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EFTA00168741

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Four W-9 ay. Decent. 2011) Data Flev , of Is Te ap rn Hal inue Sw Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. I 2 i l , (7 Name Ns tax rang ll. "TP reel 154e dikrent rieded Airy fron t shove E 5 Chock epproprhte box for federel tax der asks ri 6., irdratial/eole proprietor O C C.orporetion O S Cotperebon O Penni* O nua,.....te O linked ay company. Erer the tax dreelicetkn (c-C CCIPCfli‘r. S.'S corporaat P •Partneen)* O Car Oa rebuctisnue O E.xerrpi pawn Address (raw. street. ingest a suite no.) , . ,...-% (Of OCI kfi) th ale tAytvier. g9 flequesansneme rad actress (coma ., ay. rate end ZIP cod• i --yr Tit Loa, fl U" 00301-- lit roam numbers here foolknel) Paris I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the 'Name line to avoid backup withholding. For indridualsMN is your social security number (SSN). Hooey, to a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EN). If you do not have a number, see How fo gel a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Rani./ NetilitVranhdr Employer idenencauen ramnbor P 1 r II Certification Under penalties of pettily. 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 0)) I have not been notified by the Internal Revenue Service (RS) that I am subject to backup withholdings a result of • failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I 6m • U.S. citizen or ot

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