W9 Individual Word

Department of the Treasury Internal Revenue Service

W-9

Request for Taxpayer Identification Number and Certification Name (as shown on your income tax return)

Form (Rev. October 2007)

Give form to the requester. Do not send to the IRS.

Business name, if different from above

Other (see instructions) Address (number, street, and apt. or suite no.) Exempt payee Requester’s name and address (optional)

City, state, and ZIP code

Part I Taxpayer Identification Number (TIN) Social security number

Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident Note. If theproprietor, account isor in disregarded more than one name, on page 4on for guidelines on whose alien, sole entity, seesee thethe Partchart I instructions page 3. For other entities, it is number to enter. your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

or Employer identification number

Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am 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 failure to report all interest or dividends, or (c) the IRS has 3.notified I am a U.S. citizen or no other U.S.subject person to (defined me that I am longer backupbelow). withholding, and 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 because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. Sign For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement Here arrangementSignature (IRA), and of generally, payments other than interest and dividends, you are not required to sign the Certification, but you must person provide yourU.S. correct TIN. See the instructions on page 4. Date

General Instructions Section references are to the Internal Revenue Code unless otherwise 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) 1. Certify that the TIN you are giving is correct (or you are to report, for example, income paid to you, real estate waiting for a number to be issued), 2. Certify that you areinterest not subject backup withholding, or transactions, mortgage you to paid, acquisition or 3. Claim exemption fromproperty, backup withholding areor a U.S. abandonment of secured cancellationifofyou debt, Definition of a U.S. person. For federal tax purposes, you are exempt payee. If applicable, contributions you made to anyou IRA.are also certifying that as a considered a U.S. person if you are: ● The U.S. owner of a disregarded entity and not the entity, U.S. person, youronly allocable of any partnership income from Use Form W-9 if you share are a U.S. person (including a ● An individual who is a U.S. citizen or U.S. resident alien, a U.S. trade or business is your not subject the resident alien), to provide correctto TIN towithholding the person tax on ● A partnership, corporation, company, orForm association created or foreign partners’ of effectively connected income. requesting it (theshare requester) and, when applicable, to: organized in the United States or under the laws of the United Cat. No. 10231X Note. If a requester gives you a form other than Form W-9 to States, request your TIN, you must use the requester’s form if it is ● An estate (other than a foreign estate), or W-9 substantially similar to this Form W-9. ● A domestic trust (as defined in Regulations section (Rev. 10-2007) 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding 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 are 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 income. The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases:

Print or Form W-9 (Rev. 10-2007) type See Specifi c ● The U.S. grantor or other owner of a grantor trust and not the Instruc trust, and Foreign person. If you are a foreign person, do not use Form tions ● The U.S. trust (other than a grantor trust) and not the W-9. Instead, use the appropriate Form W-8 (see Publication onNonresident page alien who becomes a resident alien. Generally, beneficiaries of the trust. 515, Withholding of Tax on Nonresident Aliens and Foreign only a nonresident alien individual may use the terms of a tax 2. 4. The type and amount of income that qualifies for the Entities). treaty to reduce or eliminate U.S. tax on certain types of income. exemption from tax. 5. Sufficient to justifycontain the exemption from tax under However, mostfacts tax treaties a provision known as a the terms ofclause.” the treaty article. “saving Exceptions the saving clauseallows may Example. Article 20 of the specified U.S.-Chinainincome tax treaty permit an exemption from to continue for certain types an exemption from tax for tax scholarship income received by aof What is backup withholding? Persons makingbecome certainapayments income after the payee present has otherwise U.S.Under Chineseeven student temporarily in the United States. to you must under certain conditions withhold and pay to the resident alien for tax purposes. U.S. law, this student will become a resident alien for tax IRS 28%are of such payments. This who is called “backup an withholding.” If you a U.S. resident alien is relying exception purposes if his or her stay in the United States on exceeds 5 Payments that may be subject to a backup withholding include contained in the saving clause of tax treaty to claim an to the calendar years. However, paragraph 2 of the first Protocol interest, tax-exempt interest, dividends, broker and barter exemption treaty from U.S. tax April on certain typesallows of income, you mustof U.S.-China (dated 30, 1984) the provisions exchange transactions, rents, royalties, nonemployee pay, and attach to to Form W-9 thatafter specifies the following five Article a 20statement to continue apply even the Chinese student certain payments from fishing boat operators. Real estate items: becomes a resident alien of the United States. A Chinese transactions arecountry. not subject to backup 1. The who treaty this withholding. must beparagraph the same treaty student qualifies forGenerally, this exception (under 2 of You will notyou be subject to backup withholding payments under which claimed exemption from tax ason ato nonresident the first protocol) and is relying on this exception claim an you receive if you give the requester your correct TIN, make the alien. exemption from tax on his or her scholarship or fellowship proper report all your taxable interest and 2. Thecertifications, treatyattach articleand addressing income. income would to Form W-9 the a statement that includes the dividends on your tax return. 3. The article number (or location) in the tax treaty that information described above to support that exemption. contains the saving clause and its exceptions. If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W-8.

