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Enter your TIN in the appropriate box, Th
<br />Request for Taxpayer
<br />Give Form to the
<br />Form
<br />V�o
<br />identification Number and Certification
<br />requester. Do not
<br />(Rev. October
<br />2018)
<br />Department
<br />of the Treasury
<br />send to the IRS.
<br />Internal
<br />Revenue Service
<br />► Go to wwwJm,gov1FormW9 for instructions and the latest information.
<br />1 Name (as shown on your income tax return). Name Is required on this line; do not leave this line blank.
<br />2 Business name/disregarded entity name, if different from above
<br />SAGARIS CORP.
<br />m3
<br />Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
<br />4 Exemptions (codes apply only to
<br />rn
<br />�.
<br />following seven boxes.
<br />certain entities, not individuals; see
<br />Instructions on page 3);
<br />o
<br />❑ Individual/sole proprietor or ❑ C Corporation S Corporation ❑ Partnership ❑ Trust/estate
<br />ai G
<br />single -member LLC
<br />Exempt payee code Cif any)
<br />0
<br />III
<br />'S
<br />❑ Umited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)►
<br />o i?
<br />Note: Check the appropriate box in the line above forthe tax classification of the single -member owner. Do not check
<br />Exemption from FATCA reporting
<br />in
<br />LLC if the LLC is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC is
<br />code (if any)
<br />• 5
<br />another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
<br />a 9
<br />Is disregarded from the owner should check the appropriate box for the tax classification of its owner.
<br />2
<br />❑ Other (see Instructions) 0,
<br />faypr�re•rswm: momrauwaoarsa.rro usl
<br />5 Address (number, street, and apt. or suite no.) See Instructions.
<br />Requester's name and address (optional
<br />1847 N UNIVERSITY DR
<br />8 City, state, and ZIP code
<br />CORAL SPRINGS,FL 33071
<br />7 Ust account number(s) here (optional
<br />Mpg
<br />Taxpayer Identification Number
<br />(TIN)
<br />e TIN provided must match the name given on line 1 to avoid I social security number IIrrI----IIS�I----IIrrII IIIy
<br />backwithhldinFidividthiallial r(SSNHow ever, f
<br />up og. or nuals, sisgenery yoursocsecurity numbe
<br />ora -m �LJ�I�I
<br />resident alien, sole proprietor, or disregarded entity, see the Instructions for Part I, later
<br />. For otherLLU
<br />entities, it is your employer Identification number (EIN). If you do not have a number, see How to get a -L
<br />TIN, later, or
<br />Note: If the account is in more than one name, see the Instructions for line 1. Also see What Name and Employer identification number
<br />Number To Give the Requester for guidelines on whose number to enter.
<br />3 8 - 3 9 0 7 9 4 1 2
<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 waiting for a number to be issued to me); and
<br />2. 1 am not subject to backup withholding because; (a)1 am exempt from backup withholding, or (b) I have not been notified by the 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 IRS has notified me that I am
<br />no longer subject to backup withholding; and
<br />3. 1 am a U.S. citizen or other U.S. person (defined below); and
<br />4. The FATCA code(s) entered on this form (if any) Indicating that 1 am exempt from FATCA reporting Is 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 because
<br />you have fatted to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage interest paid,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
<br />other than Interest and dividendl,yo�ro� regdired-trrsign-fhes`fication, but you must provide your correct TIN. See the instructions for Part II, later.
<br />Here I u.s,
<br />Dat 111 .1
<br />General Instructions
<br />Section references are to the Internal Revenue Code unless otherwise
<br />noted.
<br />Future developments. For the latest information about developments
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, go to www.frs.gov/FormW9.
<br />Purpose of Form
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />information return with the IRS must obtain your correct taxpayer
<br />Identification number (TIN)which may be your social security number
<br />(SSN), individual taxpayer identification number (ITIN), adoption
<br />taxpayer identification number (ATIN), or employer identification number
<br />(EIN), to report on an information return the amount paid to you, or other
<br />amount reportable on an Information return. Examples of Information
<br />returns Include, but are not limited to, the following.
<br />• Form 1099 -INT (interest earned or paid)
<br />No. 10281X
<br />©
<br />•Form 1099 -DIV (dividends, including those from stocks or mutual
<br />funds)
<br />• Form 1099-MISG (various types of income, prizes, awards, or gross
<br />proceeds)
<br />• Form 1099-B (stock or mutual fund sales and certain other
<br />transactions by brokers)
<br />• Form 10995 (proceeds from real estate transactions)
<br />• Form 1099-K (merchant card and third party network transactions)
<br />• Form 1098 (home mortgage interest), 1098-E (student loan interest),
<br />1098-T (tuition)
<br />• Form 1099-0 (canceled debt)
<br />• Fonn 1099-A (acquisition or abandonment of secured property)
<br />Use Form W-9 only if you are a U.S. person (including a resident
<br />alien), to provide your correct TIN.
<br />If you do not return Form W-9 to the requester with a TIN, you might
<br />be subject to backup withholding. See What is backup withholding,
<br />later.
<br />Form
<br />Cat
<br />W -•J (Rev. 10-2018)
<br />
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