Please wait
Letter of
Transmittal
To Tender for
Exchange
8.25% Senior Notes due
2018
of
Grifols Inc.
With an unconditional, full and
irrevocable guarantee as to payment of principal and interest
from
Grifols, S.A.
and various Subsidiary
Guarantors
Pursuant to the Prospectus
dated ,
2011
THE EXCHANGE OFFER WILL EXPIRE
AT 5:00 P.M., NEW YORK CITY TIME,
ON ,
2011, UNLESS EXTENDED (SUCH TIME AND DATE, AS THE SAME MAY BE
EXTENDED FROM TIME TO TIME, THE “EXPIRATION DATE”).
TENDERS MAY BE WITHDRAWN AT ANY TIME PRIOR THE EXPIRATION
DATE.
The Exchange Agent is:
The Bank of New York Mellon
Trust Company, N.A.
By Certified or Registered Mail, Overnight Courier or
Regular Mail or by Hand:
The Bank of New York Mellon
Trust Company, N.A.
c/o The Bank of New York Mellon Corporation
Corporate
Trust Operations-Reorganization
Unit
101 Barclay St., Floor 7 East
New York, NY 10286
Attention: Mr. William Buckley
By Facsimile (eligible institutions only):
(212) 298-1915
Telephone Inquiries:
(212) 815-5788
DELIVERY OF THIS LETTER OF TRANSMITTAL TO AN ADDRESS OTHER
THAN AS SET FORTH ABOVE OR TRANSMISSION TO A FACSIMILE NUMBER
OTHER THAN AS SET FORTH ABOVE WILL NOT CONSTITUTE A VALID
DELIVERY.
The undersigned acknowledges receipt of the prospectus
dated ,
2011 (the “Prospectus”) of Grifols Inc. (the
“Company”) and the various guarantors listed on
Annex A hereto (the “Guarantors”) and this
Letter of Transmittal (the “Letter of
Transmittal”), which together with the Prospectus
constitutes the Company’s offer (the “Exchange
Offer”) to exchange up to $1,100,000,000 in aggregate
principal amount of the Company’s 8.25% Senior Notes due
2018 (the “Exchange Notes”), which are
unconditionally, fully and irrevocably guaranteed by the
Guarantors, and which have been registered under the Securities
Act of 1933, as amended (the “Securities Act”),
for $1,100,000,000 in aggregate principal amount of the
Company’s issued and outstanding 8.25% Senior Notes due
2018 (CUSIP Nos. 374500 AA4 and U3748T AA2) (the
“Existing Notes”), which are unconditionally,
fully and irrevocably guaranteed by the Guarantors. Recipients
of the Prospectus should read the requirements described in such
Prospectus with respect to eligibility to participate in the
Exchange Offer. Capitalized terms used but not defined herein
have the meaning given to them in the Prospectus.
The undersigned hereby tenders the Existing Notes described in
the box entitled “Description of Existing Notes” below
pursuant to the terms and conditions described in the Prospectus
and this Letter of Transmittal. The undersigned is the
registered holder of all the Existing Notes (the
“Holder”) and the undersigned represents that
it has received from each beneficial owner of Existing Notes
(the “Beneficial Owners”) a duly completed and
executed form of “Instruction to Registered Holder from
Beneficial Owner” accompanying this Letter of Transmittal,
instructing the undersigned to take the action described in this
Letter of Transmittal.
PLEASE READ CAREFULLY THIS ENTIRE LETTER OF TRANSMITTAL AND
COMPLETE ALL BOXES BELOW.
This Letter of Transmittal is to be used by a Holder (i) if
certificates representing Existing Notes are to be forwarded
herewith and (ii) if a tender is made pursuant to the
guaranteed delivery procedures described in the section of the
Prospectus entitled “The Exchange Offer —
Guaranteed Delivery Procedures.”
Holders that are tendering by book-entry transfer to the
Exchange Agent’s account at DTC can execute the tender
through ATOP, for which the Exchange Offer will be eligible. DTC
participants that are accepting the Exchange Offer must transmit
their acceptance to DTC, which will verify the acceptance and
execute a book-entry delivery to the Exchange Agent’s
account at DTC. DTC will then send an agent’s message
forming part of a book-entry transfer in which the participant
agrees to be bound by the terms of the Letter of Transmittal (an
“Agent’s Message”) to the Exchange Agent
for its acceptance. Transmission of the Agent’s Message by
DTC will satisfy the terms of the Exchange Offer as to execution
and delivery of a Letter of Transmittal by the participant
identified in the Agent’s Message.
Any Beneficial Owner whose Existing Notes are registered in the
name of a broker, dealer, commercial bank, trust company or
other nominee and who wishes to tender should contact such
Holder promptly and instruct such Holder to tender on behalf of
the Beneficial Owner. If such Beneficial Owner wishes to tender
on its own behalf, such Beneficial Owner must, prior to
completing and executing this Letter of Transmittal and
delivering its Existing Notes, either make appropriate
arrangements to register ownership of the Existing Notes in such
Beneficial Owner’s name or obtain a properly completed bond
power from the Holder. The transfer of record ownership may take
considerable time.
