EX-99.5 10 g26789exv99w5.htm EX-99.5 exv99w5
Exhibit 99.5
GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION
NUMBER ON SUBSTITUTE FORM W-9
     Guidelines for Determining the Proper Identification Number to Give 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 to give the payer.
         
    Give the Social Security
    Number or Employer
For this type of account:   Identification Number of—
1.
  An individual’s account   The individual
2.
  Two or more individuals (joint account)   The actual owner of the account or, if combined funds, the first individual on the account(1)
3.
  Custodian account of a minor (Uniform Gift to Minors Act)   The minor(2)
4.
 
a.   A revocable savings trust account (in which grantor is also trustee)
  The grantor-trustee(1)
 
 
b.   Any “trust” account that is not a legal or valid trust under State law
  The actual owner(1)
5.
  Sole Proprietorship or disregarded entity owned by an individual   The owner(3)
6.
  Disregarded entity not owned by an individual   The owner
7.
  A valid trust, estate or pension trust   The legal entity (do not furnish the identifying number of the personal representative or trustee unless the legal entity itself is not designated in the account title(4))
8.
  Corporate or LLC electing corporate status on IRS Form 8832   The corporation
9.
  Association, club, religious, charitable, educational or other tax-exempt organization   The organization
10.
  Partnership or multi-member LLC   The partnership
11.
  A broker or registered nominee   The broker or nominee
12.
  Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments   The public entity

 


 

 
(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)   You must show your individual name, but you may also enter your business or “doing business as” name. You may use either your social security number or your employer identification number (if you have one), but the IRS encourages you to use your social security number.
 
(4)   List first and circle the name of the legal trust, estate, or pension trust.
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.

 


 

GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION
NUMBER ON SUBSTITUTE FORM W-9
Page 2
Obtaining a Number
     If you don’t have a taxpayer identification number or you do not know your number, obtain Form SS-5, Application for a Social Security Number Card (for resident individuals). Form SS-4, Application for Employer Identification Number (for business and all other entities), or Form W-7 for International Taxpayer Identification Number (for alien individuals required to file U.S. tax returns), at an office of the Social Security Administration or the Internal Revenue Service.
     To complete Substitute Form W-9, if you do not have a taxpayer identification number, write “Applied For” in the space for the taxpayer identification number in Part I, sign and date the Form, and give it to the requester. Generally, you will then have 60 days to obtain a taxpayer identification number and furnish it to the requester. If the requester does not receiver your taxpayer identification number within 60 days, backup withholding, if applicable, will begin and will continue until you furnish your taxpayer identification number to the requester.
Payees Exempt from Backup Withholding
     Unless otherwise noted herein, all references below to section numbers or to regulations are references to the Internal Revenue Code and the regulations promulgated thereunder.
     Under current law on the date hereof, payees specifically exempted from backup withholding on ALL payments include the following:
    A corporation.
 
    A financial institution.
 
    An organization exempt from tax under section 501(a), or an individual retirement account, or a custodial account under section 403(b)(7).
 
    The United States or any agency or instrumentality thereof.
 
    A State, the District of Columbia, a possession of the United States, or any political subdivision or instrumentality thereof.
 
    A foreign government or a political subdivision, agency or instrumentality thereof.
 
    An international organization or any agency, or instrumentality thereof.
 
    A registered dealer in securities or commodities registered in the United States or a possession of the United States.
 
    A real estate investment trust.
 
    A common trust fund operated by a bank under section 584(a).
 
    An exempt charitable remainder trust, or a non-exempt trust described in section 4947(a)(1).
 
    An entity registered at all times during the tax year under the Investment Company Act of 1940.
 
    A foreign central bank of issue.
     Exempt payees described above should file a Substitute Form W-9 to avoid possible erroneous backup withholding. FILE THIS FORM WITH THE PAYER. FURNISH YOUR TAXPAYER IDENTIFICATION NUMBER, WRITE “EXEMPT” ON THE FACE OF THE FORM, AND RETURN IT TO THE PAYER.
     Certain payments other than interest, dividends, and patronage dividends that are not subject to information reporting are also not subject to backup withholding. For details, see the regulations under sections 6041, 6041A(a), 6045, and 6050A.

 


 

     Privacy Act Notices — Section 6109 requires most recipients of dividends, interest, or other payments to give taxpayer identification numbers to payers who must report the payments to the IRS. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. Payers must be given the number whether or not recipients are required to file tax returns. Under current law on the date hereof, payers must generally withhold 28% of taxable interest, dividends, and certain other payments to a payee who does not furnish a taxpayer identification number to a payer. Certain penalties may also apply.
Penalties
     (1) Penalty for Failure to Furnish Taxpayer Identification Number. — If you fail to furnish your taxpayer identification number to a payer, 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.
     (2) Civil Penalty for False Statements With Respect to Withholding. — If you make a false statement with no reasonable basis which results in no imposition of backup withholding, you are subject to a penalty of $500.
     (3) Criminal Penalty for Falsifying Information. — If you falsify certifications or affirmations, you are subject to criminal penalties including fines and/or imprisonment.
FOR ADDITIONAL INFORMATION CONTACT YOUR TAX
CONSULTANT OR THE INTERNAL REVENUE SERVICE