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<br /> Form
<br /> Request for Taxpayer Give Form to the i(Rev.November2017) Identification Number and Certification requester.Do not i
<br /> Department of the Treasury send to the IRS.
<br /> Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information., I
<br /> 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. i
<br /> A.0 Schultes of Florida, Inc. - •
<br /> 2 Business name/disregarded entity name.if different from above
<br /> d/b/a Jaffer Well Drilling
<br /> v3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1.Check only one of the 4 Exemptions(codes apply only to f
<br /> m following seven boxes. certain entities,not individuals;see
<br /> a instructions on page 3): f
<br /> o ❑ Individual/sole proprietor or El C Corporation ❑'S Corporation ❑ Partnership ❑Trust/estate
<br /> single member LLC
<br /> m c Exempt payee code(if any)
<br /> c
<br /> o ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)I. t
<br /> p` F. Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
<br /> .. wLLC if the LLC is classified as a single-member LLC that is disregardedthe ow
<br /> from the owner unless ner of the LLC is
<br /> e.E any)
<br /> code(if
<br /> another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that
<br /> d is disregarded from the owner should check the appropriate box for the tax classification of its owner. t
<br /> 2 ❑ Other(see instructions)► (eppfes to accounts maintained outside tire U.S.)
<br /> 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
<br /> toa
<br /> co 1451 SE 9th Court I
<br /> 6 City,state,and ZIP code t
<br /> Hialeah, FL 33010-5944
<br /> 7 List account number(s)here(optional) 1
<br /> Part,I!. Taxpayer Identification Number( IN)
<br /> Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid I Social security number
<br /> backup withholding.For individuals,this is generally your social security number(SSN).However,for a
<br /> resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.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,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 /> 1 4 - 1 8 7 1 1 8 6
<br /> Part II Certification
<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.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
<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 i
<br /> no longer subject to backup withholding;and
<br /> 3.I am a U.S.citizen or other U.S.person(defined below);and
<br /> 4.Tne FATCA code(s)entered on this form(if any)indicating that I 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 I
<br /> you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, I
<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 dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later. ?
<br /> Sign signature of
<br /> Here u.s.person I* *I.A.---77)1.00: ..-- Date► ` 1 /
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<br /> General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual
<br /> funds)
<br /> Section references are to the Internal Revenue Code unless otherwise [
<br /> noted. •Form 1099-MISC(various types of income,prizes,awards,or gross
<br /> proceeds)
<br /> Future developments.For the latest information about developments •Form 1099-8(stock or mutual fund sales and certain other
<br /> related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
<br /> after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions)
<br /> Purpose of Form •Form 1099-K(merchant card and third party network transactions) I
<br /> An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest),
<br /> information return with the IRS must obtain ycur correct taxpayer 1098-T(tuition)
<br /> identification number(TIN)whichmay be your social security number •Form 1099-C(canceled debt)
<br /> (SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
<br /> taxpayer identification number(ATIN),or employer identification number Use Form W-9 only if you are a U.S.person Including a resident
<br /> . (BIN),to report on an information return the amount paid to ycu,cr other alien),to provide your correct TIN.
<br /> amount reportable on an information return.Examples of information
<br /> returns include,but are not limited to,the following. If you do-not return Form W-9 to the requester with a 17N,you might
<br /> •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
<br /> later.
<br /> Cat.No.10231X Form W-9(Rev.11-2017)
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