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Farm W-9 Request for Taxpayer Give form to the (Rev.January zoaqrequester.Do not Cepar=vtd as rraary Identification Number and Certification send to the IRS. ural ate Scrio CNam 0 titaness none,f dtkmn nom abets 0 T O VIaMdUlfE32rept ton ostup — .ai¢ CIECtopN1_1le ccat sob praneor ❑corpaiscn ❑ Patrsenp 1:1litwar ❑simm r[ Tx Mdners(nuntxa,steel,ala apt a ante not Requester's num and annss Rptmreq 'c n a - it a City,state,and ZIP rade c n List a®uit runce4sl tae(epeore9 rn 17711 Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box.Fcr individuals.this is your social security number(55th). Social sectxfy natter However,for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on I I I I I I page 3.Fa other enutes.it is your employer icbrtifration number(EIN).If you do not have a number. see How to get a TIN on page 3. or Note:If tit account is in nae than one came,see the that m page 4 for gudernes m'those number brtipmyer 001T11114311011 number to enter. III I I I I I Lodi Certification Under penalties of perjury.I certify that: 1. The minter shown on the form is my correct taxpayer identification number(a I am waiting for a number to be issued to me).and 2. I am rot subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been naffed by the hl.nnat Revalue Service ORS)that I am subject to backup withholding as a result of a&dun to report all"menet or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding. and 3. I am a U.S.person(including a U.S.resident ellen). Certification instructions.You must cross out item 2 above d you have been notified by the IRS that you are currently subject to backup withholding because you have faded to resat all interest and dividends on you tax return.Far real estate transactions item 2 does not apply. For mortgage interest paid,acquisition a abandonment of secured property,cancellation of debt,contributions to an individual rairemerrt arrangement ORA),and generally,payments other than interest and dividends,you are rot required to sign the Certification,bid you must provide your correct TIN.(See the instructions on page 1.) Sign signature of Here u.s.person ► Date ► Purpose of Form Nonresident alien who becomes a resident alien. Generally,only a nonresident alien individual may use the A person who is required to file an information return with terms of a tax treaty to reduce or eliminate U.S.tax on the IRS. must obtain your correct taxpayer identification certain types of income.However,most tax treaties contain a number(TIN)to report,for example, income paid to you,real provision known as a'saving clause.'Exceptions specified estate transactions. mortgage interest you paid,acquisition in the saving clause may permit an exemption from tax to or abandonment of secured property. cancellation of debt or continue for certain types of income even after the recipient contributions you made to an IRA. has otherwise become a U.S. resident alien for tax purposes. U.S.person. the Form W-9 only if you are a U.S.person If you are a U.S.resident alien who is relying on an (uncklding a resident Siert),to provide your correct TIN to the exception contained in the saving dause of a tax treaty to person requesting it(the requester)and.when applicable. tor. claim an exemption from U.S. tax on certain types of income. 1.Certify that the TIN you are giving is correct(or you are you must attach a statement that specifies the following five waiting for a number to be issued), Items: 2.Certify that you are not subject to backup withholding. 1.The treaty country. Generally,this must be the same or treaty under which you claimed exemption from tax as a 3.Claim exemption from backup withholdng if you area nonresident alien. U.S.exempt payee. 2.The treaty article addressing the income. Note:If a requester giros you a Term other than Form W.9 3.The article number(or location)in the tax treaty that to request you TIN,you must use the requester's form if I 6 contains the saving clause and is exceptions. substantially simian to this Form W-9. 4.The type and amount of income that qualifies for the Foreign person.B you are a foreign person.use the exemption from tax. appropriate Form W-9(see Pub.515,Withholding of Tax on 5.Sufficient facts to justify the exemption from tax under Nonresident Ahens and Foreign Entities). the terms of the treaty article. Cal.fib.10231x Farr W-9 per.Lion) 00300-26/26