PDF document
- 1 -
                                                                                                  Request for Taxpayer                                                                     Give Form to the  
Form    W-9                                                                                                                                                                                requester. Do not 
(Rev. October 2018)                                                                       Identification Number and Certification
Department of the Treasury                                                                                                                                                                 send to the IRS.
Internal Revenue Service                                                               ▶ Go to www.irs.gov/FormW9 for instructions and the latest information.
                                                        1  Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.

                                                        2  Business name/disregarded entity name, if different from above

                                                        3  Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the  4  Exemptions (codes apply only to 
                                                         following seven boxes.                                                                                                       certain entities, not individuals; see 
                                                                                                                                                                                      instructions on page 3):
                              on page 3.                 Individual/sole proprietor or            C Corporation       S Corporation       Partnership             Trust/estate
                                                         single-member LLC                                                                                                           Exempt payee code (if any)
                                                         Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)▶ 
                                                         Note: Check the appropriate box in the line above for the tax classification of the single-member owner.  Do not check  Exemption from FATCA reporting
                                                         LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is 
               Print or type.                            another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that        code (if any)
                                                         is disregarded from the owner should check the appropriate box for the tax classification of its owner.
                                                         Other (see instructions) ▶                                                                                                  (Applies to accounts maintained outside the U.S.)
                                  Specific Instructions 5  Address (number, street, and apt. or suite no.) See instructions.                                      Requester’s name and address (optional)
                              See
                                                        6  City, state, and ZIP code

                                                        7  List account number(s) here (optional)

Part I                                                   Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid                                                                      Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a 
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other                                                                              –           –
entities, it is your employer identification number (EIN). If 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 instructions for line 1. Also see What Name and                                                                    Employer identification number 
Number To Give the Requester for guidelines on whose number to enter.
                                                                                                                                                                                     –
Part II                                                  Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue 
  Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am 
  no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup                                                                 withholding because 
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.                                                          For mortgage interest paid, 
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement                                                              arrangement (IRA), and generally, payments 
other than interest and dividends, you are not required to sign the certification, but you must                                                     provide your correct TIN. See the instructions for Part II, later.
Sign                                                     Signature of 
Here                                                     U.S. person ▶                                                                                Date ▶
                                                                                                                                    • Form 1099-DIV (dividends, including those from stocks or mutual 
General Instructions                                                                                                                funds)
Section references are to the Internal Revenue Code unless otherwise                                                                • Form 1099-MISC (various types of income, prizes, awards, or gross 
noted.                                                                                                                              proceeds)
Future developments. For the latest information about developments                                                                  • Form 1099-B (stock or mutual fund sales and certain other 
related to Form W-9 and its instructions, such as legislation enacted                                                               transactions by brokers)
after they were published, go to www.irs.gov/FormW9.
                                                                                                                                    • Form 1099-S (proceeds from real estate transactions)
Purpose of Form                                                                                                                     • Form 1099-K (merchant card and third party network transactions)
An individual or entity (Form W-9 requester) who is required to file an                                                             • Form 1098 (home mortgage interest), 1098-E (student loan interest), 
information return with the IRS must obtain your correct taxpayer                                                                   1098-T (tuition)
identification number (TIN) which may be your social security number                                                                • Form 1099-C (canceled debt)
(SSN), individual taxpayer identification number (ITIN), adoption 
taxpayer identification number (ATIN), or employer identification number                                                            • Form 1099-A (acquisition or abandonment of secured property)
(EIN), to report on an information return the amount paid to you, or other                                                             Use Form W-9 only if you are a U.S. person (including a resident 
amount reportable on an information return. Examples of information                                                                 alien), to provide your correct TIN. 
returns include, but are not limited to, the following.                                                                                If you do not return Form W-9 to the requester with a TIN, you might 
• Form 1099-INT (interest earned or paid)                                                                                           be subject to backup withholding. See What is backup withholding, 
                                                                                                                                    later.
                                                                                                  Cat. No. 10231X                                                                          Form W-9 (Rev. 10-2018)



