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Enter your TIN in the appropriate box. The TIN provided must nxmch the name given on line I to avoid
<br />�
<br />Request for Taxpayer
<br />backup wlien. ole For individuals
<br />etw. o r this thisego r., generally your a ins security number (SSN). However, 1w a
<br />rpgdeni Allen. solo Uroprielw. or disregarded untidy, see the insWdions ler Part I, later. For other
<br />Give Form to the
<br />Form
<br />(Rev. October 2g, g)
<br />Identification Number and Certification
<br />-
<br />requester. Do not
<br />Oewrtmra of am Tinea m
<br />send to the IRS.
<br />stories
<br />eNervvs 8envice
<br />► Go to www.Na.pov/Formol for instructions lend the latest mforma lion.
<br />I Name In shown an ypa doom , tax return). Name is resurred on this Ila. do not Inavo In,-. Iron I,
<br />BORE TECH UTILITIES AND MAINTENANCE, INC.
<br />2 Business neme/Olareges entity, name, If deferent from abWo
<br />d
<br />3 Clack approwaa Dox for IsOrel tax classnlcatron of !fe parson wnosn name n emer«1 re, erre 1 Check only one of IM
<br />1 ExemPtrm (codes apply only to
<br />r�
<br />taa" MVOs boxes.
<br />lMtain soluble, not xldwldlfals. see
<br />a
<br />o
<br />[IInnweusVsoe proprietor Or 11CCwprxaian ®SCwpn.atron 13Pmnpsnp Cl Inusvecate
<br />InfrO t pa m Tax" 3).
<br />C
<br />�a
<br />urge -member LLC
<br />Exempt ranee code (4 my)
<br />�'
<br />I�
<br />I� Limped kaWaY comWnYEnter the lax cassilxaten lC-C wrporallat.5-S <orppalron. P-Vanrvvvxpl►
<br />O
<br />Noe: CMCk the appropriate box e1 tae Wr9 above for the lax clax"f"em Of Ine s/f())IL nVmtW Owner Da not ctiwk
<br />Examebw from WCA imenting
<br />w
<br />LLC II the LLC Is classified as a Sonne neenbix 1.LC that n disregarded horn the owner unless the owner of the LLC Is
<br />LLC this dlsregpdad from ex, federal
<br />cddo d m
<br />( YI
<br />G u
<br />another Is not owner Mr 1/. S. tax jimpesos 0herfose, a more member LLC tort
<br />. cisterforded from the owner should crei the appimnate box for Ina tax casYhcalea e1 IIS oWMr
<br />Daher (sere MstNLtanst ►
<br />Wpb, b eeta.,nn.wne�.l rvJ..ar mw V S,
<br />e} Address (number, street, and apter butte nn 15 io In,le.hohi.
<br />Reguester S name ane andreas (mossil)
<br />19025 SW 194 AVE
<br />e Cly. state. and 21P coma
<br />MIAMI FL 33187
<br />T List accaum na,war(s) here loplional)
<br />IM
<br />__..
<br />Taxpayer Identification Number (TIN)
<br />Enter your TIN in the appropriate box. The TIN provided must nxmch the name given on line I to avoid
<br />I Social sewdty number
<br />backup wlien. ole For individuals
<br />etw. o r this thisego r., generally your a ins security number (SSN). However, 1w a
<br />rpgdeni Allen. solo Uroprielw. or disregarded untidy, see the insWdions ler Part I, later. For other
<br />� -
<br />m
<br />-
<br />entities, it Is your employer idonlnccauon number (EIN). If you do not have a number, see How TO gas o
<br />TIN, later.
<br />or
<br />Nob: If the accouu is in more than one nano, see Tho mstmctions for line I. Also sea What Name and I Employer Identification number
<br />Number To Give the Requester for guidelines on whose number 10 enter
<br />WS - 4 0 5 8 9 9 5
<br />Under penalties or pealury. I certify that:
<br />I. The number shown on this form is my correct taxpayer identification number (w 1 am waiting for a number to be issued tome): and
<br />2. 1 am not mblect to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been nolifted by the Internal Revenue
<br />Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dri dends, Or (c) the IRS has notified mo that l am
<br />no longer subject to backup wrthholding, and
<br />3. I am a U.S. citizen or olher, U.S. person (defvled below). and
<br />4. The FATCA codels) entered on five form (if any) indicating that I am exempt from FATCA reporting Is correct.
<br />Certification Irrtn iclions. You must cross out nom 2 above it you have been notified by the IRS that you are currently subject to backup withhodrng because,
<br />you have fabled to report as interest and dividends on your lax return. For real estate transactions, dem 2 does rot apply. Fw mortgage Interest paid,
<br />acquisition or abandonment of secured property, cancellation of debt. contributions to an ind vldual retirement arrangement IIRA). and generally, payments
<br />other than inlerest and dividends. you are not required to sign the certification, but you must provide your correct TIN. Seo the Instructions for Part II, later_
<br />sorralm, of
<br />U.S. person ►
<br />General
<br />Seclion refewnces are to the Internal Revenue Code unless Otherwise
<br />noted.
<br />Future developments. For The latest Information about developments
<br />related to Faint W-9 ane ds instructions, such as legislation enactrd
<br />after they were published, go to www. ors. govlFormW9.
<br />Purpose of Form
<br />An individual or entity (Form W-9 requester) who is required to file ail
<br />information return with the IRS must obtain your correct taxpayer
<br />dentification lumber (TIN) which may be your social security number
<br />(SSN), individual taxpayer identification number (ITIN), adoption
<br />taxpayer Womilwation number (ATIN), or employer Identification number
<br />(ETN), to report On an information return the amount pard to you, or other
<br />amount reportable on an Information return. Examples of Information
<br />returns include, but are not Ilmtntl to, the following
<br />Foran 1099-INIpnlwest earned or paid)
<br />Date► &1112021
<br />• Form IOWDIV (dividends. including those from stocks or mutual
<br />funds)
<br />• Form 1099-MISC (various types of Income. prizes, awards, of, gross
<br />prmar i
<br />• Form 1099-6 (slock or mutual fund sales and certain other
<br />Transactions by bmkws)
<br />• Form 1099-S (proceeds from real estate Transactions)
<br />• Form 1099-K (merchant card and third party network Iralsaclfons)
<br />• Form 1098 Biome mortgage interest). 1098-E (student loan Interest),
<br />1098-T Itudion)
<br />• Form IM -C (canceled debt)
<br />•
<br />Form 1099-A (acquisition Or abandonment of secured property)
<br />Use Form W-9 only if you we a U.S. person including a resident
<br />alien). to provide your correct TIN.
<br />u you do not refuse Form W-9 to she requester with a TIN, you might
<br />be subject to backup withholding. See What is backup withholding,
<br />LOW
<br />Cal. No. 10231% Fpm W-8 (9w. 10-2018)
<br />
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