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SRI
<br /> Form ■■W9 Request for Tax a -r -Give-Form-to-the
<br /> o-the
<br /> (Rev.December2014) Identification Number and Certification requester.Do not
<br /> send to the IRS.
<br /> Department of the Treasury
<br /> Internal Revenue Service
<br /> 1 Name(as shown on your Income tax return),Name Is required on this line;do not leave this line blank.
<br /> Kilgore Companies
<br /> N 2 Business name/disregarded entity name,If different from above
<br /> rn DBA; Everist Materials
<br /> a
<br /> 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to
<br /> c certain entities,not Individuals;see
<br /> 0 ❑Indlvldual/sole proprietor or ❑ C Corporation ❑S Corporation ❑ Partnership ❑Trust/estate Instructions on page 3):
<br /> m c single-member LLC Exempt payee code(If any)
<br /> 0 0 Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► S
<br /> t Exemption from FATCA reporting
<br /> 0 Note.For a single-member LLC that is disregarded,do not check LLC;check the appropriate box In the line above for
<br /> 1: the tax classification of the single-member owner. code(If any)
<br /> -pC,5 ❑Other(see Instructions)0, (Appllw to amounts math(W-d ouWd.ft U.S)
<br /> 0
<br /> 5 Address(number,street,and apt,or sulfa no.) Requester's name and address(optional)
<br /> n PO Box 869
<br /> 4) 8 City,state,and ZIP code
<br /> co Magna, UT 84044
<br /> 7 List account number(s)here(optional)
<br /> KMII Taxpayer Identification Number(TIN)
<br /> Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
<br /> backup withholding.For individuals,this is generally your social security number(page However,for a -m -
<br /> resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other
<br /> entitles,it is your employer Identification number(EIN).If you do not have a number,see How to get a
<br /> TIN on page 3. or
<br /> Note.If the account Is in more than one name,see the Instructions for line 1 and the chart on page 4 for Employer Identification number
<br /> guidelines on whose number to enter.
<br /> 2 7 - 2 9 1 0 6 5 1
<br /> Certification
<br /> Under penalties of perjury,I certify that:
<br /> 1. The number shown on this form is my correct taxpayer Identification number(or I am waiting for a number to be Issued to me);and
<br /> 2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Intemal Revenue
<br /> 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 I am
<br /> no longer subject to backup withholding;and
<br /> 3. 1 am a U.S.citizen or other U.S.person(defined below);and
<br /> 4.The FATCA code(s)entered on this form(if any)Indicating that I am exempt from FATCA reporting is correct.
<br /> Certification instructions.You must cross out Item 2 above If you have been notified by the IRS that you are currently subject to backup withholding
<br /> because you have failed to report all Interest and dividends on your tax return.For real estate transactions,Item 2 does not apply.For mortgage
<br /> Interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an Individual retirement arrangement(IRA),and
<br /> generally,payments other than Interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the
<br /> Instructions on page 3.
<br /> Sign Signature of 1• '• �•-�
<br /> Here U.s.person► Date► ` 1
<br /> General Instructions •Form 1098(home mortgage Interest),1098-E(student loan Interest),1098-T
<br /> (tuition)
<br /> Section references are to the Internal Revenue Code unless otherwise noted. -Form 1099-C(canceled debt)
<br /> Future developments.Information about developments affecting Form W-9(such -Form 1099-A(acquisition or abandonment of secured property)
<br /> as legislation enacted after we release It)Is at www,1rs.9ov/fw9.
<br /> Use Form W-9 only If you are a U.S.person(Including a resident alien),to
<br /> Purpose of Form provide your correct TIN.
<br /> An individual or entity(Form W-9 requester)who Is required to file an Information If you do not return Form W-9 to the requester with a TIN,you might be subject
<br /> return with the IRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2.
<br /> which may be your social security number(SSN),Individual taxpayer Identification By signing the filled-out form,you:
<br /> number(ITIN),adoption taxpayer Identification number(ATIN),or employer 1.Certify that the TIN you are giving Is correct(or you are waiting for a number
<br /> Identification number(EIN),to report on an information return the amount paid to to be Issued),
<br /> you,or other amount reportable on an Information return.Examples of information
<br /> returns Include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or
<br /> •Form 1099-INT(Interest earned or paid) 3.Claim exemption from backup withholding If you are a U.S.exempt payee.If
<br /> •Form 1099-DIV dividends,Including those from stocks or mutual funds applicable,you are also certifying that as a U.S,person,your allocable share of
<br /> ( 9 ) any partnership Income from a U.S.trade or business Is not subject to the
<br /> •Form 1099-MISO(various types of Income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected Income,and
<br /> •Form 1099-13(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form(if any)Indicating that you are
<br /> brokers) exempt from the FATCA reporting,Is correct.See What Is FATCA reporting?on
<br /> •Form 1099-S(proceeds from real estate transactions) page 2 for further Information.
<br /> -Form 1099-K(merchant card and third party network transactions)
<br /> Cat.No.102SIX Form W-9(Rev.12-2014)
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