DocuSign Envelope ID: 2E20F7CF-153F-42FA-8827-9889FD2D2C28 Form W-9 (Rev. 3-2024) Page 3 Certain payees and payments are exempt from backup withholding. example, if a foreign LLC that is treated as a disregarded entity for U.S. See Exempt payee code, later, and the separate Instructions for the federal tax purposes has a single owner that is a U.S. person, the U.S. Requester of Form W-9 for more information. owner’s name is required to be provided on line 1. If the direct owner of See also Establishing U.S. status for purposes of chapter 3 and the entity is also a disregarded entity, enter the first owner that is not chapter 4 withholding, earlier. disregarded for federal tax purposes. Enter the disregarded entity’s name on line 2. If the owner of the disregarded entity is a foreign person, What Is FATCA Reporting? 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. The Foreign Account Tax Compliance Act (FATCA) requires a Line 2 participating foreign financial institution to report all U.S. account holders that are specified U.S. persons. Certain payees are exempt from If you have a business name, trade name, DBA name, or disregarded FATCA reporting. See Exemption from FATCA reporting code, later, and entity name, enter it on line 2. the Instructions for the Requester of Form W-9 for more information. Line 3a Updating Your Information Check the appropriate box on line 3a for the U.S. federal tax You must provide updated information to any person to whom you classification of the person whose name is entered on line 1. Check only claimed to be an exempt payee if you are no longer an exempt payee one box on line 3a. and anticipate receiving reportable payments in the future from this IF the entity/individual on line 1 THEN check the box for . . . person. For example, you may need to provide updated information if is a(n) . . . you are a C corporation that elects to be an S corporation, or if you are no longer tax exempt. In addition, you must furnish a new Form W-9 if • Corporation Corporation. the name or TIN changes for the account, for example, if the grantor of a • Individual or Individual/sole proprietor. grantor trust dies. Penalties • Sole proprietorship • LLC classified as a partnership Limited liability company and Failure to furnish TIN. If you fail to furnish your correct TIN to a for U.S. federal tax purposes or enter the appropriate tax requester, you are subject to a penalty of $50 for each such failure • LLC that has filed Form 8832 or classification: unless your failure is due to reasonable cause and not to willful neglect. 2553 electing to be taxed as a P = Partnership, Civil penalty for false information with respect to withholding. If you corporation C = C corporation, or make a false statement with no reasonable basis that results in no S = S corporation. backup withholding, you are subject to a $500 penalty. • Partnership Partnership. Criminal penalty for falsifying information. Willfully falsifying • Trust/estate Trust/estate. certifications or affirmations may subject you to criminal penalties Line 3b including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of Check this box if you are a partnership (including an LLC classified as a federal law, the requester may be subject to civil and criminal penalties. partnership for U.S. federal tax purposes), trust, or estate that has any foreign partners, owners, or beneficiaries, and you are providing this Specific Instructions form to a partnership, trust, or estate, in which you have an ownership interest. You must check the box on line 3b if you receive a Form W-8 Line 1 (or documentary evidence) from any partner, owner, or beneficiary You must enter one of the following on this line; do not leave this line establishing foreign status or if you receive a Form W-9 from any blank. The name should match the name on your tax return. partner, owner, or beneficiary that has checked the box on line 3b. If this Form W-9 is for a joint account (other than an account Note: A partnership that provides a Form W-9 and checks box 3b may maintained by a foreign financial institution (FFI)), list first, and then be required to complete Schedules K-2 and K-3 (Form 1065). For more circle, the name of the person or entity whose number you entered in information, see the Partnership Instructions for Schedules K-2 and K-3 Part I of Form W-9. If you are providing Form W-9 to an FFI to document (Form 1065). a joint account, each holder of the account that is a U.S. person must If you are required to complete line 3b but fail to do so, you may not provide a Form W-9. receive the information necessary to file a correct information return with • Individual. Generally, enter the name shown on your tax return. If you the IRS or furnish a correct payee statement to your partners or have changed your last name without informing the Social Security beneficiaries. See, for example, sections 6698, 6722, and 6724 for Administration (SSA) of the name change, enter your first name, the last penalties that may apply. name as shown on your social security card, and your new last name. Line 4 Exemptions Note for ITIN applicant: Enter your individual name as it was entered If you are exempt from backup withholding and/or FATCA reporting, on your Form W-7 application, line 1a. This should also be the same as enter in the appropriate space on line 4 any code(s) that may apply to the name you entered on the Form 1040 you filed with your application. you. • Sole proprietor. Enter your individual name as shown on your Form Exempt payee code. 1040 on line 1. Enter your business, trade, or “doing business as” (DBA) • Generally, individuals (including sole proprietors) are not exempt from name on line 2. backup withholding. • Partnership, C corporation, S corporation, or LLC, other than a • Except as provided below, corporations are exempt from backup disregarded entity. Enter the entity’s name as shown on the entity’s tax withholding for certain payments, including interest and dividends. return on line 1 and any business, trade, or DBA name on line 2. • Other entities. Enter your name as shown on required U.S. federal tax • Corporations are not exempt from backup withholding for payments documents on line 1. This name should match the name shown on the made in settlement of payment card or third-party network transactions. charter or other legal document creating the entity. Enter any business, • Corporations are not exempt from backup withholding with respect to trade, or DBA name on line 2. attorneys’ fees or gross proceeds paid to attorneys, and corporations • Disregarded entity. In general, a business entity that has a single that provide medical or health care services are not exempt with respect owner, including an LLC, and is not a corporation, is disregarded as an to payments reportable on Form 1099-MISC. entity separate from its owner (a disregarded entity). See Regulations The following codes identify payees that are exempt from backup section 301.7701-2(c)(2). A disregarded entity should check the withholding. Enter the appropriate code in the space on line 4. appropriate box for the tax classification of its owner. Enter the owner’s 1—An organization exempt from tax under section 501(a), any IRA, or name on line 1. The name of the owner entered on line 1 should never a custodial account under section 403(b)(7) if the account satisfies the be a disregarded entity. The name on line 1 should be the name shown requirements of section 401(f)(2). on the income tax return on which the income should be reported. For