In order to properly complete this Letter of Transmittal, a
Holder must (i) complete the box entitled “Description
of Existing Notes,” (ii) if appropriate, check and
complete the boxes relating to book-entry transfer, guaranteed
delivery, Special Issuance Instructions and Special Delivery
Instructions, (iii) sign the Letter of Transmittal by
completing the box entitled “Sign Here To Tender Your
Existing Notes” and (iv) complete the Substitute
Form W-9.
Each Holder should carefully read the detailed instructions
below prior to completing this Letter of Transmittal.
Holders of Existing Notes who desire to tender their Existing
Notes for exchange and (i) whose Existing Notes are not
immediately available or (ii) who cannot deliver their
Existing Notes, this Letter of Transmittal and all other
documents required hereby to the Exchange Agent on or prior to
the Expiration Date, must tender the Existing Notes pursuant to
the guaranteed delivery procedures set forth in the section of
the Prospectus entitled “The Exchange Offer —
Guaranteed Delivery Procedures.” See Instruction 2.
Holders of Existing Notes who wish to tender their Existing
Notes for exchange must complete columns (1) through
(3) in the box below entitled “Description of Existing
Notes,” and sign the box below entitled “Sign Here to
Tender Your Existing Notes.” If only those columns are
completed, such Holder will have tendered for exchange all
Existing Notes listed in column (3) below. If the Holder
wishes to tender for exchange less than all of such Existing
Notes, column (4) must be completed in full. In such case,
such Holder should refer to Instruction 5.
The Exchange Offer may be extended, terminated or amended, as
provided in the Prospectus. During any such extension of the
Exchange Offer, all Existing Notes previously tendered and not
withdrawn pursuant to the Exchange Offer will remain subject to
such Exchange Offer.
The undersigned hereby tenders for exchange the Existing Notes
described in the box entitled “Description of Existing
Notes” below pursuant to the terms and conditions described
in the Prospectus and this Letter of Transmittal.
2
DESCRIPTION
OF EXISTING NOTES
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(1)
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(2)
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(3)
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(4)
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Name(s) and Address(es)
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Aggregate Principal
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Principal Amount
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of Registered Holder(s)
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Certificate
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Amount Represented by
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Tendered For
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(Please Fill in, if Blank)
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Number(s)
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Certificate(s)(A)
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Exchange(B)
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Total Principal
Amount Tendered
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| (A) |
Unless indicated in this column, any tendering Holder will be
deemed to have tendered the entire aggregate principal amount
represented by the Existing Notes indicated in the column
labeled “Aggregate Principal Amount Represented by
Certificate(s).” See Instruction 5.
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The minimum permitted tender is $2,000 in principal amount of
Existing Notes. All other tenders must be in integral multiples
of $1,000 in excess of $2,000.
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CHECK HERE IF TENDERED EXISTING NOTES ARE ENCLOSED HEREWITH.
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CHECK HERE IF TENDERED EXISTING NOTES ARE BEING DELIVERED
PURSUANT TO A NOTICE OF GUARANTEED DELIVERY ENCLOSED HEREWITH
AND COMPLETE THE FOLLOWING (FOR USE BY ELIGIBLE INSTITUTIONS
ONLY):
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Name(s) of Registered Holder(s):
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Date of Execution of Notice of Guaranteed Delivery:
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Window Ticket Number (if any):
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Name of Institution that Guaranteed Delivery:
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Only Holders are entitled to tender their Existing Notes for
exchange in the Exchange Offer. Any financial institution that
is a participant in DTC’s system and whose name appears on
a security position listing as the record owner of the Existing
Notes and who wishes to make book-entry delivery of Existing
Notes as described above must complete and execute a
participant’s letter (which will be distributed to
participants by DTC) instructing DTC’s nominee to tender
such Existing Notes for exchange. Persons who are Beneficial
Owners of Existing Notes but are not Holders and who seek to
tender Existing Notes should (i) contact the Holder and
instruct such Holder to tender on its behalf, (ii) obtain
and include with this Letter of Transmittal, Existing Notes
properly endorsed for transfer by the Holder or accompanied by a
properly completed bond power from the Holder, with signatures
on the endorsement or bond power guaranteed by a firm that is an
eligible guarantor institution within the meaning of
Rule 17Ad-15
under the Exchange Act of 1934, as amended (the
“Exchange Act”), including a firm that is a
member of a registered national securities exchange, a member of
the Financial Industry Regulatory Authority, Inc., a commercial
bank or trading company having an office in the United States or
certain other eligible guarantors (each, an “Eligible
Institution”), or (iii) effect a record transfer
of such Existing Notes from the Holder to such Beneficial Owner
and comply with the requirements applicable to Holders for
tendering Existing Notes prior to the Expiration Date. See the
section of the Prospectus entitled “The Exchange
Offer — Procedures for Tendering.”
SIGNATURES
MUST BE PROVIDED BELOW. PLEASE READ THE ACCOMPANYING
INSTRUCTIONS CAREFULLY.