- 2 -
Form W-9 (Rev. 10-2018)                                                                                                                             Page 2 
   By signing the filled-out form, you:                                        Example. Article 20 of the U.S.-China income tax treaty allows an 
   1. Certify that the TIN you are giving is correct (or you are waiting for a exemption from tax for scholarship income received by a Chinese 
number to be issued),                                                          student temporarily present in the United States. Under U.S. law, this 
                                                                               student will become a resident alien for tax purposes if his or her stay in 
   2. Certify that you are not subject to backup withholding, or               the United States exceeds 5 calendar years. However, paragraph 2 of 
   3. Claim exemption from backup withholding if you are a U.S. exempt         the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows 
payee. If applicable, you are also certifying that as a U.S. person, your      the provisions of Article 20 to continue to apply even after the Chinese 
allocable share of any partnership income from a U.S. trade or business        student becomes a resident alien of the United States. A Chinese 
is not subject to the withholding tax on foreign partners' share of            student who qualifies for this exception (under paragraph 2 of the first 
effectively connected income, and                                              protocol) and is relying on this exception to claim an exemption from tax 
   4. Certify that FATCA code(s) entered on this form (if any) indicating      on his or her scholarship or fellowship income would attach to Form 
that you are exempt from the FATCA reporting, is correct. See What is          W-9 a statement that includes the information described above to 
FATCA reporting, later, for further information.                               support that exemption.
Note: If you are a U.S. person and a requester gives you a form other          If you are a nonresident alien or a foreign entity, give the requester the 
than Form W-9 to request your TIN, you must use the requester’s form if        appropriate completed Form W-8 or Form 8233.
it is substantially similar to this Form W-9.
                                                                               Backup Withholding
Definition of a U.S. person. For federal tax purposes, you are 
considered a U.S. person if you are:                                           What is backup withholding? Persons making certain payments to you 
                                                                               must under certain conditions withhold and pay to the IRS 24% of such 
• An individual who is a U.S. citizen or U.S. resident alien;                                                                             
                                                                               payments. This is called “backup withholding.”  Payments that may be 
• A partnership, corporation, company, or association created or               subject to backup withholding include interest, tax-exempt interest, 
organized in the United States or under the laws of the United States;         dividends, broker and barter exchange transactions, rents, royalties, 
• An estate (other than a foreign estate); or                                  nonemployee pay, payments made in settlement of payment card and 
• A domestic trust (as defined in Regulations section 301.7701-7).             third party network transactions, and certain payments from fishing boat 
                                                                               operators. Real estate transactions are not subject to backup 
Special rules for partnerships. Partnerships that conduct a trade or           withholding.
business in the United States are generally required to pay a withholding      You will not be subject to backup withholding on payments you 
tax under section 1446 on any foreign partners’ share of effectively           receive if you give the requester your correct TIN, make the proper 
connected taxable income from such business. Further, in certain cases         certifications, and report all your taxable interest and dividends on your 
where a Form W-9 has not been received, the rules under section 1446           tax return.
require a partnership to presume that a partner is a foreign person, and 
pay the section 1446 withholding tax. Therefore, if you are a U.S. person      Payments you receive will be subject to backup withholding if: 
that is a partner in a partnership conducting a trade or business in the       1. You do not furnish your TIN to the requester,
United States, provide Form W-9 to the partnership to establish your           2. You do not certify your TIN when required (see the instructions for 
U.S. status and avoid section 1446 withholding on your share of                Part II for details),
