Form W - 9 (Rev. Decade 20tt) Depethent d the tray tent Revenue Sink* Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. . i Namep shown ere bat income tat fawn) nou A pv ci.c. cgstearded may mew, a deferent from above deck appropriste O b.,,smcknysora Efi linited Wiley C1 on. (i. naruclion.). box for leckneItor desenoadon PDO-t r.r4taa-L-q-- pt.:crimp • C Corporatka O S Corporation • PartnershiP O Trueleststo snow. Free the Is deselficanan (C=C ccrpenelon, geS corpcselko. Parer/MI Br . ot Pero GA44 ts7 kirr eil ri/7147".444442 got Recuesteea named addressfaXionag Wooden u 5yr cioSa'Y Clew Ste. and Sr Dummis„. Liat wan number(*) here leMiails. Pad I Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given on the 'Nos' line l Social soCurill nil/1w to avoid backup withholding. For individuals, this is your social security number (SSN). However, for • resident alien sole proprietor. or disregarded entity, see the Pat I instructions on page 3. For other entities, it Is your employer identification number (ELM If you do not have a number, see How to get a TIN on page 3. Note. It the account Is In more than one name, see the chart on page 4 for guidelines on whose number to enter. Part II Certification Employer Identifier:fon nitro*. C 7 I Under penalties of perjury, I certify that 1. The number shown on this foam Is my correct taxpayer Identification number (orient waiting for a number to be Issued to me), and 2. lam not subject to backup withholding because: (a) I am exempt from backup withholding, or (b)1 have not been notified by the Internal Revenue Service (IRS) that I ant 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 ern no longer subject to backup withholding, and a I am a U.S. chase, or other U.S. p