3
SPECIAL ISSUANCE INSTRUCTIONS
(See Instructions 1, 6, 7, 8 and 9)
To be completed ONLY (i) if the Exchange Notes issued in
exchange for the Existing Notes, certificates for Existing Notes
in a principal amount not exchanged for Exchange Notes or
Existing Notes (if any) not tendered for exchange are to be
issued in the name of someone other than the undersigned or
(ii) if Existing Notes tendered by book-entry transfer that
are not exchanged are to be returned by credit to an account
maintained at DTC.
Issue to:
(Please Type or Print)
(Include Zip Code)
(Taxpayer Identification
or
Social Security No.)
Credit Existing Notes not exchanged and delivered by book-entry
transfer to DTC account set forth below:
(Account Number)
SPECIAL DELIVERY INSTRUCTIONS
(See Instructions 1, 6, 7, 8 and 9)
To be completed ONLY (i) if the Exchange Notes issued in
exchange for Existing Notes, certificates for Existing Notes in
a principal amount not exchanged for Exchange Notes or Existing
Notes (if any) not tendered for exchange are to be mailed or
delivered (i) to someone other than the undersigned or
(ii) to the undersigned at an address other than the
address shown below the undersigned’s signature.
Mail or deliver to:
(Please Type or Print)
(Include Zip Code)
(Taxpayer Identification
or
Social Security No.)
4
SIGNATURES
MUST BE PROVIDED BELOW
PLEASE READ THE ACCOMPANYING
INSTRUCTIONS CAREFULLY
Ladies and Gentlemen:
Upon the terms and subject to the conditions of the Exchange
Offer, the undersigned hereby tenders to the Company for
exchange the Existing Notes indicated above. Subject to, and
effective upon, acceptance for exchange of the Existing Notes
tendered for exchange herewith, the undersigned will have
irrevocably sold, assigned, transferred and exchanged, to the
Company, all right, title and interest in, to and under all of
the Existing Notes tendered for exchange hereby, and hereby will
have appointed the Exchange Agent as the true and lawful agent
and attorney-in-fact (with full knowledge that the Exchange
Agent also acts as agent of the Company) of such Holder with
respect to such Existing Notes, with full power of substitution
(i) to deliver certificates representing such Existing
Notes, or transfer ownership of such Existing Notes on the
account books maintained by DTC (together, in any such case,
with all accompanying evidences of transfer and authenticity),
to the Company, (ii) to present and deliver such Existing
Notes for transfer on the books of the Company and (iii) to
receive all benefits and otherwise exercise all rights and
incidents of beneficial ownership with respect to such Existing
Notes, all in accordance with the terms of the Exchange Offer.
The power of attorney granted in this paragraph shall be deemed
to be irrevocable and coupled with an interest.
The undersigned hereby represents and warrants that it has full
power and authority to tender, exchange, assign and transfer the
Existing Notes; and that when such Existing Notes are accepted
for exchange by the Company, the Company will acquire good and
marketable title thereto, free and clear of all liens,
restrictions, charges and encumbrances and not subject to any
adverse claims. The undersigned further warrants that it will,
upon request, execute and deliver any additional documents
deemed by the Exchange Agent or the Company to be necessary or
desirable to complete the exchange, assignment and transfer of
the Existing Notes tendered for exchange hereby. The undersigned
further agrees that acceptance of any and all validly tendered
Existing Notes by the Company and the issuance of Exchange Notes
in exchange therefor shall constitute performance in full by the
Company of its obligations under the Registration Rights
Agreement.
By tendering, the undersigned hereby further represents to the
Company that:
(i) the Exchange Notes to be acquired by the undersigned in
exchange for the Existing Notes tendered hereby and any
Beneficial Owner(s) of such Existing Notes in connection with
the Exchange Offer will be acquired by the undersigned and such
Beneficial Owner(s) in the ordinary course of their respective
businesses,
(ii) the undersigned is not engaged in, and does not intend
to engage in, a distribution of the Exchange Notes,
(iii) the undersigned does not have an arrangement or
understanding with any person to engage in the distribution of
the Exchange Notes in violation of the provisions of the
Securities Act,
(iv) the undersigned and each Beneficial Owner acknowledge
and agree that any person who is a broker-dealer registered
under the Exchange Act or is participating in the Exchange Offer
for the purpose of distributing the Exchange Notes must comply
with the registration and prospectus delivery requirements of
Section 10 of the Securities Act in connection with a
secondary resale transaction of the Exchange Notes acquired by
such person and cannot rely on the position of the staff of the
Commission set forth in certain no-action letters,
(v) the undersigned and each Beneficial Owner understand
that a secondary resale transaction described in clause
(iv) above and any resales of Exchange Notes obtained by
the undersigned in exchange for the Existing Notes acquired by
the undersigned directly from the Company should be covered by
an effective registration statement containing the selling
securityholder information required by Item 507 or
Item 508, as applicable, of
Regulation S-K
of the Commission, and
(vi) neither the undersigned nor any Beneficial Owner is an
“affiliate,” as defined under Rule 405 under the
Securities Act, of the Company.
If the undersigned is a broker-dealer that will receive Exchange
Notes for its own account in exchange for Existing Notes that
were acquired as a result of market-making activities or other
trading activities, it acknowledges that it will deliver a
prospectus meeting the requirements of Section 10 of the
Securities Act in connection with any resale of such Exchange
Notes; however, by so acknowledging and by delivering such
prospectus, the undersigned will not be deemed to
5
admit that it is an “underwriter” within the meaning
of the Securities Act. A broker-dealer may not participate in
the Exchange Offer with respect to the Existing Notes acquired
other than as a result of market-making activities or other
trading activities.
