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<br />Forrn W -9 (Rear. 1 •20421
<br />Specific Instructions
<br />Name. If you are an individual, you must
<br />generally enter the name shown 0n your
<br />social security card. However, ifyou have
<br />changed your last name, fa instance, due to
<br />marriage without informing the Social Security
<br />Administration of the name change, enter
<br />your first name, the last name shown on your
<br />social security card, and your new last. name.
<br />If the account is in joint names list first and
<br />then circle tl-e name of the person or entity
<br />who..c number you enter in Part I of the form.
<br />Sole proprietor. Enter your Individual
<br />name as shown on you- social security card
<br />an the "Name" line. You may enter your
<br />business, trade, or "doing business as (DBA)"
<br />name' on the "Business name" line.
<br />Limited lability company (UP. If you are
<br />a single- member LLC including a foreign LLC
<br />with a domestic owner) that is disregarded as
<br />an entity separate from its owner under
<br />Treasury regulations section 301.7701 -3,
<br />enter the owner's name an the "Name"
<br />line, Enter the LLC's name on the "Business
<br />name" fire.
<br />Other entities. Enter your business name
<br />as shown on required Federal tax documents
<br />on the "Nam" line. The, name should match
<br />the name shown on the charter or other legal
<br />document ,seating the entity. You may enter
<br />any business, trade, or RBA name on the
<br />"BLainess name" line.
<br />Exempt from backup withhafdirag If you
<br />are exempt, enter your name as described
<br />above, then check the "E:aoempt from backup
<br />withholding" box in the fine felbwing the
<br />business name, sign and date the form.
<br />Individuals (including sole proprietors) are
<br />nut exempt from backup withholding.
<br />Corptxations are exempt from backup
<br />withholding for certain payments; su=:h as
<br />interest and dividends. For more information
<br />on exempt payees, sc-e the Instructions for
<br />Me Requester of Form W -9.
<br />If you are a nonresident alien or a faeign
<br />entity not subject to backup withholding, give
<br />the requester the appropriate completed
<br />Form W -B.
<br />Note: If you are exempt.fixam beraiatp
<br />ao iti'rdding. pet s; ot&d stiff cernpiete this
<br />kern to avoid possible erroreeous &Kee p
<br />seiderxa'dTrg.
<br />Part [ Taxpayer Identification
<br />Number (TIN)
<br />Enter your TIN in the appropriate box.
<br />If you are a resident aliens: and you do not
<br />have and are not eligible to get an SSN, your
<br />TIN is your IRS individual taxpayer
<br />dentificatien number (ITIN). Enter it in tt-e
<br />social security numbs box. If you do not
<br />have an 111N., see :How to get a TIN! below.
<br />If you are a sole proprietor and you have
<br />an EIN, you may enter either you- SSN or
<br />EIN. However, the IRS prefer that you use
<br />your SSN.
<br />If you are an LLC that is disregarded as
<br />an entity separate from its owner (see
<br />iitrrited.lia:biiity company (Up) above), and
<br />are owed by an individual, enter your SSN
<br />(cr "pre -LLC" EIN, if desiedi. If the owner of
<br />a disregarded LLC is a corporation,
<br />partnership, etc., enter the owner's El N.
<br />Note: See the tart on this page .far firram-
<br />cfarrficati5ra of name and NW combinations.
<br />How to get a TIN.. If you do not have a TIN,
<br />applyfar one immediately. To apply for an
<br />SSN, get Fans 55 -5, Application for a Social
<br />Security Card, from your local Social Security
<br />Administration office. Get Fcirne W -7.
<br />Minnesota Option Structure Lease
<br />2005
<br />ersge i
<br />5appucation for IRS Individual Taxpayer
<br />Identification Number. to apply for an ITIN, or
<br />Form 5S -4, Application for Employer
<br />Identification Number, to apply for an EIN.
<br />You can get Forms W-7 and SS -4 from the
<br />IRS by calling 1-BOO-TAX-FORM
<br />(14109-82 9- ax from the IRS Web Site at
<br />t wwers,:gay.
<br />If you arts asked to complete Fame W -9 but
<br />do not have a TIN, mite "Applied For" in the
<br />space for the TIN, sign and date the fans,
<br />and give it to the requester. For interest and
<br />dividend payments, and certain payment
<br />made with respect to readily tradatle
<br />instruments, generally you will have 60 days
<br />to get a TIN and give it to the raqueet
<br />before you as subject to backup withholding
<br />on payments. The 60-day rule dri not apply
<br />ba other types of payments. You will be
<br />subject to backup withholding on all soh
<br />payments until you provide your TIN to the
<br />requester.
<br />Note: Writing " Applied Ecr "means that you
<br />have already applied fir a TIN :or brat yeti
<br />intend to apply far rroe soon
<br />Caution: A d& dis-eparderfebmestic entity that
<br />has a foreign owner must use the a{pp-cpriate
<br />Fo erW -B.
<br />Part II—Certification
<br />To establish to the withholding agent that you
<br />ere a. U.S. person, or resident alien, sign Form
<br />W -9. You may be requested to sign by the
<br />withholding agent even if items 1, 3, and
<br />below indicate otherwise.
<br />For a joint account, only the person whose
<br />TIN is shown in Part I should sign (when
<br />required). Exempt recipients, see .Exempt
<br />from backep ra ffahrhofding above.
<br />Signature requirements, Complete the
<br />certification as indcated in 1 through 6
<br />below.
