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To: Page 2 of 2 2012-0510 16:59:14(GMT) From:Rick Van Unen
<br /> Form
<br /> W-9 V I :Request. for Taxpayer I Give form to the
<br /> (Ray.Octot 2007) Identificrequester. Do not
<br /> ation Number and Certification
<br /> tay.mwrau.n..,..y send to the IRS.
<br /> Name(as shown on your,income tax mum)
<br /> G �wt��nlu „t1e [..G_C
<br /> s Buaness fora,H dRferenl from above
<br /> 51
<br /> c ! wok appppriate cox: C Indivldual/Saa,pispnmW ❑ Corpomaon ❑ partnership
<br /> YJ timttod aeollay company Ester ma tax gassifie hon N�isre9arded entry,c=corporetion,v- ❑ Exempt
<br /> L u -cartnarsmP)►-...... Pay.
<br /> a= "mesimynber street.and a .or suite ro.�� P<�� ) Requesters name and address(opaonaQ
<br /> ti
<br /> tZri ZIP Code
<br /> o� CA, G
<br /> m -,st accwrc mono")here(dpronal)
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<br /> Taxpayer.Identification.Number (TIN)
<br /> Enter your TIN in the appropriate box.The TIN provided Mustmatch the name given on Line I to avoid aocialaecuriry o ind"'
<br /> backup withholding, For Individuals,this is your social security number(SSN).However,for a residant
<br /> alien,sole proprietor,or disregarded entity,see the Pan 1 instructions an page 3.For other entities,a is
<br /> your employer x erarflcabon slumber(EM)_If you tlo rot have a number,see How to get TIN on page 3. or
<br /> NoW[ate aospatt as in more man she name.Sae ate cn3n'or page 4 for guidelines on whose Cmpfoyw ment coon rustier
<br /> na,nv td exk.r. I O = 11 80 3-
<br /> Cerdfieadon
<br /> Urges penalties of perjury.I certify that:
<br /> . The rarmber shown on this form is my comect taxpayer identification number(or I am waiting for a number to be issued to.me),and
<br /> 2. I am net subjeet to backup withholding because:(a) I am exempt from backup withholding,or(b)I have not been notified by the Internal
<br /> Revenue Service(IRS)that I am subject to backup withholding as a.result of aiailure to report all interest or dividends,or(c)the IRS has
<br /> notified me that t am no longer sup)ect to backup withhold-mg,and
<br /> 3. I am a U.S. sheen or other US.person(defined below).
<br /> Certification instructions.you must cross out item 2 above if you have been notified by the IRS:that you are currently subject to backup.
<br /> withholding because you have failed to report all interest and dividends on your tax return.For real-estate transactions,item 2 does net apply.
<br /> For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributionsto an individual retirement
<br /> arrangement(IRA),and generally,pay is other an interest and dividends.You are not required to sign the Certification,but you must
<br /> provice your correct TIN.See the, u i so age 4.
<br /> SignsVenaw�c or
<br /> Here u.s.peman Date► l /f
<br /> General Instructions Definition of:a U.S. perso or fade al tax pu poses, you aze
<br /> considered a U.S,person if you are:
<br /> Section inferences.are to the Internal Revenue Code unless
<br /> otherwise noted. a An individual who is a U.S.citizen or U.S.resident alien,
<br /> 0 A partnership,corporation,company,or association created or
<br /> Purpose of Foem organized in the United Status or under the laws of the United
<br /> A I: vaho iiiesq iM to Me an Information retum:with the States,
<br /> His must obrektyour correct taxpayer Identification number MN) • An estate(other than a foreign estate),or
<br /> to report,for example.income paid to you,real estate Is A domestic trust(as defined in Regulations section
<br /> transactions, mortgage interest you paid, acquisition or 301.7701,7).
<br /> abandonment of secured property,cancellation of debt,or
<br /> contributions you mace to an IRA Spacial rules for partnerships.partnerships that conduct a
<br /> Use Form W-9 only it you are a U.S. person(nclurting§ trade or business in the United States are generally required to
<br /> resident alien),to provide your correct T person
<br /> o the person pay a.withholding tax on any foreign partners' share of income
<br /> from such business. Further, in certain cases where a Form W-9
<br /> requesting it(the requester)and,when applicable,to: has not been received,a parmerehip Is required to presume that
<br /> 1.Certify that the TIN you are giving is correct ior you are a paMar is a foreign person, and pay the withholding tax.
<br /> wading for a number tobeissued), Therefore, if.you are a U.S-person that Is a partner in a
<br /> 2. Certify that you are not subject to backup withholding.or partnership conducting a tradeor business in the United States,
<br /> provide Form W9 to the partnership to establish your U.S.
<br /> 3.Claim exemption from backup withholding it you are-a U.S. status and avoid withholding on your share of partnership
<br /> exempt payee. If applicable,you are also caddying that as a income-
<br /> U.S.person,your allocable share of any partnershipincome from The person who given Form 4V-9 to the partnership for
<br /> a U.S.trade or business is not subject to the withholding tax on
<br /> foreign partners share of effectively connected income. Purposes of establishing its U.S.status and avoiding withholding
<br /> on its alocab(e share of net Income from the partnership
<br /> Note.If a requester gives you a town other than Forth W-9 to conducting a trade or business in the United States is in the
<br /> request your TIN,you must use the requester's form if it is following cases:
<br /> substantially similar to this Form W-9. e The U.S.owner of a disregarded entity and not the entity,
<br /> Cal.No.10231X Forth W-9 (Rev.10-2M)
<br />
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