ESBD_363907_1718917962432_SOL_EXH_F.6 thru SOL_EXH_F.9_405-24R0016539.pdf

EXHIBIT F.6

APPLICATION FOR TEXAS

IDENTIFICATION NUMBER (AP-152)

SIC

code

5. Mailing address where you want to receive payments

6. (Optional)

7. (Optional)

8. (Optional)

9. City State ZIP code

10. Payee telephone number (Area code and number)

Security type code ( 0, 1, 2 )

Zone code

(SSN)Social Security number (9 digits)

Individual Taxpayer Identification Number (ITIN) (9 digits)

Enter the number indicated

If "YES," enter Texas Taxpayer Number

1. Is this a new account? YES Mail Code 000 NO Enter Mail Code Agency number Complete Sections 1 - 5 Complete Sections 1, 2 & 5

For Comptroller's use only

11. Ownership Codes - Check only one code by the appropriate ownership type that applies to you or your business.

L - Texas Limited Partnership:

If checked, enter the Texas File Number

Owner's name

T - Texas Corporation:

If checked, enter the Texas File Number

SSN / ITIN (9 digits) A - Professional Association:

If checked, enter the Texas File Number

If checked, enter the exas File Number

C - Professional Corporation:

T

Name

SSN / ITIN / EIN (9 digits)

Name

SSN / ITIN / EIN (9 digits)

I - Individual Recipient (not owning a business)

P - Partnership: If checked, enter two partner's names and

O - Out-of-State Corporation

G - Governmental Entity

U - State agency / University

F - Financial Institution

R - Foreign (out of U.S.A.)

N - Other: If checked, explain.

12. Payment Assignment? YES NO Note: A copy of the assignment agreement between payees must be attached.

Assignee name

Assignee TIN Assignment date

13. Comments Authorized signature (Applicant or authorized agent) Date

14.

Agency name Prepared by Phone (Area code and number)

15.

AP-152

(Rev.8-21/18)

Application for Texas Identification Number

• See instructions on back

Se ct io n

Se ct io n

Se ct io n

Se ct io n

Se ct io n

L..........J... I I I I I

- I I I I I L___J

I I I I I I I I I I I I I I I I I I I sign ► here

Form AP-152 (Back)(Rev.8-21/18)

Application for Texas Identification Number Instructions G L E N N H E G A R T E X A S C O M P T R O L L E R O F P U B L I C A C C O U N T S

to bill agencies of the state government for goods, services provided, refunds, public assistance, etc. When the application is processed by the

the completed application to the state agency with which the applicant is conducting business.

application or with processing the form.

Specific Instructions Item 1: Is this a new account?

Select YES if the applicant has never received a payment from a Texas state agency and does not have an assigned TIN.

Select NO if the applicant has received payments from a Texas state agency and already has an assigned TIN.

Mail Code / Agency number – Will be entered by the state agency that processes the application.

agency that needs to pay a foreign entity or a foreign individual who does not have an EIN, SSN or ITIN.

Current Texas Identification Number (FOR STATE AGENCY USE ONLY): The 11-digit current Comptroller-assigned TIN.

and begin the address in Item 6.

Item 9: Enter the city, state and ZIP code.

Item 10: Enter the payee telephone number.

SIC code / Security type code / Zone code – These fields will be completed by the state agency that will process the application.

Section 4 — Payment Assignment Item 12: Select YES if the payee is assigning its payments to a third party and the state agency that will process the application has ap-

attached.

Select NO if the payee is not assigning its payments to a third party.

date signed.

Item 15: Agency name, Prepared by, Phone: Will be entered by the state agency that will process the application.

Under Ch. 559, Government Code, you are entitled to review, request and correct information we have on file about you, with limited exceptions in accordance with Ch. 552, Government Code. To request information for review or to request error correction, contact us at the address or phone numbers listed on this form.

https://fmx.cpa.texas.gov/fm/pubs/payment/ mailto: tins.mail@cpa.texas.gov

EXHIBIT F.7

DIRECT DEPOSIT AUTHORIZATION FORM

~ .,_. 74-176 _ W ~5 (Rev.9-21/21)li'~

Direct Deposit Authorization

STATE OF TEXAS

This form may be used by vendors, individual recipients or state employees to receive payments from the state of Texas by direct deposit or to change/cancel existing direct deposit information.

