EX-99.5 13 dex995.txt FORM W-9 EXHIBIT 99.5 GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Provide to the Payer - Social Security numbers have nine digits separated by two hyphens: i.e., 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e., 00-0000000. The table below will help determine the number that you should provide to the payer.
---------------------------------- ---------------------- ------------------------------ -------------------- Give the Give the EMPLOYER For this type of account: SOCIAL SECURITY For this type of account: IDENTIFICATION number of: number of: ---------------------------------- ---------------------- ------------------------------ -------------------- 1. An individual's account The individual 9. A valid trust, estate, Legal entity (Do or pension trust not furnish the identifying number of the personal representative or trustee unless the legal entity itself is not designated in the account title.) (3) 2. Two or more individuals The actual owner of 10. Corporate account The corporation (joint account) the account or, if combined funds, the first individual on the account (1) 3. Husband and wife (joint The actual owner of 11. Religious, charitable, The organization account) the account or, if educational or other joint funds, the tax-exempt organization first individual on account the account (1) 4. Custodian account of a The minor (2) 12. Partnership account held The partnership minor (Uniform Gift to in the name of the Minors Act) business 5. Adult and minor (joint The adult or, if the 13. Association, club, or The organization account) minor is the only other tax-exempt contributor, the organization minor (3) 6. Account in the name of The ward, minor, or 14. A broker or registered The broker or guardian or committee for a incompetent person (4) nominee nominee designated ward, minor, or incompetent person 7. a. The usual revocable The grantor trustee (3) 15. Account with the The public entity savings trust Department of account (grantor is also Agriculture in the name trustee) of a public entity (such as a State or local b. So called trust account The actual owner (3) government, school that is not a legal or district, or prison) valid trust under State that receives law agricultural program payments 8. Sole proprietorship The owner (5) account
---------- (1) List first and circle the name of the person whose number you furnish. (2) Circle the minor's name and furnish the minor's social security number. (3) List first and circle the name of the legal trust, estate, or pension trust. (4) Circle the ward's, minor's or incompetent persons name and furnish such person's social security number. (5) Show the name of the owner. You may use either a social security number or an employer identification number (if you have one). Note: If no name is circled when there is more than one name, the number will be considered to be that of the first name listed.