Payments you receive will be subject to backup withholding if: furnish your TIN to the requester, 1. You do not

2. You do not certify your TIN when required (see the Part II instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN,

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2

4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and 5. You do not certify to the requester that you are not subject dividends on your tax return (for reportable interest and to backup withholding under 4 above (for reportable interest and dividends only), or Penalties dividend accounts opened after 1983 only). Failure topayees furnish and TIN. payments If you fail to your correct TIN to a Certain arefurnish exempt from backup requester, you are subject to a penalty of $50 for each such withholding. the instructions and the Civil penalty See for false information below with respect toseparate failure unless your is due to reasonable and not to Instructions the failure Requester of statement Form W-9. withcause withholding. for If you make a false no reasonable willful neglect. Also that see Special rules for partnerships on page 1. subject to a basis results in no backup withholding, you are

Specific Instructions

$500 penalty. Name Criminal for falsifying information. falsifying If you arepenalty an individual, you must generallyWillfully enter the name certifications orincome affirmations may subject youif to criminal shown on your tax return. However, you have changed If the account is in joint names, list first, and then circle, the penalties including and/or imprisonment. your last name, for fines instance, due to marriage without informing name ofofthe person orrequester entity whose number you entered in Part I Misuse TINs. If the discloses or uses TINs in For an LLC classified as a partnership or a corporation, enter the Social Security Administration of the name change, enter of the form. violation federal law, the requester may be subject to civil or and the name on line and any business, trade, yourLLC’s first of name, thethe last“Name” name shown on your social security Sole proprietor. Enter your individual name as shown on your criminal DBA on the “Business name” line. card,name andpenalties. your new last name. income tax return on the “Name” line. You may enter your Other entities. Enter your business name as shown on required business, trade, or “doing business as (DBA)” name on the federal tax documents on the “Name” line. This name should “Business name” line. Exempt Payee match the name shown on the charter or other legal document Limited liability company (LLC).withholding, Check the “Limited liability If you are exempt entertrade, your name creating the entity.from You backup may enter any business, or DBAas company” above box only enter appropriate code for the tax described andand check thethe appropriate box for your status, name on the “Business name” line. classification (“D” for disregarded entity, “C” forfollowing corporation, “P” then check the “Exempt payee” the line Note. You are requested to checkbox thein appropriate box for the your for partnership) in the space business name, sign and dateprovided. thecorporation, form. status (individual/sole proprietor, etc.). For a single-member LLC (including a foreign LLC with a domestic owner) that is disregarded as an entity separate from its owner under Regulations section 301.7701-3, enter the owner’s name on the “Name” line. Enter the LLC’s name on the “Business name” line.

