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Form -9
<br />(Rev. March 2024)
<br />Department of the!
<br />Intemal Revenue Se
<br />Request for Taxpayer
<br />Identification Number and Certification
<br />Go to wwwJrs.gov1FbrmW9 for instructions and the latest information.
<br />Exhibit 4
<br />Give form to the
<br />requester. bo not
<br />send to the iRS.
<br />Before you begin. For-quidonce related to the purpose of Form W-9, see. Purpose of Form; below.
<br />i Name of enthy/individual. An entry is required. (Fora sole proprietor or disregarded entity, enterthe owner's name online 1, and enter the business/disregarded
<br />entity's name on line, 2.)
<br />business name/disregarded entity name, if different from above.
<br />Check the appropriate box for federal tax classification of the ent"ityAndividual whose: name Is entered on line t. Check
<br />only one of the following seven boxes.
<br />❑ Individuallsole proprietor Q C corporation ❑ S corporation ❑ Partnership ❑ Trust/estate:
<br />❑ LLC. Enter the tax classification (C- = C corporation, S = S corporation,P = Partnership) . .
<br />Note: Check the "LLC" box above and, in the entry space, enterthe appropriate code (C, 8, or P) for the tax
<br />classification of the LLC, unless It is a disregarded entity. A disregarded entity should instead'check the appropriate
<br />box for the tax classification of its owner,
<br />❑ Other (see instructions)
<br />Sb, If on line3a you -chocked "Partnership" or "Trust/estate; or checked "LLC" and entered "P" es its tax classification,
<br />and you areproAding this form to a partnership, trust, or estate in which you have an ownership interest,. check ❑
<br />this box if you have any foreign partners, owners, or beneficiaries. See instructions .
<br />street, and apt or suite
<br />state, and.ZJP code
<br />7 t.istaccount ni
<br />4 Exemptions (codes apply only to
<br />certain entities, not individuals;
<br />see instructions on page 3):
<br />Exempt payee code (f any)
<br />Exemption from Foreign Account Tax
<br />Compliance Act (FATCA) reporting
<br />code (if any)
<br />Requester's name and
<br />(Applies to accounts maintained
<br />cutside the United Sfates. J'
<br />Enter your TIN in the appropriate box, The TIN provided must match the name given on line 1 to avoid I sociai security numner
<br />backup withholding. For individuals, this is generally yoursocialsecurity number ($SN). However, fora
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other FM–M–FFM
<br />entities,
<br />it is your employer identiflcetion number (SIN). if you do not have a number, see Now toget a or
<br />TTN, later.
<br />Empioyer identification number
<br />Note: If the account is In more than one name, see the instructions for line 1. See also What Name and—
<br />NumberTo Give the Requester for guidelines on whose numberto enter. 16 15 ( 0 1 8 1 2 1 90 9 1 0
<br />Under penalties of perjury, I certify that:
<br />1. The number shown or this form is my correct taxpayer identification number (or l am waiting for a number to be issued to me); and
<br />2.1 am not subject to backup withholding because (a) I ani exempt from backup withholding, or (b) I have not been notified by the Internal RevenUe
<br />tiervtCP.'QA5) that I am.subje,-t to backup withhole frig as a reciilt of a failure tn,report all Intere_gt or d1vtdeneis; or (c;)' the. IRS has. ncytified me that I am
<br />no longer subject to backup withholding; and
<br />3.1 am a U.S. citizen or other U.S. person (defined below); and.
<br />4. The FATCA code(s) ertered 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 I you have been notified by the IRS that you are currently subject to backup withholding
<br />because 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 (IRA), and, generally, payments
<br />otherthan interest.and dividends, you are not requiredto sign ihe.certification; but you must provide your correctTIN.See the: Instructions for Pad ll, later.
<br />Sign Signature of
<br />Here I U.S. person l/BG//�IGF.r f?aie 10/31!24
<br />General Instructions
<br />Section references.are to the internal Revenue Code unless otherwise
<br />noted.
<br />Future developments. For the latest information about developments
<br />related to Form W-9 and its instructions, such as lE9islation enacted
<br />after they were pubilshed, go to wwwJrs.gov1FormW9.
<br />What's New
<br />Une 3a has beenmodified to clarify how a disregarded entity completes
<br />this line. An LLC that is a disregarded entity should check the.
<br />appropriate box for the tab classification of its owner. Otherwise, it
<br />should check the "LLC" pox and enter its appropriate tax classification.
<br />rat Nn. tnPatx
<br />New line 3b has been added to this form. A flow-through entity is
<br />required to complete this line to indicate that it has direct or indirect
<br />foreign partners, owners, or beneficiaries when it provides the Form W-9
<br />to another flow-through entity in which it has an ownership interest. This
<br />change is intended to provide a flow-through entity with information.
<br />regarding; the status of its indirect foreign partners, owners, or
<br />beneficiaries, so that it can satisfy any applicable reporting
<br />requirements. For example,a partnership that has any indirect foreign
<br />partners may required to complete Schedules K-2` and K-3. Seethe
<br />Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
<br />Purpose of Forret
<br />An individual or entity (Form W-9 requester) whois, required to file an
<br />Information return with the IRS is giving you this form because they
<br />Fnrrn w-9 (Rau. 3-IPn24)
<br />38
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