For purposes of the Exchange Offer, the Company will be deemed
to have accepted for exchange, and to have exchanged, validly
tendered Existing Notes, if, as and when the Company gives oral
or written notice thereof to the Exchange Agent. Tenders of
Existing Notes for exchange may be withdrawn at any time prior
to 5:00 p.m., New York City time, on the Expiration Date.
See “The Exchange Offer — Withdrawal of
Tenders” in the Prospectus. Any Existing Notes tendered by
the undersigned and not accepted for exchange will be returned
to the undersigned at the address set forth above unless
otherwise indicated in the box above entitled “Special
Delivery Instructions” promptly after the Expiration Date.
The undersigned acknowledges that the Company’s acceptance
of Existing Notes validly tendered for exchange pursuant to any
one of the procedures described in the section of the Prospectus
entitled “The Exchange Offer” and in the instructions
hereto will constitute a binding agreement between the
undersigned and the Company upon the terms and subject to the
conditions of the Exchange Offer.
Unless otherwise indicated in the box entitled “Special
Issuance Instructions,” please return any Existing Notes
not tendered for exchange in the name(s) of the undersigned.
Similarly, unless otherwise indicated in the box entitled
“Special Delivery Instructions,” please mail any
certificates for Existing Notes not tendered or exchanged (and
accompanying documents, as appropriate) to the undersigned at
the address shown below the undersigned’s signature(s). In
the event that both “Special Issuance Instructions”
and “Special Delivery Instructions” are completed,
please issue the certificates representing the Exchange Notes
issued in exchange for the Existing Notes accepted for exchange
in the name(s) of, and return any Existing Notes not tendered
for exchange or not exchanged to, the person(s) so indicated.
The undersigned recognizes that the Company has no obligation
pursuant to the “Special Issuance Instructions” and
“Special Delivery Instructions” to transfer any
Existing Notes from the name of the Holder(s) thereof if the
Company does not accept for exchange any of the Existing Notes
so tendered for exchange or if such transfer would not be in
compliance with any transfer restrictions applicable to such
Exchange Note(s).
In order to validly tender Existing Notes for exchange,
Holders must complete, execute and deliver this Letter of
Transmittal.
Except as stated in the Prospectus, all authority herein
conferred or agreed to be conferred shall survive the death,
incapacity or dissolution of the undersigned, and any obligation
of the undersigned hereunder shall be binding upon the heirs,
personal representatives, successors and assigns of the
undersigned. Except as otherwise stated in the Prospectus, this
tender for exchange of Existing Notes is irrevocable.
6
SIGN HERE TO TENDER YOUR EXISTING NOTES
Signature(s) of
Owner(s)
Dated:
, 20
Must be signed by the Holder(s) exactly as name(s) appear(s) on
certificate(s) representing the Existing Notes or on a security
position listing or by person(s) authorized to become registered
Exchange Note holder(s) by certificates and documents
transmitted herewith. If signature is by trustees, executors,
administrators, guardians, attorneys-in-fact, officers of
corporations or others acting in a fiduciary or representative
capacity, please provide the following information. (See
Instruction 6.)
(Please Type or Print)
(Include Zip Code)
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| Principal place of business (if different from address listed above): |
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| Area Code and Telephone No.: |
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| Tax Identification or Social Security Nos.: |
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GUARANTEE
OF SIGNATURE(S)
(Signature(s) must be guaranteed if required by
Instruction 1)
(Please Type or Print)
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| Area Code and Telephone No.: |
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IMPORTANT: COMPLETE AND SIGN THE SUBSTITUTE
FORM W-9
IN THIS LETTER OF TRANSMITTAL.
7
INSTRUCTIONS
Forming
Part of the Terms and Conditions of the Exchange Offer
1. Guarantee of Signatures. Except as
otherwise provided below, all signatures on this Letter of
Transmittal must be guaranteed by an institution that is
(1) a member of a registered national securities exchange
or of the Financial Industry Regulatory Authority, Inc.,
(2) a commercial bank or trust company having an office or
correspondent in the United States, or (3) an Eligible
Institution that is a member of one of the following recognized
Signature Guarantee Programs:
(a) The Securities Transfer Agents Medallion Program
(STAMP);
(b) The New York Stock Exchange Medallion Signature Program
(MSP); or
(c) The Stock Exchange Medallion Program (SEMP).
Signatures on this Letter of Transmittal need not be guaranteed
(i) if this Letter of Transmittal is signed by the
Holder(s) of the Existing Notes tendered herewith and such
Holder(s) have not completed the box entitled “Special
Issuance Instructions” or the box entitled “Special
Delivery Instructions” on this Letter of Transmittal or
(ii) if such Existing Notes are tendered for the account of
an Eligible Institution. In all other cases, all signatures
must be guaranteed by an Eligible Institution.
