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Exhibit
(a)(1)(F)
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Form W-9
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(Rev. October 2007)
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Give form to the
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Department of the Treasury
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Request for
Taxpayer
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requester. Do not
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Internal Revenue Service
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Identification Number and
Certification
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send to the IRS.
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Print or type
See Specific Instructions on page 2.
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Name (as shown on your income tax return)
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Business name, if different from above
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Check appropriate
box: o Individual/Sole
proprietor o Corporation o Partnership
o Limited
liability company. Enter the tax classification (D=disregarded
entity, C=corporation, P=partnership) ►.......
o Other
(see instructions) ►
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o Exempt
payee
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Address (number, street, and apt. or suite no.)
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Requester’s name and address (optional)
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City, state, and ZIP code
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List account number(s) here (optional)
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Part I Taxpayer
Identification Number (TIN)
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Enter your TIN in the appropriate box. The TIN provided must
match the name given on Line 1 to avoid backup withholding. For
individuals, this is your social security number (SSN). However,
for a resident alien, sole proprietor, or disregarded entity,
see the Part I instructions on page 3. For other entities,
it is your employer identification number (EIN). If you do not
have a number, see How to get a TIN on page 3.
Note. If the account is in more than one name, see the
chart on page 4 for guidelines on whose number to enter.
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Social security number
or
Employer identification number
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Part II Certification
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Under penalties of perjury, I certify that:
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1. The number shown on this form is my correct taxpayer
identification number (or I am waiting for a number to be issued
to me), and
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2. I am not subject to backup withholding because: (a) I am
exempt from backup withholding, or (b) I have not been notified
by the Internal Revenue Service (IRS) that I 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 I am
no longer subject to backup withholding, and
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3. I am a U.S. citizen or other U.S. person (defined below).
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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 on
page 4.
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Sign
Here
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Signature of
U.S. person ►
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Date ►
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General
Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
Purpose
of Form
A person who is required to file an information return with the
IRS must obtain your correct taxpayer identification number
(TIN) to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
Use
Form W-9
only if you are a U.S. person (including a resident alien), to
provide your correct TIN to the person requesting it (the
requester) and, when applicable, to:
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. If applicable, you are also certifying that
as a U.S. person, your allocable share of any partnership income
from a U.S. trade or business is not subject to the withholding
tax on foreign partners’ share of effectively connected
income.
Note: If 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:
• An individual who is a U.S. citizen or U.S. resident
alien,
• A partnership, corporation, company, or association
created or organized in the United States or under the laws of
the United States,
• An estate (other than a foreign estate), or
• A domestic trust (as defined in Regulations
section 301.7701-7).
Special rules for partnerships. Partnerships that conduct
a trade or business in the United States are generally required
to pay a withholding tax on any foreign partners’ share of
income from such business. Further, in certain cases where a
Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide
Form W-9
to the partnership to establish your U.S. status and avoid
withholding on your share of partnership income.
The person who gives
Form W-9
to the partnership for purposes of establishing its U.S. status
and avoiding withholding on its allocable share of net income
from the partnership conducting a trade or business in the
United States is in the following cases:
• The U.S. owner of a disregarded entity and not the
entity,
• The U.S. grantor or other owner of a grantor trust
and not the trust, and
• The U.S. trust (other than a grantor trust) and not
the beneficiaries of the trust.
Foreign person. If you are a foreign person, do not use
Form W-9.
Instead, use the appropriate
Form W-8
(see Publication 515, Withholding of Tax on Nonresident Aliens
and Foreign Entities).
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the
terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a
provision known as a “saving clause.” Exceptions
specified in the saving clause may permit an exemption from tax
to continue for certain types of income even after the payee has
otherwise 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.
5. 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 become a
resident alien for tax purposes if his or her stay in the United
States exceeds 5 calendar years. However, paragraph 2 of
the first Protocol to the
U.S.-China
treaty (dated April 30, 1984) allows the provisions of
Article 20 to continue to apply even after the Chinese
student becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2
of the first protocol) and is relying on this exception to claim
an exemption from tax on his or her scholarship or fellowship
income would attach to
Form W-9
a statement that includes the information described above to
support that exemption.
If you are a nonresident alien or a foreign entity not subject
to backup withholding, give the requester the appropriate
completed
Form W-8.
What is backup withholding? Persons making certain
payments to you must under certain conditions withhold and pay
to the IRS 28% of such payments. This is called “backup
withholding.” Payments that may be subject to backup
withholding include interest, tax-exempt interest, dividends,
broker and barter exchange transactions, rents,
royalties, nonemployee pay, and certain payments from fishing
boat operators. Real estate transactions are not subject to
backup withholding.
You will not be subject to backup withholding on payments you
receive if you give the requester your correct TIN, make the
proper certifications, and report all your taxable interest and
dividends on your tax return.
