Sign Here Form law. December p ut Stn. W-9 2011) el bTarry Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. FtwertueSeivks csi t Check , a 1 ! 1 Name (ssehown on your name tax ream) TE 6I, ..r—s&C • Saiwass nthstederegerdad nay nomad, Mont from above targetless 0 Indindualieole CI Untied lebility box for federal tax deteaketiors rtCorporstko CI Pannerthp 0 TessUrerate rxcerletor 0 C Corporation rg / earroeny. Enter ate too ellseallostkn (CaC capontkn. 8=8 oceporsticn nnmernentup) is ...---..—________. .. 0 Elena Meg In COW ONISIMInX,DOM)fr (P nwiter oo rof d WrOvt4.4 , , g name and edctessireakno0 uy, am.. *xi ZIP code .0 5 7- Titan 4-$ 115v/ 0001-- Lot eccout nunixelentere 0400 4 Rag I Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on the 'Name' Fine to avoid backup withholding. For individude, this is your social security number (SSN). However, for a resident alien, sole proprietor. or disregarded entity, see lho Pal I hsbuctions on pipe 3. For other entities, It is your employer Identification number (EIN). If you do not have • number, see How to get a TIN on page 3. Note. If the amount is in more than one name, see the chart on page 4 for guidelines on whose number to enter. I Segel **maw natter Employer Identification number Part Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I Mn 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 (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 RS has notified me that I arn no longer subject to backup withholding. and 3. I am a