partnership income.
                                                                               3. The IRS tells the requester that you furnished an incorrect TIN,
   In the cases below, the following person must give Form W-9 to the 
partnership for purposes of establishing its U.S. status and avoiding          4. The IRS tells you that you are subject to backup withholding 
withholding on its allocable share of net income from the partnership          because you did not report all your interest and dividends on your tax 
conducting a trade or business in the United States.                           return (for reportable interest and dividends only), or
• In the case of a disregarded entity with a U.S. owner, the U.S. owner        5. You do not certify to the requester that you are not subject to 
of the disregarded entity and not the entity;                                  backup withholding under 4 above (for reportable interest and dividend 
                                                                               accounts opened after 1983 only).
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, 
generally, the U.S. grantor or other U.S. owner of the grantor trust and       Certain payees and payments are exempt from backup withholding. 
not the trust; and                                                             See Exempt payee code, later, and the separate Instructions for the 
                                                                               Requester of Form W-9 for more information.
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust 
(other than a grantor trust) and not the beneficiaries of the trust.           Also see Special rules for partnerships, earlier.
Foreign person. If you are a foreign person or the U.S. branch of a            What is FATCA Reporting?
foreign bank that has elected to be treated as a U.S. person, do not use 
Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see              The Foreign Account Tax Compliance Act (FATCA) requires a 
Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign                 participating foreign financial institution to report all United States 
Entities).                                                                     account holders that are specified United States persons. Certain 
Nonresident alien who becomes a resident alien. Generally, only a              payees are exempt from FATCA reporting. SeeExemption from FATCA 
nonresident alien individual may use the terms of a tax treaty to reduce       reporting code, later, and the Instructions for the Requester of Form 
or eliminate U.S. tax on certain types of income. However, most tax            W-9 for more information.
treaties contain a provision known as a “saving clause.” Exceptions 
specified in the saving clause may permit an exemption from tax to             Updating Your Information
continue for certain types of income even after the payee has otherwise        You must provide updated information to any person to whom you 
become a U.S. resident alien for tax purposes.                                 claimed to be an exempt payee if you are no longer an exempt payee 
   If you are a U.S. resident alien who is relying on an exception             and anticipate receiving reportable payments in the future from this 
contained in the saving clause of a tax treaty to claim an exemption           person. For example, you may need to provide updated information if 
from U.S. tax on certain types of income, you must attach a statement          you are a C corporation that elects to be an S corporation, or if you no 
to Form W-9 that specifies the following five items.                           longer are tax exempt. In addition, you must furnish a new Form W-9 if 
   1. The treaty country. Generally, this must be the same treaty under        the name or TIN changes for the account; for example, if the grantor of a 
which you claimed exemption from tax as a nonresident alien.                   grantor trust dies.
   2. The treaty article addressing the income.
   3. The article number (or location) in the tax treaty that contains the     Penalties
saving clause and its exceptions.                                              Failure to furnish TIN. If you fail to furnish your correct TIN to a 
   4. The type and amount of income that qualifies for the exemption           requester, you are subject to a penalty of $50 for each such failure 
from tax.                                                                      unless your failure is due to reasonable cause and not to willful neglect.
   5. Sufficient facts to justify the exemption from tax under the terms of    Civil penalty for false information with respect to withholding. If you 
the treaty article.                                                            make a false statement with no reasonable basis that results in no 
                                                                               backup withholding, you are subject to a $500 penalty.