Form W-9 (Rev. 10-2007) Page

3 Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup 2. The United States or any of its agencies or withholding for certain payments, such as interest and dividends. instrumentalities, 3. A state, the exempt District of Columbia, possession you of the United Note. If you are from backup a withholding, should States, or anythis of their political or instrumentalities, still form to avoidsubdivisions possible erroneous backup 5. complete An international organization or any of its agencies or 4. A foreign government or any of its political subdivisions, withholding. instrumentalities. 10. Afollowing real investment trust, agencies, orestate instrumentalities, or The are Other payees payees that may beexempt exemptfrom frombackup backupwithholding: withholding 1. An exempt from taxduring under the section 501(a), any 11. Anorganization entity registered at all times tax year under include: IRA, orcorporation, a custodial accountAct under section 403(b)(7) if the account the Company of 1940, 6. Investment A The chart below shows types of payments that may be satisfies the requirements of section by 401(f)(2), 12.AAforeign common trustbank fund of operated a bank under section 7. central issue, exempt from backup withholding. The chart applies to the IF the payment is for . . . or commodities required to register in 584(a), 8. A dealer in securities exempt payees listed above, 1 through 15. 13.United A financial institution, the the District of Columbia, or a possession of Interest andStates, dividend payments 14.United A middleman the States, known in the investment community as a Broker transactions nominee or custodian, or merchant registered with the 9. A futures commission 15. A trust Futures exempt Trading from taxCommission, under section 664 or described Commodity THEN the payment is exempt in section 4947. for . . . All exempt payees except for 9 Exempt payees 1 through 13. Also, a person registered under Exempt payees Advisers 1 throughAct 5 of the Investment 1940 who regularly acts as a Generally, exempt payees broker 2 1 through 7

Barter exchange transactions and patronage dividends Payments over $600 required to be reported and direct 1 1sales over $5,000 2

See Form 1099-MISC, Miscellaneous Income, and its instructions. However, the following payments made to a corporation (including gross proceeds paid to an attorney under section 6045(f), even if the attorney is a corporation) and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys’ fees, and payments for services paid by a federal executive agency.

Part I. Taxpayer Identification Enter your TIN in the appropriate box. If you are a resident Number (TIN) alien and you do not have and are not eligible to get an SSN, Part II. isCertification your TIN your IRS individual taxpayer identification number

To establish the withholding agentnumber that you areIfayou U.S.do person, (ITIN). Enter to it in the social security box. not or resident alien, You may be requested to sign have an ITIN, see sign HowForm to getW-9. a TIN below. byIfthe agent even if items 1, 4,an and 5 below indicate youwithholding are a sole proprietor and you have EIN, you may otherwise. enter either your SSN or EIN. However, the IRS prefers that you Foryour a joint account, only the person whose TIN is shown in use SSN. Part I should (when required). Exempt payees, see If you are asign single-member LLC that is disregarded as Exempt an Payee on page 2. entity separate from its owner (see Limited liability company Signature requirements. Complete certification as indicated (LLC) on page 2), enter the owner’sthe SSN (or EIN, if the owner in 1 one). through below. has Do 5not enter the disregarded entity’s EIN. If the LLC is 1. Interest, andor barter exchange accounts classified as adividend, corporation partnership, enter the entity’s EIN. opened before 1984on and broker accounts considered active Note. See the chart page 4 for further clarification of name during You must give your correct TIN, but you do not and TIN1983. combinations. have to get signa the How to TIN.certification. If you do not have a TIN, apply for one 2. Interest, dividend, broker, andget barter immediately. To apply for an SSN, Formexchange SS-5, Application accounts opened after 1983 andyour broker accounts considered for a Social Security Card, from local Social Security inactive during office 1983. or You must certification or backup Administration get this sign formthe online at www.ssa.gov. You withholding apply. are subject to backup Use withholding may also getwill this form Ifbyyou calling 1-800-772-1213. Form and are merely yourTaxpayer correct TIN to the requester, W-7,you Application for providing IRS Individual Identification you mustto cross out item 2 in the certification before signing Number, apply for an ITIN, or Form SS-4, Application for the form. Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting www.irs.gov or by calling 1-800-TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8.

