How to complete this form
The Internal Revenue Service (IRS) requires us to withhold taxes for the applicable rate of backup withholding for U.S. persons without a W-9 tax
certification who are not otherwise exempt. Parties acting as disbursement agents, such as Computershare, must withhold and pay to the IRS the
applicable tax rate of such payments under certain conditions. This is called “backup withholding.” Payments that may be subject to backup withholding
include interest, dividends, broker and barter exchange transactions, and royalties. Supplying us with your correct Taxpayer Identification Number (TIN),
and signing this form will generally allow you to receive your payments without being subject to backup withholding. Failure to supply your TIN, or
supplying us with an incorrect TIN, could result in a $50.00 penalty being assessed by the IRS.
Receipt of a completed Form W-9 will discontinue backup withholding unless otherwise required.
What Name and Number To Give the Requester
Exempt payee code. Generally, individuals (including sole proprietors) are not exempt from backup withholding.
Corporations are exempt from backup withholding for certain payments, such as interest and dividends.
Corporations are not exempt from backup withholding for payments made in settlement of payment card or third
party network transactions.
Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous
backup withholding.
The following codes identify payees that are exempt from backup withholding:
1 -- An organization exempt from tax under section 501(a), any IRA, or a custodial account under section
403(b)(7) if the account satisfies the requirements of section 401(f)(2)
2 -- The United States or any of its agencies or instrumentalities
3 -- A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions
or instrumentalities
4 -- A foreign government or any of its political subdivisions, agencies, or instrumentalities
5 -- A corporation
6 -- A dealer in securities or commodities required to register in the United States, the District of Columbia, or a
possession of the United States
7 -- A futures commission merchant registered with the Commodity Futures Trading Commission
8 -- A real estate investment trust
9 -- An entity registered at all times during the tax year under the Investment Company Act of 1940
10 -- A common trust fund operated by a bank under section 584(a)
11 -- A financial institution
12 -- A middleman known in the investment community as a nominee or custodian
13 -- A trust exempt from tax under section 664 or described in section 4947
For this type of account: Give name and SSN of:
1. Individual
2. Two or more individuals (joint account)
3. Custodian account of a minor
(Uniform Gift to Minors Act)
4. a. The usual revocable savings
trust (grantor is also trustee)
b. So-called trust account that is
not a legal or valid trust under state
law
5. Sole proprietorship or disregarded
entity owned by an individual
6. Grantor trust filing under Optional
Form 1099 Filing Method 1
(see Regulation section
1.671-4(b)(2)(i)(A))
The individual
The actual owner of the account or, if
combined funds, the first individual on
the account
The minor
The grantor-trustee
The actual owner
The owner
The grantor
Limited Liability Company or Other Classification
If you are a Limited Liability Company or Other entity, complete an IRS Form W-9 found on the IRS website www.irs.gov. Be sure to include the
information required in the IRS instructions for a Limited Liability Company (LLC) or for Other entities on page 2. Return the completed form to the
address below.
Definition of a U.S. Person. For federal tax purposes, you are considered a U.S. person if you are:
● An individual who is a U.S. citizen or U.S. resident alien,
● A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States,
● An estate (other than a foreign estate), or
● A domestic trust (as defined in Regulations Section 301.7701-7).
Exemption from FATCA reporting: If you are submitting this form for an account that is maintained in the United States, you are exempt from
FATCA reporting.
Backup Withholding
For this type of account: Give name and EIN of:
7. Disregarded entity not owned by an
individual
8. A valid trust, estate, or pension trust
9. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
10. Association, club, religious,
charitable, educational, or other tax-
exempt organization
11. Partnership or multi-member LLC
12. A broker or registered nominee
13. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
14. Grantor trust filing under the Form
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulation section
1.671-4(b)(2)(i)(B))
The owner
Legal entity
The corporation
The organization
The partnership
The broker or nominee
The public entity
The trust
.
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