2. Delivery of this Letter of Transmittal and Existing
Notes; Guaranteed Delivery Procedures. This
Letter of Transmittal is to be completed by Holders if
certificates representing Existing Notes are to be forwarded
herewith. All physically delivered Existing Notes, as well as a
properly completed and duly executed Letter of Transmittal (or
manually signed facsimile thereof) and any other required
documents, must be received by the Exchange Agent at its address
set forth herein prior to the Expiration Date or the tendering
holder must comply with the guaranteed delivery procedures set
forth below. Delivery of the documents to DTC does not
constitute delivery to the Exchange Agent.
The method of delivery of Existing Notes, this Letter of
Transmittal and all other required documents to the Exchange
Agent is at the election and risk of the Holder. Except as
otherwise provided below, the delivery will be deemed made only
when actually received or confirmed by the Exchange Agent.
Instead of delivery by mail, it is recommended that Holders use
an overnight or hand delivery service, properly insured. In all
cases, sufficient time should be allowed to assure delivery to
the Exchange Agent before the Expiration Date. Neither this
Letter of Transmittal nor any Existing Notes should be sent to
the Company. Holders may request their respective brokers,
dealers, commercial banks, trust companies or nominees to effect
the above transactions for such Holders.
Holders of Existing Notes who elect to tender Existing Notes and
(i) whose Existing Notes are not immediately available or
(ii) who cannot deliver the Existing Notes, this Letter of
Transmittal or other required documents to the Exchange Agent
prior the Expiration Date must tender their Existing Notes
according to the guaranteed delivery procedures set forth in the
Prospectus. Holders may have such tender effected if:
(a) such tender is made through an Eligible Institution;
(b) prior to 5:00 p.m., New York City time, on the
Expiration Date, the Exchange Agent has received from such
Eligible Institution a properly completed and duly executed
Notice of Guaranteed Delivery, setting forth the name and
address of the Holder, the certificate number(s) of such
Existing Notes and the principal amount of Existing Notes
tendered for exchange, stating that tender is being made thereby
and guaranteeing that, within three New York Stock Exchange
trading days after the Expiration Date, this Letter of
Transmittal (or facsimile thereof), together with the
certificate(s) representing such Existing Notes (or a Book-Entry
Confirmation), in proper form for transfer, and any other
documents required by this Letter of Transmittal, will be
deposited by such Eligible Institution with the Exchange Agent;
and
(c) a properly executed Letter of Transmittal (or facsimile
thereof), as well as the certificate(s) for all tendered
Existing Notes in proper form for transfer or a Book-Entry
Confirmation, together with any other documents required by this
Letter of Transmittal, are received by the Exchange Agent within
three NASDAQ trading days after the Expiration Date.
8
No alternative, conditional or contingent tenders will be
accepted. All tendering Holders, by execution of this Letter of
Transmittal (or facsimile thereof), waive any right to receive
notice of the acceptance of their Existing Notes for exchange.
3. Inadequate Space. If the space
provided in the box entitled “Description of Existing
Notes” above is inadequate, the certificate numbers and
principal amounts of the Existing Notes being tendered should be
listed on a separate signed schedule affixed hereto.
4. Withdrawals. A tender of Existing
Notes may be withdrawn at any time prior to the Expiration Date
by delivery of written notice of withdrawal (or facsimile
thereof) to the Exchange Agent at the address set forth on the
cover of this Letter of Transmittal. To be effective, a notice
of withdrawal of Existing Notes must (i) specify the name
of the person who tendered the Existing Notes to be withdrawn
(the “Depositor”), (ii) identify the
Existing Notes to be withdrawn (including the certificate
number(s) and aggregate principal amount of such Existing Notes)
and (iii) be signed by the Holder in the same manner as the
original signature on the Letter of Transmittal by which such
Existing Notes were tendered (including any required signature
guarantees). All questions as to the validity, form and
eligibility (including time of receipt) of such notices will be
determined by the Company in its sole discretion, whose
determination shall be final and binding on all parties. Any
Existing Notes so withdrawn will thereafter be deemed not
validly tendered for purposes of the Exchange Offer and no
Exchange Notes will be issued with respect thereto unless the
Existing Notes so withdrawn are validly retendered. Properly
withdrawn Existing Notes may be retendered by following one of
the procedures described in the section of the Prospectus
entitled “The Exchange Offer — Procedures for
Tendering” at any time prior to the Expiration Date.
5. Partial Tenders. Tenders of Existing
Notes will be accepted only in multiples of $2,000 principal
amount and integral multiples of $1,000 in excess of $2,000. If
a tender for exchange is to be made with respect to less than
the entire principal amount of any Existing Notes, fill in the
principal amount of Existing Notes that are tendered for
exchange in column (5) of the box entitled “Description of
Existing Notes,” as more fully described in the footnotes
thereto. In the case of a partial tender for exchange, a new
certificate, in fully registered form, for the remainder of the
principal amount of the Existing Notes, will be sent to the
Holders unless otherwise indicated in the appropriate box on
this Letter of Transmittal promptly after the expiration or
termination of the Exchange Offer.
6. Signatures on this Letter of Transmittal, Powers of
Attorney and Endorsements.
(a) The signature(s) of the Holder on this Letter of
Transmittal must correspond with the name(s) as written on the
face of the Existing Notes without alteration, enlargement or
any change whatsoever.
