4-RPS W-9 2026-2027.pdf

Form W-9 Request for Taxpayer Give form to the (Rev. March 2024) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS.

Internal Revenue Service

Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.

41 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2.)

Go to www.irs.gov/FormW9 for instructions and the latest information.

us c j - rf ’ Ry _ { abd ot ae wo LV EVS aenaent ICM | [), s7rigt #O 345 2 Business namé/disregarded entity name, if different from above.

Roches er7 Public NYal Ko hls 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check 4 Exemptions (codes apply only to only one of the following seven boxes. certain entities, not individuals;

see instructions on page 3):

[| Individual/sole proprietor [ C corporation [] S corporation [_] Partnership [] Trust/estate

[_] LLC. Enter the tax classification (C = C corporation, S = S corporation, P =Partnership) . . . Exempt payee code (if any) 3 ri)

2. Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax a classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax ° box for the tax classification of its owner. ; Compliance Act (FATCA) reporting = | ; ‘ es Spa f ; £ Other (see instructions) (3 TE On ment code (if any) o.

3b If on line 3a you checked “Partnership” or “Trust/estate,” or checked “LLC” and entered "P” as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions .

(Applies to accounts maintained outside the United States.)

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Sp ec if ic

In st ru ct io ns on pa ge

3.

5 Address ee street, and apt. or suite no.). See instructions. Requester’s name and address (optional) ag ct. f bs ALS r; t/ ? S i e3 VV

6 City, ous and ZIP code :

on Chessaxt { FiN 7 List account number(s) here (optional)

5 187 ~2Z0 S52

EGZiae) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid 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.

| Social security number or

| Employer identification number |

Note: If the account is in more than one name, see the instructions for line 1. See also What Name and ; ; - O Number To Give the Requester for guidelines on whose number to enter. Yt | =! eo O 7. ¥ ¢

GEM Certification Under penalties of perjury, | certify that:

1. The number shown on this form is my correct taxpayer identification number (or | am waiting for a number to be issued to me); and

2.1am not subject to backup withholding because (a) | am exempt from backup withholding, or (b) | have not been notified by the Internal Revenue

Service (IRS) that | 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 | am no longer subject to backup withholding; and

3.1am 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 | am exempt from FATCA reporting is correct.

as

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 ll, later.

Sign Signature of a, 28 oe Cy Hugi ~~ Here U.S. person mle ao = Date TS /2>o /20C6 i New line 3b has been added to this form. A flow-through entity is

General Instructions required to complete this line to indicate that it has direct or indirect Section references are to the Internal Revenue Code unless otherwise foreign partners, owners, or beneficiaries when it provides the Form W-9 noted. to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign

What’s New partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065).

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the Purpose of Form appropriate box for the tax classification of its owner. Otherwise, it should check the “LLC” box and enter its appropriate tax classification. An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they

Gat. No. 10231X Form W-9 (Rev. 3-2024)