Transaction Types

1. Select transaction types:

For Comptroller's Use Only

~ D New setup (Sections 2, 3, 5 and 6) D Change account type (Sections 2, 3, 4, 5 and 6)

~ D Change financial institution (Sections 2, 3, 4, 5 and 6) m □ Change account number (Sections 2, 3, 4, 5 and 6)

D Cancellation (Sections 2 and 6 - Sections 7 and 8 far state agency use)

D Change custodial agency ~I~-~~

Payee Identification

2. Payee type 3. Identification number D Social Security number (SSN)* 4. Mail code (If not known, D State employee D Texas Identification Number {TIN) D Individual Taxpayer Identification Number (ITIN) leave blank.)

N D Vendor or other recipient z D Employer Identification Number {EIN) I I I I I I I I I I I I I I I I 0 i== 5. Payee name I c· Phone (Area) code and number) w ext.

Cl)

7. Mailing address (Street, city, state and ZIP code)

New Account Information (Setups and Changes} (Completion by financial institution is recommended)

8. Financial institution name 19. City

M 11. Routing number (9 digits)

12. Customer account number (maximum 17 characters) z - - 0 I I I I I I I I I I L_J I I I I I I I I I I I I I I I I I i== 14. Financial representative name (optional) 115. Title (optional) 0 w Cl)

16. Financial representative signature (optional)

17. Phone (Araa code and number) (optional)

( ) ext.

Existing Account Information (Changes Only} -.r- 19. Routing number (9 digits) u w en

20. Customer account number (maximum 17 characters)

L_J

International Payments Verification (required)

110. State

13. Account type

, □ Checking □ savings

118. Date (optionaQ

21. Account type

D Checking D Savings

LO fd 22. Will these payments be forwarded to a financial institution outside the United States? ................................................... D YES en If "YES,• also complete the ACH (Direct Deposit) Payment Destination Confirmation (Form 74-227).

0 NO

Authorization for Setup, Changes or Cancellation (required)

I authorize the state agency that issues my state of Texas payments via the Texas Comptroller of Public Accounts to electronically deposit my pay-co ments to my financial institution. I understand that any payments deposited in error to my account will be reversed by the agency that issues my state z of Texas payments via the Texas Comptroller of Public Accounts.

0 I further understand that the agency that issues my state of Texas payments and the Texas Comptroller of Public Accounts will comply at all times with i== 0 the National Automated Clearing House Association's rules. (For further information on these roles, please contact your financial institution.)

w Cl) Sign ► 23. Authorized signature here

Cancellation by Agency (for state agency use) I ~ 126. Reason

State Agency Contact (for state agency use)

• 28. Authorized signature sign ► here

CX) 30. Phone (Area code and number) z ( 0 ) ext.

i== 32. Agency name 0 w Cl)

33. Comments

• See Federal Privacy Act statement on page 2.

29. Date

31. Agency number

124. Printed name 125. Date ti'

127. Date

34- Please return to the paying agency at the following address:

Form 74-176 (Back)(Rev.9-21/21)

Instructions for Direct Deposit Authorization You have certain rights under Chapters 552 and 559, Government Code, to review, request and correct information we have on file about you. To request information for review or to request error correction, use the contact information on this form.

Section 1: Transaction Type(s)

1. Select the appropriate transaction type(s) and complete the corresponding sections.

I Note: Requests to change custodial agency number are processed based on Payment SeNices research and guidelines. I

Section 2: Payee Identification (Required)

2. Payee type: Indicate whether the payee is a state employee or a vendor/recipient.

I Note: Agencies must complete box 34 with the appropriate agency's return address for the selected payee type.

3. Identification number: Indicate the type of identification number and provide the associated 9- or 11-digit number.

4. Mail code: Enter the 3-digit mail code.

5. Payee name: Enter the payee's name.

6. Phone: Enter the payee's area code, phone number (and extension, if applicable).

7. Mailing address: Enter the payee's mailing address, city, state and ZIP code.

Section 3: New Account Information (Setups and changes) (Completion by financial institution is recommended)

8. Financial institution name: Enter the name of the payee's financial institution.

9. City: Enter the city of the payee's financial institution.

10. State: Enter the 2-character abbreviation for state of the payee's financial institution.

11. Routing number: Enter the 9-digit routing number of the payee's financial institution.

12. Customer account number: Enter the payee's account number (maximum 17 characters).

13. Type of account: Indicate whether the payee's account type is a checking account or a savings account.

14. Financial representative name: (optional) Enter the name of the financial representative.

15. Title: (optional) Enter the title of the financial institution representative.

16. Financial representative signature: (optional) Original signature of the financial representative.

17. Phone: (optional) Enter the area code, phone number (and extension, if applicable) of the financial representative.

18. Date: (optional) Enter the date the financial representative signed the form.

Section 4: Existing Account Information (Changes only)