(b) If tendered Existing Notes are owned of record by two
or more joint owners, all such owners must sign this Letter of
Transmittal.
(c) If any tendered Existing Notes are registered in
different names on several certificates, it will be necessary to
complete, sign and submit as many separate copies of this Letter
of Transmittal and any necessary or required documents as there
are different registrations or certificates.
(d) When this Letter of Transmittal is signed by the Holder
listed and transmitted hereby, no endorsements of Existing Notes
or bond powers are required. If, however, Existing Notes not
tendered or not accepted are to be issued or returned in the
name of a person other than the Holder, then the Existing Notes
transmitted hereby must be endorsed or accompanied by a properly
completed bond power, in a form satisfactory to the Company, in
either case signed exactly as the name(s) of the Holder(s)
appear(s) on the Existing Notes. Signatures on such Existing
Notes or bond powers must be guaranteed by an Eligible
Institution (unless signed by an Eligible Institution).
(e) If this Letter of Transmittal or Existing Notes or bond
powers are signed by trustees, executors, administrators,
guardians, attorneys-in-fact, officers of corporations or others
acting in a fiduciary or representative capacity, such persons
should so indicate when signing, and unless waived by the
Company, evidence satisfactory to the Company of their authority
to so act must be submitted with this Letter of Transmittal.
(f) If this Letter of Transmittal is signed by a person
other than the Holder listed, the Existing Notes must be
endorsed or accompanied by a properly completed bond power, in
either case signed by such Holder exactly as the name(s) of the
Holder appear(s) on the certificates. Signatures on such
Existing Notes or bond powers must be guaranteed by an Eligible
Institution (unless signed by an Eligible Institution).
9
7. Backup Withholding; Substitute
Form W-9. Under
U.S. federal income tax law, a Holder whose tendered Existing
Notes are accepted for exchange may be subject to backup
withholding (currently at a 28% rate) on payments that may be
made by the Company on account of Exchange Notes issued pursuant
to the Exchange Offer. To prevent backup withholding, each
Holder of tendered Existing Notes must provide to the Exchange
Agent such Holder’s correct taxpayer identification number
(“TIN”) by completing the Substitute
Form W-9
below, certifying that the Holder is a U.S. person, that the TIN
provided is correct (or that the Holder is awaiting a TIN), and
that (i) the Holder is exempt from backup withholding,
(ii) the Holder has not been notified by the Internal
Revenue Service (the “IRS”) that the Holder is
subject to backup withholding as a result of a failure to report
all interest or dividends or (iii) the IRS has notified the
Holder that the Holder is no longer subject to backup
withholding. A U.S. person is (i) an individual who is a
U.S. citizen or U.S. resident alien, (ii) a partnership,
corporation, company or association created or organized in the
United States or under the laws of the United States,
(iii) an estate (other than a foreign estate) or
(iv) a domestic trust (as defined in U.S. Treasury
Regulations
Section 301.7701-7).
If the Exchange Agent is not provided with the correct TIN, the
tendering Holder may be subject to penalties imposed by the IRS.
In addition, the Holder may be subject to backup withholding on
all reportable payments made on account of the Exchange Notes
after the exchange.
If the Holder is an individual, the TIN is generally his or her
social security number. If the Holder is a nonresident alien or
a foreign entity not subject to backup withholding, the Holder
must provide to the Exchange Agent the appropriate completed
Form W-8
rather than a Substitute
Form W-9.
These forms may be obtained from the Exchange Agent. See the
enclosed Guidelines for Certification of Taxpayer Identification
Number on Substitute
Form W-9
(the
“W-9
Guidelines”) for additional instructions. If the
Existing Notes are in more than one name or are not in the name
of the actual owner, the tendering holder should consult the
W-9
Guidelines for information regarding which TIN to report.
Certain Holders (including, among others, corporations) may not
be subject to these backup withholding requirements. Please
consult the
W-9
Guidelines for more information. Such exempt Holders must
nevertheless enter their name, address, status and TIN, check
the “Exempt Payee” box in Part 3 of the
Substitute
Form W-9,
and sign, date and return the Substitute
Form W-9
to the Exchange Agent.
If the Holder whose Existing Notes are tendered does not have a
TIN or does not know its TIN, the Holder should check the box in
Part 2 of the Substitute
Form W-9,
write “Applied For” in lieu of its TIN in Part 1,
sign and date the form and provide it to the Exchange Agent. In
addition, such Holder also must sign and date the Certificate of
Awaiting Taxpayer Identification Number. A Holder that does not
have a TIN should consult the
W-9
Guidelines for instructions on applying for a TIN. Note:
Checking the box in Part 2 of the Substitute
Form W-9
and writing “Applied For” in Part 1 means that
the Holder has already applied for a TIN or that the Holder
intends to apply for one in the near future. If a Holder checks
the box in Part 2 and writes “Applied For” in
Part 1, backup withholding at the applicable rate will
nevertheless apply to all reportable payments made to such
Holder. If such a Holder furnishes its properly certified TIN to
the Exchange Agent within 60 days of the Exchange
Agent’s receipt of the Substitute
Form W-9,
however, any amounts so withheld shall be refunded to such
Holder. If, however, the Holder has not provided the Exchange
Agent with its TIN within such
60-day
period, such previously retained amounts will be remitted to the
IRS as backup withholding.
