Give Form to the
requester. Do not
send to the IRS.
(Ro, Aut 2015)
Request for Taxpayer
Sonnet, Identification Number and Certification
Tarn x SOW oh YOU HERE RTT
[The College of New Jersey Foundation, Inc.
Basins nen eoS aad Ly tara, Taare fon aoe
[Chock appropriate box Tor tedoral ax casscator ‘arpions fe nabs
Cinditinvsle proctor] CComerston ] Scorpion] Pane C] tusvestte
Exempt ayes cod tan.
CC Lied abit company. Enter ne tax cassteaton (°C corporation SS corpraton, Poparnersie)> xompton tom FATCA reson
code an)
2] otter ee atts 501 (03
ess (UE, Sos, ah aL oF TETST
'P.0. Box 7718
Ewing, NJ 09628-0718
Tat acd HER Po (Oa
[GEGM__Taxpayer identification Number (TIN)
Entry TH te apploprate box. "Fa TN proved must malch De nave Guanon he Name Tne | Sedans ane }
{olnvod bacnus withakiog For nahidun, tas you socal sesiry number SN, Honover for 7
TS aa RIT OTTO
Print or type
‘See Specific instructions on page 2.
resident avon, sole proprietor, o° csragarded oy, soe te Part Instructions on page S. For other | +
“entities, itis your employer identification number (EIN). If you do not have a number, see How to get a L
Tvon page
Note. I the account i in more than one name,
umber to ents.
Cerification
Under penalties of peur, | certify that
+. The number shown on this form is my corract taxpayer identiflation number or | ar waiting fora number tobe issued to me, and
12 chart on page 4 for guidelines on whose
2. Lam not subject to backup withholding because: (a)! am exemat fom backup withholding, or) [have not beon noted by the intemal Revenue
Servic (RS that am subject to backup witiolding asa resut of fale te report all ntorest cr vend, o (the IRS has noted me that | am
no longe subject to backup wihhalaing, and
3. Lama US. eizon or other US. person (detined below), and
4. The FATCA codes) entered on tis form any) indicating that | am exempt rom FATCA reporting s correct.
Certification instructions. You must crass out item 2 above if you have been noted by the IS that you are curently subjec to backup withholding
Because you have ‘aed to report al interest and dividends on You tax rtum. For realestate transactions, tem 2 does nat apply. For mortgage
Interest paid, aequistion ar abandonment of seoured propery, cancelation of dabt,cortrbution to an indwvdual retirement arrangement (RA), and
overly, payments oo’ than rerest and diidendsq you are not ened fo ign th cretion, But You MUS provide your oract TIN, See the
IRettons an page 8 =
Sign ‘Signature of
Here | US'pemone ow F J23/ 2
General Instructions ot tces/ conned come, ot
\wtnolang axon erin paren
“Carly hat FATCA cot) ater
Sovtonrterence arto th nea Revert Cod uns ceri tad fe fo ar net tet you
Future developments, Tho IS ha reste a page en. go for nforaton
beut Form Wa sw re pou, Iomatin about ay tie developments
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Purpose of Form
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erctune rena ansoctons, morgage mre you pa scqution or
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1. Cory that he TN you ars ging i coact you ae wating fe arabe
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2. Char exemption ram bacun wahhatsng you are 8 U.S. exane pay,
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Note. iu ste US. ptson and a equeter sve you frm ther han Form
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Definition o U.S person. For eer ox purposes, you ae corded a US.
own you ae
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* Adanaatic tt as tind egos seson 301.7017).
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Tas on any frig pers sare of elec connected eb ncore ro
‘the ule undo’ section 1446 requre a partnership to presume that x partner 3
{Srelgn paren, ana pay ha socton se winking tax Tater, You ar 8
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‘Untew Staton. rou Form W-O tothe paorano fo eteiet your U.S. ate
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