<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
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<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
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<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 />
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