Payments you receive will be subject to backup withholding
if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the
Part II instructions on page 3 for details),
3. The IRS tells the requester that you furnished an
incorrect TIN,
4. The IRS tells you that you are subject to backup
withholding because you did not report all your interest and
dividends on your tax return (for reportable interest and
dividends only), or
5. You do not certify to the requester that you are not
subject to backup withholding under 4 above (for reportable
interest and dividend accounts opened after 1983 only).
Certain payees and payments are exempt from backup withholding.
See the instructions below and the separate Instructions for the
Requester of
Form W-9.
Also see Special rules for partnerships on page 1.
Penalties
Failure to furnish TIN. If you fail to furnish your
correct TIN to a requester, 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.
Civil penalty for false information with respect to
withholding. If you make a false statement with no
reasonable basis that results in no backup withholding, you are
subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully
falsifying certifications or affirmations may subject you to
criminal penalties including fines
and/or
imprisonment.
Misuse of TINs. If the requester discloses or uses TINs
in violation of federal law, the requester may be subject to
civil and criminal penalties.
Specific
Instructions
Name
If you are an individual, you must generally enter the name
shown on your income tax return. However, if you have changed
your last name, for instance, due to marriage without informing
the Social Security Administration of the name change, enter
your first name, the last name shown on your social security
card, and your new last name.
If the account is in joint names, list first, and then circle,
the name of the person or entity whose number you entered in
Part I of the form.
Sole proprietor. Enter your individual name as shown on
your income tax return on the “Name” line. You may
enter your business, trade, or “doing business as
(DBA)” name on the “Business name” line.
Limited liability company (LLC). Check the “Limited
liability company” box only and enter the appropriate code
for the tax classification (“D” for disregarded
entity, “C” for corporation, “P” for
partnership) in the space provided.
For a single-member LLC (including a foreign LLC with a domestic
owner) that is disregarded as an entity separate from its owner
under Regulations
section 301.7701-3,
enter the owner’s name on the “Name” line. Enter
the LLC’s name on the “Business name” line.
For an LLC classified as a partnership or a corporation, enter
the LLC’s name on the “Name” line and any
business, trade, or DBA name on the “Business name”
line.
Other entities. Enter your business name as shown on
required federal tax documents on the “Name” line.
This name should match the name shown on the charter or other
legal document creating the entity. You may enter any business,
trade, or DBA name on the “Business name” line.
Note. You are requested to check the appropriate box for
your status (individual/sole proprietor, corporation, etc.).
Exempt
Payee
If you are exempt from backup withholding, enter your name as
described above and check the appropriate box for your status,
then check the “Exempt payee” box in the line
following the business name, sign and date the form.
Generally, individuals (including sole proprietors) are not
exempt from backup withholding. Corporations are exempt from
backup withholding for certain payments, such as interest and
dividends.
Note. If you are exempt from backup withholding, you
should still complete this form to avoid possible erroneous
backup withholding.
The following payees are exempt from backup withholding:
1. An organization exempt from tax under
section 501(a), any IRA, or a custodial account under
section 403(b)(7) if the account satisfies the requirements
of section 401(f)(2),
2. The United States or any of its agencies or
instrumentalities,
3. A state, the District of Columbia, a possession of the
United States, or any of their political subdivisions or
instrumentalities,
4. A foreign government or any of its political
subdivisions, agencies, or instrumentalities, or
5. An international organization or any of its agencies or
instrumentalities.
Other payees that may be exempt from backup withholding include:
6. A corporation,
7. A foreign central bank of issue,
8. A dealer in securities or commodities required to
register in the United States, the District of Columbia, or a
possession of the United States,
9. A futures commission merchant registered with the
Commodity Futures Trading Commission,
10. A real estate investment trust,
11. An entity registered at all times during the tax year
under the Investment Company Act of 1940,
12. A common trust fund operated by a bank under
section 584(a),
13. A financial institution,
14. A middleman known in the investment community as a
nominee or custodian, or
15. A trust exempt from tax under section 664 or
described in section 4947.
The chart below shows types of payments that may be exempt from
backup withholding. The chart applies to the exempt payees
listed above, 1 through 15.
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IF the payment is for...
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THEN the payment is exempt
for...
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Interest and dividend payments
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All exempt payees except for 9
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Broker transactions
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Exempt payees 1 through 13. Also, a person registered under the
Investment Advisers Act of 1940 who regularly acts as a broker
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Barter exchange transactions and patronage dividends
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Exempt payees 1 through 5
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Payments over $600 required to be reported and direct sales over
$5,0001
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Generally, exempt payees 1 through
72
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1See
Form 1099-MISC,
Miscellaneous Income, and its instructions.
