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Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I social sscurny number
<br />backup withholding. For individuals, this is generally your social security number (SSN). However, for a m _
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other -
<br />entities, it is your employer identification number (EIN). If you do not have a number, see How to get s
<br />TIN, later. or
<br />Note: If the account is In more than one name, see the instructions for line 1. Also see What Name and I Employer identification number
<br />Number To Give the Requester for guidelines on whose number to enter.
<br />7?0 -42 4 1 5 9 9 9
<br />Certification
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be Issued to me); and
<br />2.1 am nat subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified 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 dividends, or (c) the IRS has notified me that 1 am
<br />no longer subject to backup withholding; and
<br />3.1 am a U.S. chtim or other U.S. person (defined belov4; and
<br />4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting Is correct.
<br />Certification Instructions. You must cross out Item 2 above It you have been notified by the IRS that you are currently subject to backup withholding because
<br />you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement PRA), and generally, payments
<br />other than interest and dl r required to sign the cerrcafiW, but you must provide your correct TIN. See thy Instructions for Part II, later.
<br />Sign U.rratun of
<br />Here .S.persa,► Date ► 7
<br />General Instructions
<br />W_9
<br />Request for Taxpayer
<br />funds)
<br />Section references are to the Internal Revenue Code unless otherwise
<br />noted.
<br />Form
<br />F". October 2018)
<br />Identification Number and Certification
<br />proceeds)
<br />Give Form to the
<br />requester. Do not
<br />==O ue*STevice
<br />► Go to www.ksgov/FonnW9 for instructions and the latest information.
<br />transactions
<br />� b by brokers)
<br />send to the IRS.
<br />• Form 1099-S (proceeds from real estate transactions)
<br />1 Name (as shown on your Income tax return). Name is required on this Iine; do not leave this line blank.
<br />• Form 1099-K (merchant card and third party network transactions)
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />LEGO Construction Co.
<br />information return with the IRS must obtain your correct taxpayer
<br />1098-T (tuition)
<br />2 Business name/disregarded entity name, If dlffereM from above
<br />• Form 1099-C (canceled debt)
<br />(SSM, individual taxpayer Identification number (ITIN) adoption
<br />taxpayer Identification number (KnN), or employer Identification number
<br />• Form 1099-A (acquisition or abandonment of secured property)
<br />(EIN), to report on an information return the amount paid to you, or other
<br />Use Form W-9 only If you are a U.S. person (including a resident
<br />9 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the
<br />4 Exemptions (codes apply only to
<br />returns include, but are not limited to, the following.
<br />following seven boxes.
<br />cetain entitles, not krdlviduals; a"
<br />S
<br />._ /
<br />El proprietor or 11C Corporation SGS Corporation ❑ Partnership ❑ Truavestate
<br />Instructions on page 3):
<br />single -member LLC
<br />apt payse code IK arrh
<br />j
<br />❑ Limited liability company. Enter the tax classification (C=C corporation, S -S corporation, P=Partnership) lo-
<br />cici
<br />Note: Check the appropriate box In the One above for the tax classification of the single -member owner. Do not check
<br />Exemption from FATCA reporting
<br />a
<br />LLC if the LLC is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC Is
<br />another LLC that IS not disregarded from the owner for U.S. federal tax purposes. Otherwise, a aingle-member LLC that
<br />code Of any)
<br />u
<br />g
<br />Is disregarded from the owner should check the appropriate box for the tax classification of ifs owner.
<br />n
<br />❑ Other (see Instructions) ►
<br />em" b nWUM I hh OU92A* Mr uS,r
<br />ti Address (number. street, and apt or suite no.) See instructions. Requester's name and address (opfloW
<br />1011 Sunn brook Rd, Suite 905
<br />e City, state, and ZIP code
<br />Miami, FL 33136
<br />7 List account number(s) here (opUm Q
<br />Taxpayer Identification Number (TIN)
<br />Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I social sscurny number
<br />backup withholding. For individuals, this is generally your social security number (SSN). However, for a m _
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other -
<br />entities, it is your employer identification number (EIN). If you do not have a number, see How to get s
<br />TIN, later. or
<br />Note: If the account is In more than one name, see the instructions for line 1. Also see What Name and I Employer identification number
<br />Number To Give the Requester for guidelines on whose number to enter.
<br />7?0 -42 4 1 5 9 9 9
<br />Certification
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be Issued to me); and
<br />2.1 am nat subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified 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 dividends, or (c) the IRS has notified me that 1 am
<br />no longer subject to backup withholding; and
<br />3.1 am a U.S. chtim or other U.S. person (defined belov4; and
<br />4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting Is correct.
<br />Certification Instructions. You must cross out Item 2 above It you have been notified by the IRS that you are currently subject to backup withholding because
<br />you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement PRA), and generally, payments
<br />other than interest and dl r required to sign the cerrcafiW, but you must provide your correct TIN. See thy Instructions for Part II, later.
<br />Sign U.rratun of
<br />Here .S.persa,► Date ► 7
<br />General Instructions
<br />• Form 1099 -DN (dividends, inducing thosei from stocks or mutual
<br />funds)
<br />Section references are to the Internal Revenue Code unless otherwise
<br />noted.
<br />• Form 1099-MISC (various types of income, prizes, awards, or gross
<br />proceeds)
<br />Future developments. For the latest information about developments
<br />related to Form W-9 and its Instructions, such as legislation enacted
<br />•Form 10(stock or mutual fund sales and certain other
<br />after they were published, go to www.1rs.gov/Fom►W9.
<br />transactions
<br />� b by brokers)
<br />• Form 1099-S (proceeds from real estate transactions)
<br />Purpose of Form
<br />• Form 1099-K (merchant card and third party network transactions)
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />• Form 1098 (home mortgage interest), 1098-E (student loan Interest),
<br />information return with the IRS must obtain your correct taxpayer
<br />1098-T (tuition)
<br />identification number (11N) which may be your social security number
<br />• Form 1099-C (canceled debt)
<br />(SSM, individual taxpayer Identification number (ITIN) adoption
<br />taxpayer Identification number (KnN), or employer Identification number
<br />• Form 1099-A (acquisition or abandonment of secured property)
<br />(EIN), to report on an information return the amount paid to you, or other
<br />Use Form W-9 only If you are a U.S. person (including a resident
<br />amount reportable on an information return. Examples of information
<br />alien), to provide your coned TIN.
<br />returns include, but are not limited to, the following.
<br />If you do not return Form W-9 to the requester with a TIN, you might
<br />• Form 1099 -INT (Interest earned or paid)
<br />be subject to backup withholding. See What Is backup withholding,
<br />later.
<br />Cat. No. 10231X Form W-9 (Rev. 10-2018)
<br />
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