Form W-9 (Rev. 10-2007) Page

4 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been 5. Mortgage interest paid by you, acquisition or notified that you have previously given an incorrect TIN. “Other abandonment of secured property, cancellation of debt, payments” include payments made in the course of the qualified tuition program payments (under section 529), IRA, requester’s trade or business for rents, royalties, goods (other Coverdell ESA, Archer MSA or HSA contributions or than bills for merchandise), medical and health care services distributions, and pension distributions. You must give your (including payments to corporations), payments to a correct TIN, but you do not have to sign the certification. nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations).

What Name and Number To Give the Requester For this type of account: 1. Individual 2. Two or more individuals (joint 3.account) Custodian account of a minor (Uniform Gift to Minors Act) For usual this type of account: 4. a. The revocable savings trust (grantor is also trustee) 6. Disregarded not owned b. So-called entity trust account thatby is an individual not a legal or valid trust under 1 7. Astate validlaw trust, estate, or pension trust 8.5.Corporate or LLC electing Sole proprietorship or disregarded corporate status 8832 entity owned by on an Form individual 9. Association, club, religious, charitable, educational, or other tax-exempt organization 10. Partnership or multi-member LLC 11. A broker or registered nominee 12. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments

Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal information such as your name, social security number (SSN), or To reduce your risk: other identifying information, without your permission, to commit ● Protect your SSN, Protect from suspicious or phishing fraud oryourself other crimes. An identityemails thief may use your SSN to get ● Ensure your employer is protecting your SSN, and schemes. Phishing is the creation and use of to email and refund. a job or may file a tax return using your SSN you receive an choosing unsolicited email claiming toreceive be fromathe IRS, ● IfBe careful when a tax preparer. websites designed to mimic legitimate business emails and forward this message to [email protected]. You may also report Call the IRS at 1-800-829-1040 if you think your identity has Visit the The IRS website at www.irs.gov to learn websites. most common act is sending anmore emailabout to a user misuse of the IRS name, logo, or other IRS personal property to been used inappropriately for tax purposes. identity theft and to established reduce your risk. falsely claiming tohow be an legitimate enterprise in an the Treasury Inspector General for experiencing Tax Administration at harm Victims of identity theft who are economic attempt to scam the user into surrendering private information 1-800-366-4484. You can forward suspicious emails totax the or a system problem, or are seeking help in resolving that will be used for identity theft. Federal Trade at: resolved [email protected] contact them at problems that Commission have not been throughor normal channels, The IRS does not initiate contacts with taxpayers via emails. www.consumer.gov/idtheft orAdvocate 1-877-IDTHEFT(438-4338). may be eligible for Taxpayer Service (TAS) assistance. Also, the IRS does not request personal detailed information You can reach TAS by calling the TAS toll-free case intake line through email or ask taxpayers for the PIN numbers, passwords, at 1-877-777-4778 or TTY/TDD 1-800-829-4059. or similar secret access information for their credit card, bank, or other financial accounts.

Give name and SSN of: The individual The actual owner of the account or, The grantor-trustee if combined funds, the first 1individual on the account The actual owner 2The minor 3

1

1

The owner Give name and EIN of: The owner Legal entity The corporation The organization 4

The partnership The broker or nominee

List first and circle the name of the person whose number you furnish. The public entity If only one person on a joint account has an SSN, that person’s number must be furnished. Circle the minor’s name and furnish the minor’s SSN. You must show your individual name and you may also enter your business or “DBA” name on the second name line. You may use either your SSN or EIN (if you have one), but encourages you toofuse SSN. Listthe firstIRS and circle the name theyour trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in 2 the account title.) Also see Special rules for partnerships on page 1. 3 4

Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.

Privacy Act Notice

Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or You must provide your TIN whether not you are fileuses a tax return. Payers generallypurposes withholdand 28%toofhelp taxable dividend, and tax certain other contributions you made to an IRA, or or Archer MSA or required HSA. ThetoIRS the numbers for must identification verifyinterest, the accuracy of your return. payments to a payee who this does not give a to TINthe to Department a payer. Certain penalties mayand alsocriminal apply. litigation, and to cities, states, the District of Columbia, and U.S. The IRS may also provide information of Justice for civil possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.