19. Routing number: Enter the 9-digit routing number currently on file with the Comptroller's office.

20. Customer account number: Enter the payee's account number currently on file with the Comptroller's office.

21. Account type: Select the payee's account type currently on file with the Comptroller's office.

Section 5: International Payments Verification (Required)

22. Payment Destination: Select YES or NO to indicate if state payments will be forwarded to a financial institution outside the U.S.

Note: If YES, the payee must also complete the ACH (Direct Deposit) Payment Destination Confirmation (Form 7 4-227).

Section 6: Authorization for Setup, Changes or Cancellation (Required)

23. Authorized signature: Original signature of the payee is required.

24. Printed name: Enter or print the name of the payee or vendor/recipient signing the form.

25. Date: Enter or print the date the form was signed.

Section 7: Cancellation by Agency (for state agency use)

26. Reason: Enter the reason for cancellation of the payee's direct deposit information.

27. Date: Enter the date the cancellation was determined.

Section 8: State Agency Contact (for state agency use)

28. Authorized signature: Original signature of the agency's authorized representative is required.

29. Date: Enter the date the agency's representative signed the form.

30. Phone: Enter the area code, phone number and extension (if applicable) of the agency's representative.

31. Agency number: Enter the 3-digit agency number.

32. Agency name: Enter the agency's name.

33. Comments: (optional) Enter comments, if needed.

34. Return to Paying State Agency: This area autopopulates with the name and address of the paying state agency to which this form will be returned.

Questions?

State Employees:

Vendors/Recipients:

State Agencies:

Contact your agency·s Human Resource department or payroll staff.

Contact the paying agency·s accounts payable staff.

Contact Fiscal Management, Payment Services at 512-936-8138.

"Federal Privacy Act statement: Disc/asum of your Socia/ Security number is mquimd and authorized under law for the purpose of tax administration and identification of any individual affected by applicable law, 42 U.S.C. § 405(c)(2)(C)(i) and Tex. Gov'! Code§§ 403.011, 403.015, 403.055, 403.056 and 403.078. The Public Information Act, Tex. Gav'! Code Ch. 522, and applicable federal /aw shall gavem ra/ease of information on this farm in msponse to a public information mquest.

EXHIBIT F.8

REQUEST FOR TAXPAYER IDENTIFICATION

NUMBER AND CERTIFICATIONS (W-9)

Form W•9 (Rev. October 2018) Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

► 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

Give Form to the requester. Do not send to the IRS.

Mt------------------------------------------""T"""------------ Q) 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 gia. following seven boxes. certain entities, not individuals; see instructions on page 3):

5 D Individual/sole proprietor or D C Corporation D S Corporation D Partnership D Trust/estate ai :!! single-member LLC

J ~ D Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ►---- ~ 2 Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check .. i LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is -~ .5 another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that

Exempt payee code (if any) ___ _

Exemption from FATCA reporting code (if any) a.. u is disregarded from the owner should check the appropriate box for the tax classification of its owner. l i--:□=-_o_t_h_er-'('-se_e_i_ns_t_ru_ct_i_on_s.a..) _► ________________________ ~--------'-(App_lies_· _1o_acc_ou_n_ts_ma,_·n_ta_ine_d_o_u-_·_•_the_u._s._J -v, 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional) al C/Jt-------------------------------------1 6 City, state, and ZIP code

7 List account number(s) here (optionaO

■ :r.1 ii ■ Taxpayer Identification Number (TIN) I Social security number I 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.

[II] -[I] -I I I I I

or

Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.

I Employer identification number

Certification Under penalties of perjury, I certify that:

1. The number shown on this fonn 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 Here

I Signature of U.S. person ►

General Instructions Section references are to the Internal Revenue Code unless otherwise noted.

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.

Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following.

• Form 1099-INT (interest earned or paid)

Cat. No.10231X

Date ►

• Form 1099-DIV (dividends, including those from stocks or mutual funds)

• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)

• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)

• Form 1099-S (proceeds from real estate transactions)

• Form 1099-K (merchant card and third party network transactions)

• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)

• Form 1099-C (canceled debt)

• Form 1099-A (acquisition or abandonment of secured property)

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later.

