rom W-9 Request for Taxpayer ave Form to the
(hor taba 2018) Identification Number and Certification requester. Do not
aera Rover Sane” > Go to www. gov/FormW9 for Instructions and the latest information. ‘Sond to the IRS.
Tare as sown om your Rear Tx our: Ramos required ons; Go ot oave is Te Ba
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1 Specific Instructions on page 8
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ied tatty company. Ene he tax clasfication (CC corporation, $-8 corporation, PePatership)> _S.
Noe: Gneck ha appropriate boxin the ine above fo the ax casetleaton ofthe singe-mambar oom. Donat chek | Exemption tom FATCA reertng
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FORT LAUDERDALE, FL 33308.
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[EIN Taxpayer identification Number (TiN)
Enter your TN inthe appropriate box. The TIN provided must maich the name given online 1 avoid
‘backup withholding, For individuals, ths is generally your socal securty number (SSN). However, for &
isregarded eniy, S00 the Instructions for Pat later. For other - -|
's your employer identification number (EIN) you do not have & number, see How to geta
Fesident aflen, sole proprietor, or di
ents,
TN, later.
Note: I the account i in more than one name, see the Instructions for Ene 1, Also see What Name and
‘Number To Give the Requestor for guidelines on whose number to enter.
[Social secur RARER
[I certiication
Under penalties of perjury, eeeify that
1. The number shown on this frm is my correct taxpayer Identfcation number (or | am waiting for @ number to be issued to me); and
2. Lam not subject to backup withholding because: a) |am exempt from backup withholding, or (b) I have not been noted by the Internal Revenue
ro longer subject to backup withholding: and
3.1m aU.S.cltizen oF other U.S. person (defined below); and
vice (FS) that | am subject to backup withholding as a result of afar to report al inorest or dividends, or () the IRS has notfid me tha Lam
4. The FATOA code(s entered on this form i any) inccating that | am exempt from FATCA reporting is correct.
Certiication instructions, You must cross out item 2 above if you have been notiid bythe IRS that you are curently subject to backup withholding because
you have fale to report al interest and dividends on your tax return. For realestate transactions, tem 2 does rot apply. For mortgage terest pal,
Acquistion or abandonment of secured property, cancelation of deb, conbibuione to an incvdual eement
(RA, and generally, payments
rangement
‘other than intrest and dvidends, you are not required to sign the certieation, but you must provide your correct TIN: Soe ts instructions for Pa I, later
Sign] signature of
[ices (he
General Instructions
‘Section references ae to the Internal Revenue Code unless otherwise
note.
Future developments. For tho atest information about developments
‘ates to Form W- and ts nstructons, such a eglation enacted
ater they were pubksned, goto rs govlFomit.
Purpose of Form
‘An individual or entty (Form W-9 requester) who is required to fle an
Information return with the IRS must obtain your correct taxpayer
igentifcation number (TIN) which may be your social securty number
(SSN), Individual taxpayer identification number (TIN), adoption
taxpayer identication number (ATIN), or employer identification number
(EIN), to report onan information return the amount paid to you, or other
‘amoint reportable on an information retum. Examples of formation
retums include, but are not fied to, the following.
“+ For 1086-INT (nteret earned or pai)
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