- 3 -
Form W-9 (Rev. 10-2018)                                                                                                                         Page 3 

Criminal penalty for falsifying information. Willfully falsifying            IF the entity/person on line 1 is    THEN check the box for . . .
certifications or affirmations may subject you to criminal penalties         a(n) . . .
including fines and/or imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of      •  Corporation                       Corporation
federal law, the requester may be subject to civil and criminal penalties.   •  Individual                        Individual/sole proprietor or single-
                                                                             •  Sole proprietorship, or           member LLC
Specific Instructions                                                        •  Single-member limited liability 
                                                                             company (LLC) owned by an 
Line 1                                                                       individual and disregarded for U.S. 
You must enter one of the following on this line; do not leave this line     federal tax purposes.
blank. The name should match the name on your tax return.                    •  LLC treated as a partnership for  Limited liability company and enter 
If this Form W-9 is for a joint account (other than an account               U.S. federal tax purposes,           the appropriate tax classification. 
maintained by a foreign financial institution (FFI)), list first, and then   •  LLC that has filed Form 8832 or  (P= Partnership; C= C corporation; 
circle, the name of the person or entity whose number you entered in         2553 to be taxed as a corporation,  or S= S corporation)
Part I of Form W-9. If you are providing Form W-9 to an FFI to document      or 
a joint account, each holder of the account that is a U.S. person must 
provide a Form W-9.                                                          •  LLC that is disregarded as an 
                                                                             entity separate from its owner but 
a.  Individual. Generally, enter the name shown on your tax return. If       the owner is another LLC that is 
you have changed your last name without informing the Social Security        not disregarded for U.S. federal tax 
Administration (SSA) of the name change, enter your first name, the last     purposes.
name as shown on your social security card, and your new last name.  
Note: ITIN applicant: Enter your individual name as it was entered on        •  Partnership                       Partnership
your Form W-7 application, line 1a. This should also be the same as the      •  Trust/estate                      Trust/estate
name you entered on the Form 1040/1040A/1040EZ you filed with your 
application.                                                                 Line 4, Exemptions
b.  Sole proprietor or single-member LLC. Enter your individual              If you are exempt from backup withholding and/or FATCA reporting, 
name as shown on your 1040/1040A/1040EZ on line 1. You may enter             enter in the appropriate space on line 4 any code(s) that may apply to 
your business, trade, or “doing business as” (DBA) name on line 2.           you.
c.  Partnership, LLC that is not a single-member LLC, C                      Exempt payee code.
corporation, or S corporation. Enter the entity's name as shown on the       •  Generally, individuals (including sole proprietors) are not exempt from 
entity's tax return on line 1 and any business, trade, or DBA name on        backup withholding.
line 2.                                                                      •  Except as provided below, corporations are exempt from backup 
d.  Other entities. Enter your name as shown on required U.S. federal        withholding for certain payments, including interest and dividends.
tax documents on line 1. This name should match the name shown on the        •  Corporations are not exempt from backup withholding for payments 
charter or other legal document creating the entity. You may enter any       made in settlement of payment card or third party network transactions.
business, trade, or DBA name on line 2.
                                                                             •  Corporations are not exempt from backup withholding with respect to 
e.  Disregarded entity. For U.S. federal tax purposes, an entity that is     attorneys’ fees or gross proceeds paid to attorneys, and corporations 
disregarded as an entity separate from its owner is treated as a             that provide medical or health care services are not exempt with respect 
“disregarded entity.”  See Regulations section 301.7701-2(c)(2)(iii). Enter  to payments reportable on Form 1099-MISC.
the owner's name on line 1. The name of the entity entered on line 1 
should never be a disregarded entity. The name on line 1 should be the       The following codes identify payees that are exempt from backup 
name shown on the income tax return on which the income should be            withholding. Enter the appropriate code in the space in line 4.
reported. For example, if a foreign LLC that is treated as a disregarded     1—An organization exempt from tax under section 501(a), any IRA, or 
entity for U.S. federal tax purposes has a single owner that is a U.S.       a custodial account under section 403(b)(7) if the account satisfies the 
person, the U.S. owner's name is required to be provided on line 1. If       requirements of section 401(f)(2)
the direct owner of the entity is also a disregarded entity, enter the first 2—The United States or any of its agencies or instrumentalities
owner that is not disregarded for federal tax purposes. Enter the 
disregarded entity's name on line 2, “Business name/disregarded entity       3—A state, the District of Columbia, a U.S. commonwealth or 
name.” If the owner of the disregarded entity is a foreign person, the       possession, or any of their political subdivisions or instrumentalities
owner must complete an appropriate Form W-8 instead of a Form W-9.           4—A foreign government or any of its political subdivisions, agencies, 
This is the case even if the foreign person has a U.S. TIN.                  or instrumentalities 
Line 2                                                                       5—A corporation
If you have a business name, trade name, DBA name, or disregarded            6—A dealer in securities or commodities required to register in the 
entity name, you may enter it on line 2.                                     United States, the District of Columbia, or a U.S. commonwealth or 
                                                                             possession 
Line 3                                                                       7—A futures commission merchant registered with the Commodity 
Check the appropriate box on line 3 for the U.S. federal tax                 Futures Trading Commission
classification of the person whose name is entered on line 1. Check only     8—A real estate investment trust
one box on line 3.                                                           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