Form W-9 (Rev. 10-2018)

By signing the filled-out form, you:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or

3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and

4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting, later, for further information.

Note: If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien;

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States;

• An estate (other than a foreign estate); or

• A domestic trust (as defined in Regulations section 301. 7701-7).

Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 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 that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income.

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 withholding on its allocable share of net income from the partnership conducting a trade or business in the United States.

• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity;

• In the case of a granter trust with a U.S. granter or other U.S. owner, generally, the U.S. granter or other U.S. owner of the granter trust and not the trust; and

• In the case of a U.S. trust (other than a granter trust), the U.S. trust (other than a granter trust) and not the beneficiaries of the trust.

Foreign person. If you are a foreign person or the U.S. branch of a 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 Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities).

Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items.

1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions.

4. The type and amount of income that qualifies for the exemption from tax.

5. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Page2

Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese 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 the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption.

If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233.

Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 24% of such payments. This is called "backup withholding." Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding.

You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return.

Payments you receive will be subject to backup withholding if:

1. You do not furnish your TIN to the requester,

2. You do not certify your TIN when required (see the instructions for Part II for details},

3. The IRS tells the requester that you furnished an incorrect TIN,

4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only}, or

5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only}.

Certain payees and payments are exempt from backup withholding.

See Exempt payee code, later, and the separate Instructions for the Requester of Form W-9 for more information.

Also see Special rules for partnerships, earlier.

What is FATCA Reporting?

The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code, later, and the Instructions for the Requester of Form W-9 for more information.

Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account; for example, if the granter of a granter trust dies.

Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.

Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.

Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties.

Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return.

If this Form W-9 is for a joint account (other than an account maintained by a foreign financial institution (FFI)), list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. If you are providing Form W-9 to an FFI to document a joint account, each holder of the account that is a U.S. person must provide a Form W-9.

a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last 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 your Form W-7 application, line 1 a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application.

b. Sole proprietor or single-member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or "doing business as" (OBA) name on line 2.

c. Partnership, LLC that is not a single-member LLC, C corporation, or S corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or OBA name on line 2.

d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1 . This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or OBA name on line 2.

e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a "disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). Enter 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 name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S.

person, the U.S. owner's name is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business name/disregarded entity name." If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9.

This is the case even if the foreign person has a U.S. TIN.

Line2 If you have a business name, trade name, OBA name, or disregarded entity name, you may enter it on line 2.

Line3 Check the appropriate box on line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box on line 3.

Page3

IF the entity/person on line 1 is THEN check the box for ...

a(n) ...

• Corporation Corporation

• Individual Individual/sole proprietor or single-

• Sole proprietorship, or member LLC

• Single-member limited liability company (LLC) owned by an individual and disregarded for U.S.

federal tax purposes.

• LLC treated as a partnership for Limited liability company and enter U.S. federal tax purposes, the appropriate tax classification.

• LLC that has filed Form 8832 or (P= Partnership; C= C corporation;

2553 to be taxed as a corporation, or S= S corporation) or

• LLC that is disregarded as an entity separate from its owner but the owner is another LLC that is not disregarded for U.S. federal tax purposes.

• Partnership Partnership

• Trust/estate Trust/estate

Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space on line 4 any code(s) that may apply to you.

Exempt payee code.

• Generally, individuals (including sole proprietors) are not exempt from backup withholding.

• Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends.

• Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions.

• Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC.

The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line 4.

1-An organization exempt from tax under section 501 (a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401 (f)(2)

2-The United States or any of its agencies or instrumentalities

3-A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities

4-A foreign government or any of its political subdivisions, agencies, or instrumentalities

5-A corporation

6-A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession

7 -A futures commission merchant registered with the Commodity Futures Trading Commission

8-A real estate investment trust

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

The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13.

IF the payment is for ...

Interest and dividend payments

Broker transactions

Barter exchange transactions and patronage dividends

Payments over $600 required to be reported and direct sales over $5,0001

THEN the payment is exempt for ...

All exempt payees except for 7

Exempt payees 1 through 4 and 6 through 11 and all C corporations.

S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012.

Exempt payees 1 through 4

Generally, exempt payees 1 through 52

Payments made in settlement of Exempt payees 1 through 4 payment card or third party network transactions

1 See Form 1099-MISC, Miscellaneous Income, and its instructions.

2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(1), and payments for services paid by a federal executive agency.

Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with "Not Applicable" (or any similar indication) written or printed on the line for a FATCA exemption code.

A-An organization exempt from tax under section 501 (a) or any individual retirement plan as defined in section 7701 (a)(37)

B-The United States or any of its agencies or instrumentalities

C-A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities

D-A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section 1.1472-1(c)(1)(Q

E-A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1 (c)(1)(i)

F-A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state

G-A real estate investment trust

H-A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940

I-A common trust fund as defined in section 584(a)

J-A bank as defined in section 581

K-A broker

L-A trust exempt from tax under section 664 or described in section 4947(a)(1)

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M-A tax exempt trust under a section 403(b} plan or section 457(g) plan

Note: You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed.

Line5 Enter your address (number, street, and apartment or suite number).

This is where the requester of this Form W-9 will mail your information returns. If this address differs from the one the requester already has on file, write NEW at the top. If a new address is provided, there is still a chance the old address will be used until the payer changes your address in their records.

Line 6 Enter your city, state, and ZIP code.

Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS 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 below.

If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN.

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 one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN.

Note: See What Name and Number To Give the Requester, later, for further clarification of name and TIN combinations.

How to get a TIN. If you do not have a TIN, apply for one immediately.

To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 1-800-772-1213.

Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/Businesses and clicking on Employer Identification Number (EIN} under Starting a Business. Go to www.irs.gov/Forms to view, download, or print Form 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 business days.

If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on 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 you provide your TIN to the requester.

Note: Entering "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon.

Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.

Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, 4, or 5 below indicates otherwise.

For a joint account, only the person whose TIN is shown in Part I should sign (when required}. In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code, earlier.

Signature requirements. Complete the certification as indicated in items 1 through 5 below.

1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983.

You must give your correct TIN, but you do not have to sign the certification.

2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If 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 certification before signing the form.

3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification.

4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise}, medical and health care services (including payments to corporations}, payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations}.

5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), ABLE accounts (under section 529A), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification.

What Name and Number To Give the Requester For this type of account:

1. Individual

2. Two or more individuals Ooint account) other than an account maintained by an FFI

3. Two or more U.S. persons Ooint account maintained by an FFI)

4. Custodial account of a minor (Uniform Gift to Minors Act)

5. a. The usual revocable savings trust (granter is also trustee)

b. So-called trust account that is not a legal or valid trust under state law

6. Sole proprietorship or disregarded entity owned by an individual

7. Granter trust filing under Optional Form 1099 Filing Method 1 (see Regulations section 1.671-4(b)(2)(i) (A))

For this type of account:

8. Disregarded entity not owned by an individual

9. A valid trust, estate, or pension trust

10. Corporation or LLC electing corporate status on Form 8832 or Form 2553

11. Association, club, religious, charitable, educational, or other tax exempt organization

12. Partnership or multi-member LLC

13. A broker or registered nominee

Give name and SSN of:

The individual

The actual owner of the account or, if combined funds, the first individual on the account 1

Each holder of the account

The minor2

The granter-trustee 1

The actual owner1

Theowner3

The granter*

Give name and EIN of:

The owner

Legal entity 4

The corporation

The organization

The partnership The broker or nominee

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For this type of account: Give name and EIN of:

14. Account with the Department of The public entity

Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments

15. Granter trust filing under the Form The trust 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section 1.671-4(b)(2)0)(B))

1 List first and circle the name of the person whose number you furnish.

If only one person on a joint account has an SSN, that person's number must be furnished.

2 Circle the minor's name and furnish the minor's SSN.

3 You must show your individual name and you may also enter your business or OBA name on the "Business name/disregarded entity" name line. You may use either your SSN or EIN (if you have one}, but the IRS encourages you to use your SSN.

4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.} Also see Special rules for partnerships, earlier.

*Note: The granter also must provide a Form W-9 to trustee of trust.

Note: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.

Secure Your Tax Records From Identity Theft Identity theft occurs when someone uses your personal information such as your name, SSN, or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund.

To reduce your risk:

• Protect your SSN,

• Ensure your employer is protecting your SSN, and

• Be careful when choosing a tax preparer.

If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter.

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 credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039.

For more information, see Pub. 5027, Identity Theft Information for Taxpayers.

Victims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS} assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059.

Protect yourseH from suspicious emails or phishing schemes.

Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft.

The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts.

If you receive an unsolicited email claiming to be from the IRS, .

forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA)…