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2However,
the following payments made to a corporation (including gross
proceeds paid to an attorney under section 6045(f), even if
the attorney is a corporation) and reportable on
Form 1099-MISC
are not exempt from backup withholding: medical and health care
payments, attorneys’ fees, and payments for services paid
by a federal executive agency.
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Part I.
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a
resident alien and you do not have and are not eligible to get
an SSN, your TIN is your IRS individual taxpayer identification
number (ITIN). Enter it in the social security number box. If
you do not have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an EIN, you may enter
either your SSN or EIN. However, the IRS prefers that you use
your SSN.
If you are a single-member LLC that is disregarded as an entity
separate from its owner (see Limited liability company
(LLC) on page 2), enter the owner’s SSN (or
EIN, if the owner has one). Do not enter the disregarded
entity’s EIN. If the LLC is classified as a corporation or
partnership, enter the entity’s EIN.
Note. See the chart on page 4 for further
clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one
immediately. To apply for an SSN, get
Form SS-5,
Application for a Social Security Card, from your local Social
Security Administration office or get this form online at
www.ssa.gov. You may also get this form by calling
1-800-772-1213.
Use
Form W-7,
Application for IRS Individual Taxpayer Identification Number,
to apply for an ITIN, or
Form SS-4,
Application for Employer Identification Number, to apply for an
EIN. You can apply for an EIN online by accessing the IRS
website at
www.irs.gov/businesses and clicking on Employer
Identification Number (EIN) under Starting a Business. You can
get
Forms W-7
and SS-4 from the IRS by visiting www.irs.gov or by
calling 1-800-TAX-FORM
(1-800-829-3676).
If you are asked to complete
Form W-9
but do not have a TIN, write “Applied For” in the
space for the TIN, sign and date the form, and give it to the
requester. For interest and dividend payments, and certain
payments made with respect to readily tradable instruments,
generally you will have 60 days to get a TIN and give it to
the requester before you are subject to backup withholding on
payments. The
60-day rule
does not apply to other types of payments. You will be subject
to backup withholding on all such payments until you provide
your TIN to the requester.
Note. Entering “Applied For” means that you
have already applied for a TIN or that you intend to apply for
one soon.
Caution: A disregarded domestic entity that has a
foreign owner must use the appropriate
Form W-8.
Part II.
Certification
To establish to the withholding agent that you are a
U.S. person, or resident alien, sign
Form W-9.
You may be requested to sign by the withholding agent even if
items 1, 4, and 5 below indicate otherwise.
For a joint account, only the person whose TIN is shown in
Part I should sign (when required). Exempt payees, see
Exempt Payee on page 2.
Signature requirements. Complete the certification as
indicated in 1 through 5 below.
1. Interest, dividend, and barter exchange accounts
opened before 1984 and broker accounts considered active during
1983. You must give your correct TIN, but you do not have to
sign the certification.
2. Interest, dividend, broker, and barter exchange
accounts opened after 1983 and broker accounts considered
inactive during 1983. You must sign the certification or
backup withholding will apply. If you are subject to backup
withholding and you are merely providing your correct TIN to the
requester, you must cross out item 2 in the certification
before signing the form.
3. Real estate transactions. You must sign the
certification. You may cross out item 2 of the
certification.
4. Other payments. You must give your correct TIN,
but you do not have to sign the certification unless you have
been notified that you have previously given an incorrect TIN.
“Other payments” include payments made in the course
of the requester’s trade or business for rents, royalties,
goods (other than bills for merchandise), medical and health
care services (including payments to corporations), payments to
a nonemployee for services, payments to certain fishing boat
crew members and fishermen, and gross proceeds paid to attorneys
(including payments to corporations).
5. Mortgage interest paid by you, acquisition or
abandonment of secured property, cancellation of debt, qualified
tuition program payments (under section 529), IRA,
Coverdell ESA, Archer MSA or HSA contributions or distributions,
and pension distributions. You must give your correct TIN,
but you do not have to sign the certification.
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What Name and Number To Give
the Requester
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For this type of account:
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Give name and SSN of:
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1. Individual
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The individual
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2. Two or more individuals (joint account)
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The actual owner of the account or, if combined funds, the first
individual on the
account1
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3. Custodian account of a minor (Uniform Gift to Minors Act)
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The
minor2
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4. a. The usual revocable savings trust (grantor is also
trustee)
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The
grantor-trustee1
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b. So-called trust account that is not a legal or
valid trust under state law
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The actual
owner1
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5. Sole proprietorship or disregarded entity owned by an
individual
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The
owner3
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For this type of
account:
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Give name and EIN of:
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6. Disregarded entity not owned by an individual
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The owner
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7. A valid trust, estate, or pension trust
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Legal
entity4
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8. Corporate or LLC electing corporate status on
Form 8832
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The corporation
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9. Association, club, religious, charitable, educational,
or other tax-exempt organization
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The organization
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10. Partnership or multi-member LLC
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The partnership
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