|
`
<br />Request for Taxpayer (ilw Corm b ute
<br /> ~
<br />Identification Number and Certlflcation f°Q1°eb'• DO "Ot
<br /> send to the IRS.
<br />~.~ ....~.. •..v
<br />•
<br />ei Nerve w use oa yov taomr w rWeril
<br /> ate o Colorado De t of Natural Resources Div. of Reclatnation, Minigg b Safer
<br /> arrrYleee aenMl, Y dnawN Yam Wow
<br />
<br /> ®OsrYr -
<br />Grek e
<br />ro
<br />laM bat ^ P
<br />Mtor ^ cw
<br />«rton ^ Pwm.w duo
<br />~ '
<br /> pp
<br />p
<br />~
<br />v
<br />P Gover~eah v
<br /> Aedrw Glrnrbel. sheer, erd epL a tub roe Reprmere nrrr arq aodreee Iaq~W
<br />K
<br /> 1 N0.-(,oha(
<br />ING c.J-~kL
<br /> car. Wd., ero ZtP aoa
<br /> 1Ja scooter rearrberM tore faptlony
<br />• T IdanifHcatlon Number RIM
<br />Eteer your TIN h the appropdaN box. 7M TIN provided muN math s» nertr t on urr 1 to avoid aoalr e.aurip. re.naer
<br />beaWrp witearolarrp. Far hdwau.b, thb b year socdal ..curtly numwr (SSN). Naw.v.r. tar a reeklrn ~ I I ~ I ~~~ I ~ I' I
<br />elan, say ProPrbroR a dbrepardW Way. sea tM Pan I heWClbro an page 3. For Darer anltlp, a b
<br />your amployar kbndllcatbn rexMler (~ a you do not Mva ^ numbr, ar f#ow ro per • 7/N an papa 3, or
<br />Nob. M tM acrnrrd b h mtn rhos ono rrerre, sea tM Gran on Papa I for puWefirea on wha» number tdenuawtlon nunbw
<br />ro snit. I
<br />Undw paneltlee d per)uy, 1 Garay ihec
<br />t. The nurtlber shown m thb form b my correct taxpayer IdenWlcatlan number (a I am walarlp far a number b be broad a my, end
<br />Z. I am not eubied to backup wlthholdrrp baen+sa (B) I arrr exempt Irom lacarp wahholdinp, or Q1) I hew rat bean rattaed by the Internal
<br />Aavenus source pR~ that 1 errr augect to badwp aattholdinp m a reap d a lalure to report as hlereei a dhddande, a (c) Its IRS hea
<br />notlled me tart I arrr rq Ionper suged to backup vrlthholdlnp, end
<br />3. I am . U.B. person QnaWdrp • U.s. reddW elan).
<br />CeNdcatlon betructlone. Yau moat aor out Item 2 show a you have been ratlled by the IR3 that you era clarontty sub)eM to Hedarp
<br />wilhlalding because you hew toted to report d htereat end dNldende m your tax return. Far real esta4 trenseotloro, karrr 2 dose not apply.
<br />Far mattgape h4raat paid, aogWeitlon a ebandamrlent d eeeured prapany, caraNatlan d debt, aontrroutlons to n hdWidlel rotirptlam
<br />PRN. ~ paxraly, PaYmenb otMr than htaroH and dhrldeMa, yw era rat rogrrksd ro alpn the Cartilntlon, bat yur muse
<br />provkM Hour tarred TIN. (see tM inetrrretlorls on page 1.)
<br />H~ I uawrmn - ~y ~ ~~h~~E%LV tl,a - /~. /ff- O 6
<br />Purpose of Form // v -
<br />A person who is requ tits an intormadon return with the
<br />IRS, moat obtain your correct taxpayer identifltxttlon number
<br />(TIN) to report. fa example. Income pekt to you. real esters
<br />baneactlona, mortgage interest you pdd, acqulaitlon a
<br />abandonment of secured property, cancelledon of debt, or
<br />cordribudane you made ro an IRA
<br />U.B. person. Usa Fonn W-9 only if you are a U.S. person
<br />(including a resident alien), ro provide your coned TIN to the
<br />person requ~Ung It (the requester) and, when applkeble, to:
<br />1. Certify that the TIN you ere giving b correct (a you are
<br />waftlrlp for a number ro be issued),
<br />2. Certify that you ors not wb)sot m backup wahtloklMg,
<br />a
<br />3. Claim exemptan from backup wahhclding If you are e
<br />U.S. exempt Payee.
<br />Nob. // a requester gives you a lam ofhar than Form W-9 ro
<br />requett ytwr T)N, you must use the requslrter's /onrr it it is
<br />substenNary similar fo this Form W-8.
<br />Fa federal tax purposes you era considered a person If you
<br />are:
<br />• An Individual who Is a citizen or resident of the United
<br />Stereo, •
<br />e A partnership, corporetlon, company, a association
<br />craeted or organized In the United States a under the laws
<br />of the United States, a
<br />• Arty estate (other then a foreign estate) a trust. See
<br />Regulatlons sectlone 301.7701-s(a) and 7(a) for addidonel
<br />Information.
<br />Foreign person. N you are a foreign person, ~ not use
<br />Fonn W-S. Instead, use the appropriate Form W-8 (see
<br />Publlcatlon 515, Wahholding of Tax on Nonreaktem Alksa
<br />and Forefgtt Entitles).
<br />Norvesidaru adM who becomes a resident alien.
<br />Genarelty, ony a nonresident alien Individual may use the
<br />tertne of a tax treaty to reduce a eliminate U.S. tax on
<br />certain types of Income. However, most tax treat(ea contain a
<br />provision known as a •savlrp clause." Exceptbns speGfled
<br />in the sating dotter may permit an exemption from tax to
<br />contlnue for certain types d Inconts even after the recipient
<br />has otherwise become a U.S. resident alien tar tax purposes.
<br />d you are a U.S. resident alien who b relying on an
<br />exception contained h the savhg clause of a tax treaty to
<br />claim en exempton ham U.s. tax on certain types of Income,
<br />you must attach a statement to Form W-9 that specifies the
<br />following Me Items:
<br />1. The treaty country. Generelty, this must be the same
<br />treaty under which you claimed exemption from tax as a
<br />nonresident alien.
<br />2. The treaty article addressing the Income.
<br />3. The article number (a location) in the tax treaty that
<br />contains the saving clause end Its exceptbna.
<br />CH. W. 10231% Farm W.g IRw. 14aoai
<br />
|