- 4 -
Form W-9 (Rev. 10-2018)                                                                                                                         Page 4 
  The following chart shows types of payments that may be exempt              M—A tax exempt trust under a section 403(b) plan or section 457(g) 
from backup withholding. The chart applies to the exempt payees listed        plan
above, 1 through 13.                                                          Note: You may wish to consult with the financial institution requesting 
IF the payment is for . . .           THEN the payment is exempt              this form to determine whether the FATCA code and/or exempt payee 
                                      for . . .                               code should be completed.
Interest and dividend payments        All exempt payees except                Line 5
                                      for 7                                   Enter your address (number, street, and apartment or suite number). 
Broker transactions                   Exempt payees 1 through 4 and 6         This is where the requester of this Form W-9 will mail your information 
                                      through 11 and all C corporations.      returns. If this address differs from the one the requester already has on 
                                      S corporations must not enter an        file, write NEW at the top. If a new address is provided, there is still a 
                                      exempt payee code because they          chance the old address will be used until the payor changes your 
                                      are exempt only for sales of            address in their records.
                                      noncovered securities acquired          Line 6
                                      prior to 2012. 
                                                                              Enter your city, state, and ZIP code.
Barter exchange transactions and      Exempt payees 1 through 4
patronage dividends                                                           Part I. Taxpayer Identification Number (TIN)
Payments over $600 required to be  Generally, exempt payees                   Enter your TIN in the appropriate box. If you are a resident alien and 
reported and direct sales over        1 through 52                            you do not have and are not eligible to get an SSN, your TIN is your IRS 
$5,0001                                                                       individual taxpayer identification number (ITIN). Enter it in the social 
                                                                              security number box. If you do not have an ITIN, see How to get a TIN 
Payments made in settlement of        Exempt payees 1 through 4               below.
payment card or third party network                                           If you are a sole proprietor and you have an EIN, you may enter either 
transactions                                                                  your SSN or EIN. 
1 See Form 1099-MISC, Miscellaneous Income, and its instructions.             If you are a single-member LLC that is disregarded as an entity 
                                                                              separate from its owner, enter the owner’s SSN (or EIN, if the owner has 
2 However, the following payments made to a corporation and                   one). Do not enter the disregarded entity’s EIN. If the LLC is classified as 
 reportable on Form 1099-MISC are not exempt from backup                      a corporation or partnership, enter the entity’s EIN.
  withholding: medical and health care payments, attorneys’ fees, gross 
 proceeds paid to an attorney reportable under section 6045(f), and           Note: See What Name and Number To Give the Requester, later, for 
 payments for services paid by a federal executive agency.                    further clarification of name and TIN combinations.
Exemption from FATCA reporting code.The following codes identify              How to get a TIN. If you do not have a TIN, apply for one immediately. 
payees that are exempt from reporting under FATCA. These codes                To apply for an SSN, get Form SS-5, Application for a Social Security 
apply to persons submitting this form for accounts maintained outside         Card, from your local SSA office or get this form online at 
of the United States by certain foreign financial institutions. Therefore, if www.SSA.gov. You may also get this form by calling 1-800-772-1213. 
you are only submitting this form for an account you hold in the United       Use Form W-7, Application for IRS Individual Taxpayer Identification 
States, you may leave this field blank. Consult with the person               Number, to apply for an ITIN, or Form SS-4, Application for Employer 
requesting this form if you are uncertain if the financial institution is     Identification Number, to apply for an EIN. You can apply for an EIN 
subject to these requirements. A requester may indicate that a code is        online by accessing the IRS website at www.irs.gov/Businesses and 
not required by providing you with a Form W-9 with “Not Applicable” (or       clicking on Employer Identification Number (EIN) under Starting a 
any similar indication) written or printed on the line for a FATCA            Business. Go to www.irs.gov/Forms to view, download, or print Form 
exemption code.                                                               W-7 and/or Form SS-4.  Or, you can go to www.irs.gov/OrderForms to 
                                                                              place an order and have Form W-7 and/or SS-4 mailed to you within 10 
  A—An organization exempt from tax under section 501(a) or any               business days.
individual retirement plan as defined in section 7701(a)(37)
                                                                              If you are asked to complete Form W-9 but do not have a TIN, apply 
  B—The United States or any of its agencies or instrumentalities             for a TIN and write “Applied For” in the space for the TIN, sign and date 
  C—A state, the District of Columbia, a U.S. commonwealth or                 the form, and give it to the requester. For interest and dividend 
possession, or any of their political subdivisions or instrumentalities       payments, and certain payments made with respect to readily tradable 
  D—A corporation the stock of which is regularly traded on one or            instruments, generally you will have 60 days to get a TIN and give it to 
more established securities markets, as described in Regulations              the requester before you are subject to backup withholding on 
section 1.1472-1(c)(1)(i)                                                     payments. The 60-day rule does not apply to other types of payments. 
                                                                              You will be subject to backup withholding on all such payments until 
  E—A corporation that is a member of the same expanded affiliated            you provide your TIN to the requester.
group as a corporation described in Regulations section 1.1472-1(c)(1)(i)
                                                                              Note: Entering “Applied For” means that you have already applied for a 
  F—A dealer in securities, commodities, or derivative financial              TIN or that you intend to apply for one soon.
instruments (including notional principal contracts, futures, forwards, 
and options) that is registered as such under the laws of the United          Caution: A disregarded U.S. entity that has a foreign owner must use 
States or any state                                                           the appropriate Form W-8.
  G—A real estate investment trust                                            Part II. Certification
  H—A regulated investment company as defined in section 851 or an            To establish to the withholding agent that you are a U.S. person, or 
entity registered at all times during the tax year under the Investment       resident alien, sign Form W-9. You may be requested to sign by the 
Company Act of 1940                                                           withholding agent even if item 1, 4, or 5 below indicates otherwise.
  I—A common trust fund as defined in section 584(a)                          For a joint account, only the person whose TIN is shown in Part I 
  J—A bank as defined in section 581                                          should sign (when required). In the case of a disregarded entity, the 
  K—A broker                                                                  person identified on line 1 must sign. Exempt payees, seeExempt    payee 
                                                                              code, earlier.
  L—A trust exempt from tax under section 664 or described in section 
4947(a)(1)                                                                    Signature requirements.Complete the certification as indicated in 
                                                                              items 1 through 5 below.



