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Home My WebLink AboutW-9 formEnter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I social sscurny number backup withholding. For individuals, this is generally your social security number (SSN). However, for a m _ resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other - entities, it is your employer identification number (EIN). If you do not have a number, see How to get s TIN, later. or Note: If the account is In more than one name, see the instructions for line 1. Also see What Name and I Employer identification number Number To Give the Requester for guidelines on whose number to enter. 7?0 -42 4 1 5 9 9 9 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 2.1 am nat 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 notified me that 1 am no longer subject to backup withholding; and 3.1 am a U.S. chtim or other U.S. person (defined belov4; and 4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting Is correct. Certification Instructions. You must cross out Item 2 above It 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. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement PRA), and generally, payments other than interest and dl r required to sign the cerrcafiW, but you must provide your correct TIN. See thy Instructions for Part II, later. Sign U.rratun of Here .S.persa,► Date ► 7 General Instructions W_9 Request for Taxpayer funds) Section references are to the Internal Revenue Code unless otherwise noted. Form F". October 2018) Identification Number and Certification proceeds) Give Form to the requester. Do not ==O ue*STevice ► Go to www.ksgov/FonnW9 for instructions and the latest information. transactions � b by brokers) send to the IRS. • Form 1099-S (proceeds from real estate transactions) 1 Name (as shown on your Income tax return). Name is required on this Iine; do not leave this line blank. • Form 1099-K (merchant card and third party network transactions) An individual or entity (Form W-9 requester) who is required to file an LEGO Construction Co. information return with the IRS must obtain your correct taxpayer 1098-T (tuition) 2 Business name/disregarded entity name, If dlffereM from above • Form 1099-C (canceled debt) (SSM, individual taxpayer Identification number (ITIN) adoption taxpayer Identification number (KnN), or employer Identification number • Form 1099-A (acquisition or abandonment of secured property) (EIN), to report on an information return the amount paid to you, or other Use Form W-9 only If you are a U.S. person (including a resident 9 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 returns include, but are not limited to, the following. following seven boxes. cetain entitles, not krdlviduals; a" S ._ / El proprietor or 11C Corporation SGS Corporation ❑ Partnership ❑ Truavestate Instructions on page 3): single -member LLC apt payse code IK arrh j ❑ Limited liability company. Enter the tax classification (C=C corporation, S -S corporation, P=Partnership) lo- cici Note: Check the appropriate box In the One above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting a LLC if the LLC is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC Is another LLC that IS not disregarded from the owner for U.S. federal tax purposes. Otherwise, a aingle-member LLC that code Of any) u g Is disregarded from the owner should check the appropriate box for the tax classification of ifs owner. n ❑ Other (see Instructions) ► em" b nWUM I hh OU92A* Mr uS,r ti Address (number. street, and apt or suite no.) See instructions. Requester's name and address (opfloW 1011 Sunn brook Rd, Suite 905 e City, state, and ZIP code Miami, FL 33136 7 List account number(s) here (opUm Q Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I social sscurny number backup withholding. For individuals, this is generally your social security number (SSN). However, for a m _ resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other - entities, it is your employer identification number (EIN). If you do not have a number, see How to get s TIN, later. or Note: If the account is In more than one name, see the instructions for line 1. Also see What Name and I Employer identification number Number To Give the Requester for guidelines on whose number to enter. 7?0 -42 4 1 5 9 9 9 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 2.1 am nat 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 notified me that 1 am no longer subject to backup withholding; and 3.1 am a U.S. chtim or other U.S. person (defined belov4; and 4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting Is correct. Certification Instructions. You must cross out Item 2 above It 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. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement PRA), and generally, payments other than interest and dl r required to sign the cerrcafiW, but you must provide your correct TIN. See thy Instructions for Part II, later. Sign U.rratun of Here .S.persa,► Date ► 7 General Instructions • Form 1099 -DN (dividends, inducing thosei from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise noted. • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) Future developments. For the latest information about developments related to Form W-9 and its Instructions, such as legislation enacted •Form 10(stock or mutual fund sales and certain other after they were published, go to www.1rs.gov/Fom►W9. transactions � b by brokers) • Form 1099-S (proceeds from real estate transactions) Purpose of Form • Form 1099-K (merchant card and third party network transactions) An individual or entity (Form W-9 requester) who is required to file an • Form 1098 (home mortgage interest), 1098-E (student loan Interest), information return with the IRS must obtain your correct taxpayer 1098-T (tuition) identification number (11N) which may be your social security number • Form 1099-C (canceled debt) (SSM, individual taxpayer Identification number (ITIN) adoption taxpayer Identification number (KnN), or employer Identification number • Form 1099-A (acquisition or abandonment of secured property) (EIN), to report on an information return the amount paid to you, or other Use Form W-9 only If you are a U.S. person (including a resident amount reportable on an information return. Examples of information alien), to provide your coned TIN. returns include, but are not limited to, the following. If you do not return Form W-9 to the requester with a TIN, you might • Form 1099 -INT (Interest earned or paid) be subject to backup withholding. See What Is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018)