Form W-9 (Rev. December 20t1) Deena or me Treasury internal Parvenus Sank* Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. N Check appropriate box for Were tax • cation: 2 Irdreiduairsole proprietor O C Corporation O s Corporation O Partnership O Tnavestate • tensed liability company. Enter itie tax classification (C-C OCOPOlatiOn. S•S corporation Pipettes:add to O Other (see instructiora)e (optional) ti Exempt payee Address (number, street and opt. es W 3 0 i b ) te{ , 4 8 Requester's name and address 6 1151 Gay suds. and ZP code ,.. 11,?.././ }1,01. Ai,/ 1006C list acorns numbehn here (ootionai) Part I Taxpayer Identification Number (TIN) Enter your flu in the appropriate box. The TIN provided must match the name elven on the 'Name Me to avoid backup withholding. For individuals, this Is your social security number (SSN). However. for a resident alien, sot° proprietor, or disregarded entity. see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a nurnber, see How to get 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. Employer Identification number CZEL— Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my coned 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 (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. I am a V.S. citizen or other U.S. person (defined below). Certif