IV. TAX ELECTION/DECLARATION OF TAX STATUS This Account Agreement la designed for use by both U.S. NOCOS and Non-U.S. Persons. Please check the box next to the applicable dem belcnv. °lent certifies that Client will notify DBSI In writing Immediately If the representation certified to below ceases to be true and correct. 1.0 U.S. Citizen or U.S. Reeklent Allen Form W9 Request for Taxpayer Identification Number and Certification Substitute Name ore er...3.tytior Income tax 'return) 'ACA ' bkr611 ( I% V 3104 AlCi ittiditithl)40,.SAKv (faerne.e 4 is., guaidas manage ant name, different from aboini Chock oppropdaste box for federal tax classification (roduired)• 3 Individual/sole proprietor ii C Corporation K S Comonstion O Partnership O Tnietiestate O Limited liability company. Eller the tax classification (C-C corporation. S.S corporation. P•pertnershipj 4 •/ AVA Tray Other 0 2r i vill-e r 0 erecnot • bliVed Address umber, etc and opt or /0O .0fA 3 City. Stole, and ZIP code .. 57 .7 kor“v,„ 1/5 te; Cola 1.- 3Taxpayer Identification Number (TR Enter your TIN In the eppropriate box. The TIN provided must match the name given on the "Name" I kw to avoid baCkup wahhceding. For Individuals. this is your social security number (SSN). Far other entitles. It is your employer identification number (EIN). EMI Certification Sign Here u 1 -00-(1111 mom Under penalties of perjury, I certify that; 1. Tho number shown on des form is my correct taxpayer Identification number (or I am waiting for a number to bo issued to me), and 2. 1 am not subject to backup withholding because: Ie) I am exempt from backup withholding, or (b) i have not been notified by the Internal (revenue Service that lam subject to backup withholding as • result of a failure to report all 01101051 or dividends. or (cline IRS hes notified me that I am no longer subject to backup withholding. end 3. I am a U.S. citizen or other U.S. person (defined In the