EX-99.5 14 d545210dex995.htm EX-99.5 EX-99.5

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 Payor — 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 payor.

 

For this type of account:  

Give the Social Security

Number or Employer

Identification Number of —

      

For this type of account:

  Give the Social Security
Number or Employer
Identification Number of —

1.

  An individual’s account   The individual     

8.

  Corporate or LLC electing corporate status on IRS Form 8832 or IRS Form 2553   The corporation

2.

  Two or more individuals (joint account)   The actual owner of the account or, if combined funds, the first individual on the account(1)     

9.

  Association, club, religious, charitable, educational or other tax-exempt organization   The organization

3.

  Custodian account of a minor (Uniform Gift to Minors Act)   The minor(2)     

10.

  Partnership or multi-member LLC   The partnership

4.

 

a. A revocable savings trust account (in which grantor is also trustee)

  The grantor-trustee(1)     

11.

  A broker or registered nominee   The broker or nominee
 

b. Any “trust” account that is not a legal or valid trust under State law

  The actual owner(1)     

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

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))     

13.

  Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Treasury Regulation Section 1.671-4(b)(2)(i)(B))   The trust
        

14.

  Grantor trust filing under Optional Form 1099 Filing Method 1 (see Treasury Regulation Section 1.671-4(b)(2)(i)(A))   The grantor

 

(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, check “Awaiting TIN” in Part 3, 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 receive 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 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) if the account satisfies the requirements of section 401(f)(2).

 

   

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 futures commission merchant registered with the Commodity Futures Trading Commission.

 

   

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.

 

   

A middleman known in the investment community as a nominee or custodian.

Exempt payees described above should file a Substitute Form W-9 to avoid possible erroneous backup withholding. FILE THIS FORM WITH THE PAYOR. FURNISH YOUR TAXPAYER IDENTIFICATION NUMBER, CHECK THE LINE FOR “EXEMPT FROM BACKUP WITHHOLDING” ON THE FORM, AND RETURN IT TO THE PAYOR.


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 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil 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 28% (under current law) 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.

Penalties

(1) Penalty for Failure to Furnish Taxpayer Identification Number. — If you fail to furnish your taxpayer identification number to a payor, 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

ADVISOR OR THE INTERNAL REVENUE SERVICE