- 5 -
Form W-9 (Rev. 10-2018)                                                                                                                                  Page 5 

  1. Interest, dividend, and barter exchange accounts opened                           For this type of account:                   Give name and EIN of:
before 1984 and broker accounts considered active during 1983.                     14. Account with the Department of          The public entity
You must give your correct TIN, but you do not have to sign the                        Agriculture in the name of a public 
certification.                                                                         entity (such as a state or local 
  2. Interest, dividend, broker, and barter exchange accounts                          government, school district, or 
opened after 1983 and broker accounts considered inactive during                       prison) that receives agricultural 
1983. You must sign the certification or backup withholding will apply. If             program payments
you are subject to backup withholding and you are merely providing 
your correct TIN to the requester, you must cross out item 2 in the                15. Grantor trust filing under the Form     The trust
certification before signing the form.                                                 1041 Filing Method or the Optional 
  3. Real estate transactions. You must sign the certification. You may                Form 1099 Filing Method 2 (see 
cross out item 2 of the certification.                                                 Regulations section 1.671-4(b)(2)(i)(B))
  4. Other payments.You must give your correct TIN, but you do not                 1 List first and circle the name of the person whose number you furnish. 
have to sign the certification unless you have been notified that you              If only one person on a joint account has an SSN, that  person’s number 
have previously given an incorrect TIN. “Other payments” include                   must be furnished.
payments made in the course of the requester’s trade or business for               2 Circle the minor’s name and furnish the minor’s SSN.
rents, royalties, goods (other than bills for merchandise), medical and            3 You must show your individual name and you may also enter your 
health care services (including payments to corporations), payments to 
a nonemployee for services, payments made in settlement of payment                 business or DBA name on the “Business name/disregarded entity” 
card and third party network transactions, payments to certain fishing             name line. You may use either your SSN or EIN (if you have one), but the 
boat crew members and fishermen, and gross proceeds paid to                        IRS encourages you to use your SSN.
attorneys (including payments to corporations).                                    4 List first and circle the name of the trust, estate, or pension trust. (Do 
  5. Mortgage interest paid by you, acquisition or abandonment of                  not furnish the TIN of the personal representative or trustee unless the 
secured property, cancellation of debt, qualified tuition program                  legal entity itself is not designated in the account title.) Also see Special 
payments (under section 529), ABLE accounts (under section 529A),                  rules for partnerships, earlier.
IRA, Coverdell ESA, Archer MSA or HSA contributions or                             *Note: The grantor also must provide a Form W-9 to trustee of trust.
distributions, and pension distributions. You must give your correct               Note: If no name is circled when more than one name is listed, the 
TIN, but you do not have to sign the certification.                                number will be considered to be that of the first name listed.
What Name and Number To Give the Requester                                         Secure Your Tax Records From Identity Theft
     For this type of account:                 Give name and SSN of:               Identity theft occurs when someone uses your personal information 
1. Individual                              The individual                          such as your name, SSN, or other identifying information, without your 
2. Two or more individuals (joint          The actual owner of the account or, if  permission, to commit fraud or other crimes. An identity thief may use 
    account) other than an account         combined funds, the first individual on your SSN to get a job or may file a tax return using your SSN to receive 
    maintained by an FFI                   the account1                            a refund.
3. Two or more U.S. persons                Each holder of the account                 To reduce your risk:
    (joint account maintained by an FFI)                                           • Protect your SSN,
4. Custodial account of a minor            The minor  2                            • Ensure your employer is protecting your SSN, and
    (Uniform Gift to Minors Act)                                                   • Be careful when choosing a tax preparer.
5. a. The usual revocable savings trust    The grantor-trustee1
    (grantor is also trustee)                                                         If your tax records are affected by identity theft and you receive a 
    b. So-called trust account that is not  The actual owner1                      notice from the IRS, respond right away to the name and phone number 
    a legal or valid trust under state law                                         printed on the IRS notice or letter.
6. Sole proprietorship or disregarded      The owner3                                 If your tax records are not currently affected by identity theft but you 
                                                                                   think you are at risk due to a lost or stolen purse or wallet, questionable 
    entity owned by an individual                                                  credit card activity or credit report, contact the IRS Identity Theft Hotline 
7. Grantor trust filing under Optional     The grantor*                            at 1-800-908-4490 or submit Form 14039.
    Form 1099 Filing Method 1 (see                                                    For more information, see Pub. 5027, Identity Theft Information for 
    Regulations section 1.671-4(b)(2)(i)                                           Taxpayers.
    (A))                                                                              Victims of identity theft who are experiencing economic harm or a 
     For this type of account:                 Give name and EIN of:               systemic problem, or are seeking help in resolving tax problems that 
8. Disregarded entity not owned by an      The owner                               have not been resolved through normal channels, may be eligible for 
    individual                                                                     Taxpayer Advocate Service (TAS) assistance. You can reach TAS by 
9. A valid trust, estate, or pension trust Legal entity4                           calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 
                                                                                   1-800-829-4059.
10. Corporation or LLC electing            The corporation                         Protect yourself from suspicious emails or phishing schemes.  
    corporate status on Form 8832 or                                               Phishing is the creation and use of email and websites designed to 
    Form 2553                                                                      mimic legitimate business emails and websites. The most common act 
11. Association, club, religious,          The organization                        is sending an email to a user falsely claiming to be an established 
    charitable, educational, or other tax-                                         legitimate enterprise in an attempt to scam the user into surrendering 
    exempt organization                                                            private information that will be used for identity theft.
12. Partnership or multi-member LLC        The partnership
13. A broker or registered nominee         The broker or nominee



