EX-99.(A)(1)(F) 7 dex99a1f.htm FORM OF GUIDELINES FOR CERTIFICATION OF TAXPAYER ID NUMBERS ON FORM W-9 Form of Guidelines for Certification of Taxpayer ID Numbers on Form W-9

Exhibit (a)(1)(F)

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 proper identification number to give the payor.

 

For this type of account:

 

  

Give the NAME and

SOCIAL SECURITY

number of:

 

       

For this type of account:

 

  

Give the NAME and

EMPLOYER
IDENTIFICATION
number of:

 

1.    An individual’s account    The individual         6.    Disregarded entity not owned by an individual    The owner
2.    Two or more individuals (joint account)    The actual owner of the account or, if combined funds, the first individual on the account(1)         7.    A valid trust, estate, or pension trust    The legal entity(4)
3.    Custodian account of a minor (Uniform Gift to Minors Act)    The minor(2)         8.    Corporate or LLC electing corporate status on Form 8832    The corporation
4.    (a) The usual revocable savings trust account (grantor is also trustee)    The grantor-trustee(1)         9.    Association, club, religious, charitable, educational, or other tax-exempt organization    The organization
   (b) So-called trust account that is not a legal or valid trust under State law    The actual owner(1)       10.    Partnership or multi-member LLC    The partnership
5.    Sole proprietorship or disregarded entity owned by an individual    The owner(3)       12.    A broker or registered nominee    The broker or nominee
                  13.   

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. If only one person on a joint account has a Social Security Number, the person’s number must be furnished.
(2) Circle the minor’s name and furnish the minor’s social security number.
(3) You must show your individual name and you may also enter your business or “DBA” name. You may use either your Social Security Number or 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 trust, estate, or pension trust. Do not furnish the number of the personal representative or trustee unless the legal entity itself is not designated in the account title.

 

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


How to Obtain a TIN

If you don’t have a taxpayer identification number or you don’t know your number, write “Applied For” in the space for the TIN and sign and date the certification. To obtain a TIN, use Form SS-5, Application for a Social Security Number Card (for individuals), or Form SS-4, Application for Employer Identification Number (for businesses and all other entities), available at the local office of the Social Security Administration or the Internal Revenue Service. If you do not provide a TIN to the payer, the payor may withhold 28% of any reportable payment made to you until you provide a TIN.

Payees Exempt from Backup Withholding

Payees generally exempted from backup withholding on payments in broker transactions include the following (Section references are to the Internal Revenue Code):

 

   

A corporation.

 

   

A financial institution.

 

   

An organization exempt from tax under section 501(a), 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 subdivision or instrumentality thereof.

 

   

A foreign government, a political subdivision of a foreign government, or any agency or instrumentality thereof.

 

   

An international organization or any agency or instrumentality thereof.

 

   

A dealer in securities or commodities required to register in the United States, the District of Columbia, 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 entity registered at all times during the tax year under the Investment Company Act of 1940.

 

   

A foreign central bank of issue.

Payments of dividends and patronage dividends not generally subject to backup withholding include the following:

 

   

Payments to nonresident aliens subject to withholding under section 1441.

 

   

Payments to partnerships not engaged in a trade or business in the U.S. and which have at least one nonresident alien partner.

 

   

Payments of patronage dividends where the amount received is not paid in money.

 

   

Payments made by certain foreign organizations.

 

   

Section 404(k) distributions made by an ESOP.

Payments of interest not generally subject to backup withholding include the following:

 

   

Payments of interest on obligations issued by individuals.

Note: You may be subject to backup withholding if this interest is $600 or more and is paid in the course of the payor’s trade or business and you have not provided your correct taxpayer identification number to the payor.

 

   

Payments described in section 6049(b)(5) to nonresident aliens.

 

   

Payments on tax-free covenant bonds under section 1451.

 

   

Payments made by certain foreign organizations.

 

   

Payments of mortgage or student loan interest.

Exempt payees described above should file the Substitute Form W-9 to avoid possible erroneous backup withholding. FILE THIS FORM WITH THE PAYOR, FURNISH YOUR TAXPAYER IDENTIFICATION NUMBER, WRITE “EXEMPT” IN PART II OF THE FORM, SIGN AND DATE THE FORM AND RETURN IT TO THE PAYOR.

Payments that are not subject to information reporting generally are also not subject to backup withholding. For details, see sections 6041, 6041A, 6042, 6044, 6045, 6049, 6050A and 6050N, and the regulations under those sections.


 

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Privacy Act Notice. Section 6109 requires most recipients of dividend, interest, or other payments to give taxpayer identification numbers to payors who must report the payments to the IRS. The IRS uses the numbers for identification purposes and to help verify the accuracy of tax returns. Payors must be given the numbers whether or not recipients are required to file a tax return. Payors must generally withhold, at a 28% rate, a portion of taxable interest, dividend, and certain other payments to a payee who does not furnish a taxpayer identification number to a payor. 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 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 Information 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. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

FOR ADDITIONAL INFORMATION CONTACT YOUR TAX CONSULTANT OR THE INTERNAL REVENUE SERVICE.


 

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