SONY-0000116
USAO_001082
EFTA_000 18992
EFTA00168739
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----------------------------------------
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