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<br /> <br />corm 1t ~J <br />Request for Taxpayer <br />Give form to the <br />IRer. March 195x) Identification Number and Certification requester. Do NOT <br />Degartmwx of IIV Trsaaury send to the IRS. <br />Ir,ISN1 RNIf,W $fVKC <br /> Name III pint namts. list Ilrsl and orde me name pl the person or enhry whose number you enter In Pan I below see instmdlpns an page 2 it your name Acts NalyaE.l <br /> <br />r Business name (Sole proprietors see instructwns on <br />page 2.1 <br />0 <br />c <br />C Please Uepk approPrlale bon: ~ IndrvlduaVSole poPnetor ~ Corppalipn ~ PartnershlP ^ Other - ..... ... ....................... <br />~ Address bomber, street, and apt, or suite no.l ReOUestei s name and atltlress loplronail <br />A <br />- <br />° <br />FOUR CORNERS MATERIALS, INC. <br />a CIry. state. and ZIP code P.O. BOX 16 <br /> FARMINGTON NEW MEXICO 8749 <br /> Tax ayer Identification Number N) List account numbeds) here IoplionaQ <br />Enter your TIN in the appropriate box. For <br />individuals, this is your social security number social secudry number <br />ISSN). For sole proprietors, see the instructions <br /> <br />on page 2. For other entities, it is your employer <br />identification number (EIN). I1 you do not have a pR For Payees Exempt From Backup <br />number, see How To Get a TIN below. Withholding (See Part II <br />Note: I/ the account is in more than one name Employer Idenenraeon number instructions on page 2) <br />, <br />see the chart on page 2 for guidelines on whose <br />number to enter. <br />9-001 <br />Under penalties of peryury, I certify that: <br />1. The number shown on this form is my correct taxpayer identification number (01 I am waiting for a number to be issued to me), atsd <br />2 I am not .subject to Dackup withholding because: (a) 1 am exempt horn backup withholding, or (b) I have not been notifed by the Internal <br />Revenue service that I am subject to backup withholding as a resort of a failure to report all interest or dividends, or (e) the IRS has natifed <br />me that I am no bnger subject to backup, withholding. <br />Cartiflcation Instructions.-You must cross out item 2 above it you have been notified by the IRS that you are cunently subject to backup <br />withholding because of undeneporting Interest or dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage <br />interest paid, the acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement <br />(IRA(, antl generaly payments other than interest and dividends, you are not required to Slgn the Gertlfication, Dut you must provide your boned <br />TIN. (Also see Part 111 instructions on page 2.) <br />Sign <br />Hero Signature - Date - <br />Section 2/erences are to the Internal <br />Revenue Code. <br />Purpose of Form.-A person who is <br />required to lile'an information return with <br />the IRS must get your coned TIN to report <br />income paid to you, real estate <br />transactions, mortgage interest you paid, <br />the acquisition or abandonment of secured <br />property, cc;~cella;ion of debt, or <br />contributions you made to an IRA. Use <br />Form W-9 to give your coned TIN to the <br />requester (the person requesting your TIN) <br />and, when applicable. (1) to certify the TIN <br />you are giving is correct (or you are waiting <br />Tor a number to be issued), (2) to certify <br />you are not subject to backup withholding, <br />or (3) to claim exemption from backup <br />withholding A you are an exempt payee. <br />Giving your coned TIN and making the <br />appropriate certifications will prevent <br />certain payments from being subject to <br />backup withholding. <br />Note: II a requester gives you a form other <br />than a W-9 to request your TIN, you must <br />use the requesters form i! rf is substantially <br />similar to this Form W-g: <br />What Is Backup Withholding?-Persons <br />making certain payments to you must <br />withhold and pay to the IRS 31 °h of such <br />payments under certain conditions. This is <br />called "backup withholding." Payments <br />that could be sublecl to backup <br />withholding include interest, dividends, <br />broker and barter exchange transactions, <br />rents, royalties, nonemployee pay, and <br />certain payments from fishing boat <br />operators. Real estate transactions are not <br />subject to backup withholding. <br />If you give the requester your caned <br />TIN, make the proper certifications, and <br />report all your taxable interest and <br />dividends on your tax return, your <br />payments will not be subject to backup <br />withholding. Payments you receive will be <br />subject to backup withholding if: <br />1. You do not furnish your TIN to the <br />requester, or <br />2. The IRS tells the requester that you <br />furnished an incorrect TIN, or <br />3. The IRS tells you that you are subject <br />to backup withholding because you did not <br />report all your interest and dividends on <br />your tax return (tor reportable interest and <br />dividends only), or <br />4. Vou do not Certify to the requester <br />that you are not subject to backup <br />withholding under 3 above (for reportable <br />interest and dividend accounts opened <br />after 1983 only), or <br />5. You do not certify your TIN. See the <br />PaA 111 instructions for exceptions. <br />Certain payees and payments are <br />exempt from backup withholding and <br />inforrrtation reporting. See the Part II <br />instructions and the separate Instructions <br />for the Requester of Form W-9. <br />How To Get aTIN -1f you do not have a <br />TIN, apply for one immediately. To apply, <br />get Forth SS-5, Application for a Social <br />Security Number Card (tor individuals), <br />Irom your local office of the Social Security <br />Administration, or Fonn SS-4, Application <br />for Employer Identification Number (for <br />businesses and all other entities), Irom <br />your local IRS office. <br />If you do not have a TIN, write "AppVled <br />For" in the space for the TIN in Part I, sign <br />and date the form, and give it to the <br />requester. Generally, you will then have 60 <br />days to get a 71N and give it to the <br />requester. II the requester does not receive <br />your TIN within 60 days, backup <br />withholding, if applicable. will begin and <br />continue until you furnish your TIN. , <br />Cal No. 10235x Form W-9 tRe~r. Y9+I <br />