Form W-9

(Rev. Ocloher 20 1 8)
Request for Taxpayer
Identification Number and Certification
G ive Form to the
requester. Do not
0er,artmenl of Ille Tre.1•1J,Y send to the IRS.
ln!Pmai Revenue Service ► Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name (as sl1own on your in<,ome 1�, rel,1r n). Nan,e is requ;rw on tl 1is line: do not leave this line blank.

2 Business nameldisr<,garded enlily nami;. if different f1om aoove

RDS of Virqinia, LLC
c,j
a, 3 C!ieck approprialJ? box for fed-=- 1dl I.A:<. classifil ;il ir,q of the pi;..rson who,;,e name is en1�1ed on line 1 . Chl?Ck only one of II,e 4 E>'-mp:ions (CodPs apply only to
following seven bnxi=i,s. c.:-rtrtin e11tit1�':i. not individu::ils; s0�

0
Ill
□ Individual/sole prop6Plor or
single-member LLC
D C Co1 pv, al int1 D S Cm poralinn D Partnership D Trusl/esl�le
inslru,ot ions on p�ge 3):

Gi E,.,mpl pn;•Ce code (if any)

..
C:
0. 0
� 'fl::, 0 Limited liahiiity comp,Iny. Enl�r the ta< ci�ssifica lion (C=C co, po,alion. S=S <-eo1 po1dlinn, P=Partnership) ►

.. -
0 .. Note: Ch.,r.k the app,op,iate bo,: in the line abov.a for the 1a, cl,15,ifi.-:�tion of the single-member owner. Do not cl ,eGk EX<'lll[)l;on from FATCA r,iporting
1: ti LLC if lhe LLC is clas,ifif'd as a single-member LLC lhat is disrega• d?d f,om the ow11er unl�ss l11e owner of the LLC is
·- C:
another LLC lhat is not disi;,go•d 0d from the owner for U.S. f<erl<'ral 1 ,1 ' purpos->s. Olherwis". a single-member LLC that code fif any)
.!a! is clisrll?garrlcd from t11e owner s!1()uld chi:-rk the app1 0µ, t,1ltl- bnx for the l�x r:lassificalion of its owner.
□ Other (<;ee in<;l1Licl in11s) ►
5 Address (number. slr""t. and apl. or suile no.) Soe instruct;r,ns.
(,".r;,i;...� -� ,. ,,, •:� , ,..,,/ , ''''"'" ., - '
Requ.,,,.,r·s name and adclrns, (opl innal)
,"f• "

(/)
a,
632 N Witchduck Rd., Ste 1 08
6 City. state. and ZIP code
Virqinia Beach, VA 23462
7 Lisi arrount number(s) here (oplionill)

mu Taxpayer Identification N u mber (TIN)

I Social security number I
[Il] -DJ -I I I I I
Enter your. TIN in. the appropriate
. . . box. The TIN provided must .match the name given on line 1 lo avoid
.
backup w1lhhold111g. Fot 1nd1v1duals, th,s ,s generally your social secu11ty number (SSN). However. for a
resident alien, sole proprietor, or disregarded entity, see the inst ructions for Part I, !filer. For other
en l i l iPs. il is your employer ident i fication number (EIN). It you do not have a number, see How to get a
TIN, later. or
Note: If the account is in more than one name. see the inst ructions for line 1 . Also see What Name and I Employer identification number
Number To Give the Requester for g uidelines on whose numbe, to enter.
4 7 - 4 3 6 7 1 1 6
Certification
Under penalties of perj ury. I ce, lily that:
1 . The nu mber shown on this fo1 111 is my correct ta� r,ayer iclf'n l i f;cfllion num ber (or I am wail ing for a number to be issued to me): and
2 . I am not subject to backup wit hholding bec11use: (a) I am ex<>mpt from backup withl1olding. or (b) I have not been notified by the I n ternal Revenue
Se,vice (IRS) that I am subj ect lo back1 1p wi thholdi ng as a result of a failure lo report all interest or diviclends, or (c) lhe IRS has noti fied me that I am
no longer subject to b;ickup wi thl1olding: and
3. I am a U.S. cil izen or oth e,· U .S. person (defi ned below); and
4. Tl1e FATCA code(s) en tered on this form (if any) indiraling lhal I am exempl from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by lhe IRS that you are cuI rently subject lo backup withholding beca1 1�9
you have failed to report all interest and dividends on your tax return. For real estate transact ions. item 2 do\'s nol apply. For mortgage interest paid.
acqu isition or abandonment of secured property, cancell ation of debt. contributions to an individual relirement arrangement (IRA) . and generally, payme,>ls
other than interest and dividends, you are not required lo sign llie certification. bul you must provide your correct TIN. See lhe instructions for Part II, lalPr.

Sign Signature of
Here U.S. person ► Date ► 1/9/2023

• Form 1 099-DIV (dividends. including those from stocks or mutual

Section references are to t he Inter nal Revenue Code unless ol11erwise
noted.
Future developments. For the lalest in forma t ion about developments
related lo Fo1 1n W-9 and its instructions. such as legisla t ion enacted
after they were published. go to www.irs.gov/Form W9.
Purpose of Form
An individual or entity (Form W-9 requPsler) who is required lo file an
informa tion return with the IRS must obtain your correct taxpayer
iden lification num ber (T I N) whir:h may be your soci;il securil11 number
(SSN). individual tax payer idenli fieo l ion number (ITIN). ado ption
taxpayer identification number (ATI N). or employer iden l ific;, tion number
(EI N). lo report on an informa l inn return lhe amount paid lo you. or o l11er
amounl reportable on an info, malion re turn. Examples of info, nv1l ion
re t urns include. but are not limil"'d lo. the following.
• Form 1 099-INT (in terest earned or paid)
funds)
• Forrn 1 099- MISC (various types of income. prizes, awards, or gross
proceeds)
• Form 1 099-B (stock or mutual fund sales and certa i n other
transactions by brokers)
• Form 1 099-S (proceeds from real es tale transactions)
• Form 1 099-K (me,chant card and third party nelwot k transactions)
• Form 1 098 (home morlg<1ge inle, es l), 1 098-E (student loan int erest),
1 098-T (tuit ion)
• Form 1 099-C (r:anceled debt)
• Forrn 1 099-A (ac quisition or abandonment ot secured propert y)
Use Form W-9 only if you are a U.S. person (including a resident
alien ) . lo provide your crn-rect TIN.
Ifyou do not return Fom, W-9 to the requester wil/1 a TIN, you might
be subject to barkup withholding. See Whal is backup withholding.
la ter.

C�l. No. 1 023 1 X Form W-9 (Rev. 1 0-20 1 8)