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Form W -9 (Rev. 10 -2007) Page 4
<br />3. Real estate transactions. You must sign the certification.
<br />You may cross out item 2 of the certification.
<br />4. Other payments. You must give your correct TIN, but you
<br />do not have to sign the certification unless you have been
<br />notified that you have previously given an incorrect TIN. "Other
<br />payments" include payments made in the course of the
<br />requester's trade or business for rents, royalties, goods (other
<br />than bills for merchandise), medical and health care services
<br />(including payments to corporations), payments to a
<br />nonemployee for services, payments to certain fishing boat crew
<br />members and fishermen, and gross proceeds paid to attorneys
<br />(including payments to corporations).
<br />5. Mortgage interest paid by you, acquisition or
<br />abandonment of secured property, cancellation of debt,
<br />qualified tuition program payments (under section 529), IRA,
<br />Coverdell ESA, Archer MSA or HSA contributions or
<br />distributions, and pension distributions. You must give your
<br />correct TIN, but you do not have to sign the certification.
<br />What Name and Number To Give the Requester
<br />For this type of account:
<br />Give name and SSN of:
<br />1. Individual
<br />The individual
<br />2 Two or more individuals (joint
<br />The actual owner of the account or,
<br />account)
<br />if combined funds, the first
<br />individual on the account'
<br />3 Custodian account of a minor
<br />The minor'
<br />(Uniform Gift to Minors Act)
<br />4 a The usual revocable savings
<br />The grantor - trustee
<br />trust (grantor is also trustee)
<br />b. So- called trust account that is
<br />The actual owner'
<br />not a legal or valid trust under
<br />state law
<br />5 Sole proprietorship or disregarded
<br />The owner'
<br />entity owned by an individual
<br />For this type of account:
<br />Give name and EIN of:
<br />6. Disregarded entity not owned by an
<br />The owner
<br />individual
<br />7. A valid trust, estate, or pension trust
<br />Legal entity
<br />8 Corporate or LLC electing
<br />The corporation
<br />corporate status on Form 8832
<br />9. Association, club, religious,
<br />The organization
<br />charitable, educational, or other
<br />tax - exempt organization
<br />10 Partnership or multi- member LLC
<br />The partnership
<br />11 A broker or registered nominee
<br />The broker or nominee
<br />12 Account with the Department of
<br />The public entity
<br />Agriculture in the name of a public
<br />entity (such as a state or local
<br />government, school district, or
<br />prison) that receives agricultural
<br />program payments
<br />' List first and circle the name of the person whose number you furnish if only one person
<br />on a joint account has an SSN, that person's number must be furnished.
<br />Circle the minor's name and furnish the minor's SSN
<br />You must show your individual name and you may also enter your bustress or 'DW
<br />name on the second name line. You may use either your SSN or EIN (if you have one),
<br />but the IRS encourages you to use your SSN.
<br />4 List first and circle the name of the trust, estate. or pension trust. (Do not furnish the TIN
<br />of the personal representative or trustee unless the legal entity itself is not desgnated in
<br />the account title.) Also see Special rules for partnerships on page 1
<br />Note. If no name is circled when more than one name is listed,
<br />the number will be considered to be that of the first name listed.
<br />Privacy Act Notice
<br />Secure Your Tax Records from Identity Theft
<br />Identity theft occurs when someone uses your personal
<br />information such as your name, social security number (SSN), or
<br />other identifying information, without your permission, to commit
<br />fraud or other crimes. An identity thief may use your SSN to get
<br />a job or may file a tax return using your SSN to receive a refund.
<br />To reduce your risk:
<br />• Protect your SSN,
<br />Ensure your employer is protecting your SSN, and
<br />Be careful when choosing a tax preparer.
<br />Call the IRS at 1 -800- 829 -1040 If you think your identity has
<br />been used inappropriately for tax purposes.
<br />Victims of identity theft who are experiencing economic harm
<br />or a system problem, or are seeking help in resolving tax
<br />problems that have not been resolved through normal channels,
<br />may be eligible for Taxpayer Advocate Service (TAS) assistance,
<br />You can reach TAS by calling the TAS toll -free case intake line
<br />at 1- 877 - 777 -4778 or TTY/TDD 1- 800 - 829 -4059.
<br />Protect yourself from suspicious emails or phishing
<br />schemes. Phishing is the creation and use of email and
<br />websites designed to mimic legitimate business emails and
<br />websites. The most common act is sending an email to a user
<br />falsely claiming to be an established legitimate enterprise in an
<br />attempt to scam the user into surrendering private information
<br />that will be used for identity theft.
<br />The IRS does not Initiate contacts with taxpayers via emails.
<br />Also, the IRS does not request personal detailed information
<br />through email or ask taxpayers for the PIN numbers, passwords,
<br />or similar secret access information for their credit card, bank, or
<br />other financial accounts.
<br />If you receive an unsolicited email claiming to be from the IRS,
<br />forward this message to phishing@irs.gov. You may also report
<br />misuse of the IRS name, logo, or other IRS personal property to
<br />the Treasury Inspector General for Tax Administration at
<br />1 -800 -366 -4484. You can forward suspicious emails to the
<br />Federal Trade Commission at: spamCuce.gov or contact them at
<br />www.consumer.gov/idfheft or 1- 877- IDTHEFT(438- 4338).
<br />Visit the IRS website at www.irs.gov to learn more about
<br />identity theft and how to reduce your risk.
<br />Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest,
<br />dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or
<br />contributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for identification purposes and to help venfy the accuracy of your tax return.
<br />The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S.
<br />possessions to carry out their tax laws We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal
<br />nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.
<br />You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other
<br />payments to a payee who does not give a TIN to a payer Certain penalties may also apply.
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