1966D8F5 Blank W 9 Form 2024 2¶

Form W-9

Request for Taxpayer Identification Number and Certification

(Rev. March 2024)

Department of the Treasury

Internal Revenue Service

Give form to the requester. Do not

send to the IRS.

Go to www.irs.gov/FormW9 for instructions and the latest information.

Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. 1

Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2.)

2

Ptroyipnret.

SI3npstoeruca.tinefogisec

Business name/disregarded entity name, if different from above.

3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes.

[] Individual/sole proprietor

[] C corporation

4 Exemptions (codes apply only to certain entities, not individuals;

[_] S corporation

[_] Partnership

[_] Trust/estate

CJ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)

see instructions on page 3): Exempt payee code (if any)

Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner.

[] Other (see instructions)

Exemption from Foreign Account Tax Compliance Act (FATCA) reporting

code (if any)

3b If on line 3a you checked “Partnership” or “Trust/estate,” or checked “LLC” and entered “P” as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check

(Applies to accounts maintained outside the United States.)

this box if you have any foreign partners, owners, or beneficiaries. See instructions .

oe

5

Address (number, street, and apt. or suite no.). See instructions.

Requester’s name and address (optional)

6

City, state, and ZIP code

7

List account number(s) here (optional)

Kean

Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid

|Social security number

backup withholding. For individuals, this is generally your social security number (SSN). However, for a

resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.

or

| Employer identification number

Note: If the account is in more than one name, see the instructions for line

1. See also What Name and

Number To Give the Requester for guidelines on whose number to enter.

Gena)

Certification

Under penalties of perjury, | certify that: 1. The number shown on this form is my correct taxpayer identification number (or | am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because (a) | am exempt from backup withholding, or (b) | have not been notified by the Internal Revenue Service (IRS) that | am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that | am no longer subject to backup withholding; and 3.

lamaU.S. citizen or other U.S. person (defined below); and

1. The FATCA code(s) entered on this form (if any) indicating that | am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part Il, later.

Sign

Here

Signature of U.S. person

Date

General Instructions

New line 3b has been added to this form. A flow-through entity is required to complete this line to indicate that it has direct or indirect

Section references are to the Internal Revenue Code unless otherwise noted.

foreign partners, owners, or beneficiaries when it provides the Form W-9

Future developments. For the latest information about developments

change is intended to provide a flow-through entity with information

related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting

What’s New

partners may be required to complete Schedules K-2 and K-3. See the

Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the “LLC” box and enter its appropriate tax classification.

Cat. No. 10231X

to another flow-through entity in which it has an ownership interest. This

requirements. For example, a partnership that has any indirect foreign

Partnership Instructions for Schedules K-2 and K-3 (Form 1065).

Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they

Form W-9 (Rev. 3-2024)

Page 2

Form W-9 (Rev. 3-2024)

must obtain your correct taxpayer identification number (TIN), which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. ® Form 1099-INT (interest earned or paid). ¢ Form 1099-DIV (dividends, including those from stocks or mutual

funds).

¢ Form 1099-MISC (various types of income, prizes, awards, or gross

Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person (under Regulations section 1.1441-1(b)(2)(iv) or other applicable section for chapter 3 or 4 purposes), do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. 515). If you are a qualified foreign pension fund under Regulations section 1.897(I)-1(d), or a partnership that is wholly owned by qualified foreign pension funds, that is treated as a non-foreign person for purposes of section 1445 withholding, do not use Form W-9. Instead, use Form W-8EXP (or other certification of non-foreign status). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce

proceeds).

or eliminate U.S. tax on certain types of income. However, most tax

e Form 1099-NEC (nonemployee compensation).

treaties contain a provision known as a saving clause. Exceptions

Form 1099-B (stock or mutual fund sales and certain other transactions by brokers).

specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise

e Form 1099-S (proceeds from real estate transactions). ¢ Form 1099-K (merchant card and third-party network transactions).

¢ Form 1098 (home mortgage interest), 1098-E (student loan interest), and 1098-T (tuition). Form 1099-C (canceled debt). e Form 1099-A (acquisition or abandonment of secured property).

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. Caution: If you don’t return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a

number to be issued); 2. Certify that you are not subject to backup withholding; or 3. Claim exemption from backup withholding if you are a U.S. exempt payee; and 4. Certify to your non-foreign status for purposes of withholding under chapter 3 or 4 of the Code (if applicable); and 5. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting is correct. See What Is FATCA Reporting, later, for further information. Note: If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are

considered a U.S. person if you are:

become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption

from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items. 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax.

1. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will