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Form W-9(Rev. 10-2007) Page 4
<br /> 3. Real estate transactions. You must sign the certification. Secure Your Tax Records from Identity Theft
<br /> You may cross out item 2 of the certification.
<br /> Identity theft occurs when someone uses your personal
<br /> 4. Other payments.You must give your correct TIN, but you information such as your name, social security number(SSN), or
<br /> do not have to sign the certification unless you have been other identifying information, without your permission, to commit
<br /> notified that you have previously given an incorrect TIN. "Other fraud or other crimes. An identity thief may use your SSN to get
<br /> payments" include payments made in the course of the a job or may file a tax return using your SSN to receive a refund.
<br /> requester's trade or business for rents, royalties, goods (other
<br /> than bills for merchandise), medical and health care services To reduce your risk:
<br /> (including payments to corporations), payments to a • Protect your SSN,
<br /> nonemployee for services, payments to certain fishing boat crew • Ensure your employer is protecting your SSN, and
<br /> members and fishermen, and gross proceeds paid to attorneys a Be careful when choosing a tax preparer.
<br /> (including payments to corporations).
<br /> 5. Mortgage interest paid by you, acquisition or Call the IRS at 1-80tely fo tax if you think your identity has
<br /> abandonment of secured property, cancellation of debt, been used inappropriately for tax purposes.
<br /> qualified tuition program payments (under section 529), IRA, Victims of identity theft who are experiencing economic harm
<br /> Coverdell ESA, Archer MSA or HSA contributions or or a system problem, or are seeking help in resolving tax
<br /> distributions, and pension distributions.You must give your problems that have not been resolved through normal channels,
<br /> correct TIN, but you do not have to sign the certification. may be eligible for Taxpayer Advocate Service (TAS) assistance.
<br /> You can reach TAS by calling the TAS toll-free case intake line
<br /> What Name and Number To Give the Requester at 1-877-777-4778 or TTY/TDD 1-800-829-4059.
<br /> Protect yourself from suspicious emails or phishing
<br /> For this type of account: Give name and SSN of: schemes. Phishing is the creation and use of email and
<br /> 1. Individual The individual websites designed to mimic legitimate business emails and
<br /> 2. Two or more individuals()Dint The actual owner of the account or, websites. The most common act is sending an email to a user
<br /> account) if combined funds,the first falsely claiming to be an established legitimate enterprise in an
<br /> individual on the account' attempt to scam the user into surrendering private information
<br /> 3. Custodian account of a minor The minor' that will be used for identity theft.
<br /> (Uniform Gift to Minors Act) The IRS does not initiate contacts with taxpayers via emails.
<br /> 4. a. The usual revocable savings The grantor-trustee' Also, the IRS does not request personal detailed information
<br /> trust(grantor Is also trustee) through email or ask taxpayers for the PIN numbers, passwords,
<br /> b. So-called trust account that Is The actual owner' or similar secret access information for their credit card, bank, or
<br /> not a legal or valid trust under other financial accounts.
<br /> state law
<br /> 5. Sole proprietorship or disregarded The owner 3 If you receive an unsolicited email claiming to be from the IRS,
<br /> entity owned by an individual forward this message to phishing@irs.gov. You may also report
<br /> For this type of account: Give name and EIN of: misuse of the IRS name, logo, or other IRS personal property to
<br /> the Treasury Inspector General for Tax Administration at
<br /> 6. Disregarded entity not owned by an The owner 1-800-366-4484. You can forward suspicious emails to the
<br /> individual Federal Trade Commission at:spam@uce.gov or contact them at
<br /> 7. A valid trust,estate,or pension trust Legal entity` www.consumer.gov/idtheft or 1-877-IDTHEFT(438-4338).
<br /> 8 Corporate or LLC electing The corporation
<br /> corporate status on Form 8832 Visit the IRS website at www.irs.gov to learn more about
<br /> 9. Association,club,religious, The organization identity theft and how to reduce your risk.
<br /> charitable,educational,or other
<br /> tax-exempt organization
<br /> 10 Partnership or multi-member LLC The partnership
<br /> 11 A broker or registered nominee The broker or nominee
<br /> 12. Account with the Department of 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 fumished.
<br /> 2
<br /> Circle the minor's name and furnish the minor's SSN.
<br /> 3
<br /> You must show your individual name and you may also enter your business or"DBA"
<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 /> °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 designated 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 /> 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 verify 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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