- 6 -
Form W-9 (Rev. 10-2018)                                                                                                                     Page 6 

The IRS does not initiate contacts with taxpayers via emails. Also, the  Privacy Act Notice
IRS does not request personal detailed information through email or ask 
taxpayers for the PIN numbers, passwords, or similar secret access       Section 6109 of the Internal Revenue Code requires you to provide your 
information for their credit card, bank, or other financial accounts.    correct TIN to persons (including federal agencies) who are required to 
                                                                         file information returns with the IRS to report interest, dividends, or 
If you receive an unsolicited email claiming to be from the IRS,         certain other income paid to you; mortgage interest you paid; the 
forward this message to phishing@irs.gov. You may also report misuse     acquisition or abandonment of secured property; the cancellation of 
of the IRS name, logo, or other IRS property to the Treasury Inspector   debt; or contributions you made to an IRA, Archer MSA, or HSA. The 
General for Tax Administration (TIGTA) at 1-800-366-4484. You can        person collecting this form uses the information on the form to file 
forward suspicious emails to the Federal Trade Commission at             information returns with the IRS, reporting the above information. 
spam@uce.gov or report them at www.ftc.gov/complaint. You can            Routine uses of this information include giving it to the Department of 
contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338).    Justice for civil and criminal litigation and to cities, states, the District of 
If you have been the victim of identity theft, see www.IdentityTheft.gov Columbia, and U.S. commonwealths and possessions for use in 
and Pub. 5027.                                                           administering their laws. The information also may be disclosed to other 
Visit www.irs.gov/IdentityTheft to learn more about identity theft and   countries under a treaty, to federal and state agencies to enforce civil 
how to reduce your risk.                                                 and criminal laws, or to federal law enforcement and intelligence 
                                                                         agencies to combat terrorism. You must provide your TIN whether or 
                                                                         not you are required to file a tax return. Under section 3406, payers 
                                                                         must generally withhold a percentage of taxable interest, dividend, and 
                                                                         certain other payments to a payee who does not give a TIN to the payer. 
                                                                         Certain penalties may also apply for providing false or fraudulent 
                                                                         information.






PDF file checksum: 1681349694

(Plugin #1/9.12/13.0)