Backup withholding is not an additional U.S. federal income tax.
Rather, the U.S. federal income tax liability of persons subject
to backup withholding will be reduced by the amount of tax
withheld. If withholding results in overpayment of taxes, a
refund may be obtained from the IRS, provided the required
information is timely furnished to the IRS.
8. Transfer Taxes. Holders whose Existing
Notes are tendered for exchange will not be obligated to pay any
transfer taxes in connection therewith. If, however, the
Exchange Notes are delivered to, or are to be issued in the name
of, any person other than the Holder of the Existing Notes
tendered hereby, or if tendered Existing Notes are registered in
the name of any person other than the person signing this Letter
of Transmittal, or if a transfer tax is imposed for any reason
other than the exchange of Existing Notes in connection with the
Exchange Offer, the amount of any such transfer taxes (whether
imposed on the Holder or any other persons) will be payable by
the Holder. If satisfactory evidence of payment of such taxes or
exemption therefrom is not submitted herewith, the amount of
such transfer taxes will be billed directly to such Holder.
9. Special Issuance and Delivery
Instructions. If the Exchange Notes are to be
issued, or if any Existing Notes not tendered for exchange are
to be issued or sent to someone other than the Holder or to an
address other than that shown above, the appropriate boxes on
this Letter of Transmittal should be completed. Holders of
Existing Notes tendering
10
Existing Notes by book-entry transfer may request that Existing
Notes not exchanged be credited to such account maintained at
DTC as such Holder may designate.
10. Irregularities. All questions as to
the validity, form, eligibility (including time of receipt),
compliance with conditions, acceptance and withdrawal of
tendered Existing Notes will be determined by the Company in its
sole discretion, which determination shall be final and binding.
The Company reserves the absolute right to reject any and all
Existing Notes not properly tendered or any Existing Notes the
Company’s acceptance of which would, in the opinion of
counsel for the Company, be unlawful. The Company also reserves
the right to waive any defects, irregularities or conditions of
tender as to particular Existing Notes. The Company’s
interpretation of the terms and conditions of the Exchange Offer
(including the instructions in this Letter of Transmittal) will
be final and binding on all parties. Unless waived, any defects
or irregularities in connection with tenders of Existing Notes
must be cured within such time as the Company shall determine.
Although the Company intends to notify Holders of defects or
irregularities with respect to tenders of Existing Notes,
neither the Company, the Exchange Agent nor any other person
shall incur any liability for failure to give such notification.
Tenders of Existing Notes will not be deemed to have been made
until such defects or irregularities have been cured or waived.
Any Existing Notes received by the Exchange Agent that are not
properly tendered and as to which the defects or irregularities
have not been cured or waived will be returned by the Exchange
Agent to the tendering holders, unless otherwise provided in
this Letter of Transmittal, promptly following the Expiration
Date.
11. Waiver of Conditions. The Company
reserves the absolute right to waive, amend or modify certain of
the specified conditions as described under “The Exchange
Offer — Conditions” in the Prospectus in the case
of any Existing Notes tendered (except as otherwise provided in
the Prospectus).
12. Mutilated, Lost, Stolen or Destroyed Existing
Notes. Any tendering Holder whose Existing Notes
have been mutilated, lost, stolen or destroyed, should contact
the Exchange Agent at the address indicated herein for further
instructions.
13. Requests for Information or Additional
Copies. Requests for information or for
additional copies of the Prospectus and this Letter of
Transmittal may be directed to the Exchange Agent at the address
or telephone number set forth on the cover of this Letter of
Transmittal.
IMPORTANT: This Letter of Transmittal (or a
facsimile thereof) together with certificates, or confirmation
of book-entry or the Notice of Guaranteed Delivery, and all
other required documents must be received by the Exchange Agent
prior the Expiration Date.
11
TO BE
COMPLETED BY ALL TENDERING HOLDERS
(See Instruction 7)
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PAYOR’S NAME:
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SUBSTITUTE Form W-9
Department of the Treasury Internal Revenue Service
Payor’s Request for Taxpayer Identification Number (“TIN”) and Certification
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Part 1 — PLEASE PROVIDE YOUR TIN IN THE
BOX AT THE RIGHT AND CERTIFY BY SIGNING AND DATING BELOW. For
individuals this is your Social Security Number
(“SSN”). For a sole proprietor, a resident alien, a
disregarded entity, or if your account is in more than one name,
see enclosed
W-9
Guidelines. For other entities, it is your Employer
Identification Number (“EIN”). If you do not have a
number, see “Obtaining a Number” by consulting the
enclosed W-9
Guidelines.
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TIN: Social Security Number
OR Employer Identification Number
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Part 2 — Awaiting
TIN. o
(If you check the box in Part 2, also complete the
“Certificate of Awaiting Taxpayer Identification
Number” below.)
Part 3 — Exempt
Payee. o
(Check the box in Part 3 if you are an exempt payee.)
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CERTIFICATION — 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),
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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 (the
“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.