<br />1, interest, dividend, and barter
<br />exehaage accounts opened before 1984
<br />and broker accounts :considered active
<br />during 1083, You must give your correct TIN,
<br />but you do not have to sign the certification.
<br />2. interest, dividend, broker, and barter
<br />exchange accounts opened after 1983 and
<br />broker accounts considered inactive during
<br />1883. You must sign the certification or
<br />backup withhold ing will apply. If you are
<br />a.tbject to backup withholding and you are
<br />merely providing your correct 11N to the
<br />requester, you must cross out item 2 in the
<br />certification tefarm signing the farm.
<br />3. Real state transactions, You must .
<br />sign the certification. You may cross out
<br />item 2 of the certification.
<br />4. Other payments. You must give your
<br />correct TIN, but you do net have to sign the
<br />certification unless you have been notified
<br />that you have previously given an incorrect.
<br />TIN. "Other payments" include payments
<br />made in the course of the requesters trade
<br />or business for rents royalties., goods (other
<br />than bills for merchandise), medical and
<br />health care services (including payments to
<br />corporations), payments to a nonemplcyee for
<br />serei;;es, payments to certain fishing boat
<br />aew members and fishermen, and gross
<br />proceeds paid to attorneys (including
<br />payments to corporations).
<br />re. Mortgage interest paid by you,
<br />acquisition or abandonment of secured
<br />property, cancellation of debt, qualified
<br />tuition program payments (under section
<br />529),. IRA or Archer h1S t contributions or
<br />distributions, and pension. distributions.
<br />You must give your correct TIN, but yrau do
<br />not have to sign the certification.
<br />e^e
<br />-50—
<br />GU
<br />Privacy Act Notice
<br />Section 61CA of the Internal Revenue Code
<br />requires you to give your correct TIN to
<br />persons who must file information returns
<br />with the IRS to report interest, dividends, anc
<br />aartain other income paid to you, mortgage
<br />interest you paid.. the acquisition or
<br />abandonment of secured property,
<br />cancellation of debt, or contributions you
<br />made to an IRA or Archer VISA. The IRS use
<br />the numbers for identification purposes and
<br />to help verify the accuracy of your tax return.
<br />The IRS may also provide this information to
<br />the Department of Justice for civil and
<br />criminal litigation, and to cities, states, and
<br />the District of Columbia to carry out their tax
<br />Issas.
<br />You must provide your TIN whether or not .
<br />you are required to file a tax rotten. Payees
<br />must generally withhold 3034 of taxable
<br />interest, dividend, and certain other paymenu
<br />to a payee hstio does not give a TIN to
<br />payer. Certain penalties may also apply.
<br />What Name and Number To
<br />Give the Requester
<br />For this type O act
<br />111,0 :name and SSN of
<br />1. n]lvttusl
<br />2. Two cr were
<br />lndtvkil= IErt
<br />ecrourfl
<br />3. Custodian atxrtnt rf
<br />o mhos ilinrcrm all
<br />to Minas Act)
<br />A. a. The aoual
<br />reercatte t'van1r1
<br />MST granter G
<br />dso trustee)
<br />b. so- called hest
<br />account tlt1 Is rel
<br />a leoal to- vale hint
<br />uncfr 115:010 law
<br />5. &ti? prrlrldastip
<br />The ndvldual
<br />The acted coons 01 ID?
<br />t nt cr, tictxnbhed
<br />hods, tie? tilt Irdti lmLk1
<br />on the a:cnurt 1
<br />The Irirna 3
<br />The 9-arta- trustee 1
<br />The artul CAM' 1
<br />The caaler 3
<br />For this t} of account
<br />Sive name and ElfJ ot:
<br />B. Sole anglntor -lip
<br />7. It valt7 Met, estate, a
<br />Ferslcn trust
<br />B. corporate
<br />9. Asseclit L chin,
<br />religious, rxantabG,
<br />eltrationat, or eves
<br />lax exempt
<br />awn: 011m
<br />10. Pantera1p
<br />11. 4Inter erregGirrc1
<br />rorrinee
<br />12. Accourtwtm the
<br />Cepertment LI
<br />retinae In the retire
<br />rf a orbit entity Larch
<br />as a state a lo:al
<br />greantnart, schod
<br />atdilct, cr preen) that
<br />receives ag istliu al
<br />pnxfram pameris
<br />The parer 3
<br />L si WIG r
<br />The caporanen
<br />The lxgantJallcn
<br />The patnerslip
<br />The rn11so a- nanirr
<br />The pubic a tlty
<br />1 LGt 11st and tdree the naive ct the pets0n whose
<br />numtcrp.1lumen. 11 only core persra on al:Int
<br />amount rvrs an 55N, 1Iai per son's renter ems 130
<br />tUmSht.
<br />'Circe the mitt's name are lurisll tie mrmr's 1"N.
<br />' You met alicw your lndriodua I name, but yai may
<br />dso enter wtr boons 11 "l:50I Hanle. You troy we
<br />ether your 5514 rx EIN (Rya] h=ive onr.9.
<br />' Lit t[st and orduthe nine cr the egal -Met, 5510110
<br />cr parent trust (f7o not knish the TIN c( the nil
<br />rtfrecenLaltw_ ca trustee urine, the legal witty user Is
<br />net designated In Inc accourt tee)
<br />Note: If rats name is circled Wren more tharr
<br />core mantle is fisted, the rncrtber viii be
<br />considered to be that of the first name Pitted.
<br />Final Date: 050617
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