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Certification Instructions — You must cross out
item (2) of the above certification if you have been
notified by the IRS that you are currently subject to backup
withholding because of underreporting of interest or dividends
on your tax return and you have not received another
notification from the IRS that you are no longer subject to
backup withholding.
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Signature of U.S.
Person
Date
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Name (as shown on your tax return)
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PLEASE
SIGN
HERE
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Business name (if different from above)
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Address
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City
State
Zip
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Check the appropriate box to indicate your status:
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o Individual/Sole
Proprietor o C
Corporation
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o LLC
(Enter the tax classification
(C = C Corporation, S = S Corporation
P = partnership
)) o S
Corporation
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o Partnership o Trust/Estate o Other
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NOTE: FAILURE TO COMPLETE AND RETURN THIS
FORM MAY RESULT IN BACKUP WITHHOLDING ON ANY PAYMENTS MADE
TO YOU ON ACCOUNT OF THE EXCHANGE NOTES. IN
12
ADDITION, FAILURE TO PROVIDE SUCH INFORMATION MAY RESULT IN A
PENALTY IMPOSED BY THE IRS. PLEASE REVIEW THE ENCLOSED
GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER
ON SUBSTITUTE
FORM W-9
FOR ADDITIONAL DETAILS.
YOU MUST
COMPLETE THE FOLLOWING CERTIFICATE IF YOU CHECKED
THE BOX IN PART 2 OF SUBSTITUTE
FORM W-9.
CERTIFICATE OF AWAITING TAXPAYER IDENTIFICATION NUMBER
I certify, under penalties of perjury, that a taxpayer
identification number has not been issued to me, and either
(a) I have mailed or delivered an application to receive a
taxpayer identification number to the appropriate Internal
Revenue Service Center or Social Security Administration Office
or (b) I intend to mail or deliver an application in the
near future. I understand that if I do not provide a taxpayer
identification number by the time of payment, the payor may
withhold a percentage (currently 28%) of all reportable payments
paid to my account until I provide a number. I understand that
if I do not provide a taxpayer identification number to the
payor within 60 days of the payor’s receipt of this
form, such retained amounts will be remitted to the Internal
Revenue Service as backup withholding and the specified rate of
all reportable payments made to me thereafter will be withheld
and remitted to the Internal Revenue Service until I provide a
taxpayer identification number.
13
GUIDELINES
FOR CERTIFICATION OF TAXPAYER IDENTIFICATION
NUMBER ON SUBSTITUTE
FORM W-9
General Instructions. All section references
are to the Internal Revenue Code unless otherwise stated.
U.S. person. 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 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.
For federal tax purposes you are considered a U.S. person
if you are:
1. An individual who is a citizen or resident of the United
States,
2. A partnership, corporation, company, or association
created or organized in the United States or under the laws of
the United States, or
3. Any estate (other than a foreign estate) or domestic
trust. See Treasury regulations
section 301.7701-7
for additional information.
Partners and partnerships must consult their own tax advisors
regarding the application of these rules to them.
Foreign person. If you are a foreign person,
do not use Substitute
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 recipient 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 Substitute
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 Substitute
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 a percentage of such payments. This is called
“backup withholding.” Payments that may be subject to
14
backup withholding include 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, or
2. You do not certify your TIN when required (see the Part
II instructions below for details), or
3. The IRS tells the requester that you furnished an
incorrect TIN, or
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.
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 on 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/disregarded entity
name” line.
Partnership, C Corporation, or
S Corporation. Enter the entity’s name
on the “Name” line and any business, trade, or
“doing business as (DBA) name” on the “Business
name/disregarded entity name” line.
Disregarded entity. Enter the owner’s
name on the “Name” line. The name of the entity
entered on the “Name” line should never be a
disregarded entity. The name on the “Name” line must
be the name shown on the income tax return on which the income
will be reported. For example, if a foreign LLC that is treated
as a disregarded entity for U.S. federal tax purposes has a
domestic owner, the domestic owner’s name is required to be
provided on the “Name” line. If the direct owner of
the entity is also a disregarded entity, enter the first owner
that is not disregarded for federal tax purposes. Enter the
disregarded entity’s name on the “Business
name/disregarded entity name” line. If the owner of the
disregarded entity is a foreign person, you must complete an
appropriate
Form W-8.
15
Note. Check the appropriate box for the
federal tax classification of the person whose name is entered
on the “Name” line (Individual/sole proprietor,
Partnership, C Corporation, S Corporation, Trust/estate).
Limited Liability Company (LLC). If the person
identified on the “Name” line is an LLC, check the
“Limited liability company” box only and enter the
appropriate code for the tax classification in the space
provided. If you are an LLC that is treated as a partnership for
federal tax purposes, enter “P” for partnership. If
you are an LLC that has filed a Form 8832 or a
Form 2553 to be taxed as a corporation, enter “C”
for C corporation or “S” for S corporation. If
you are an LLC that is disregarded as an entity separate from
its owner under Regulation
section 301.7701-3
(except for employment and excise tax), do not check the LLC box
unless the owner of the LLC (required to be identified on the
“Name” line) is another LLC that is not disregarded
for federal tax purposes. If the LLC is disregarded as an entity
separate from its owner, enter the appropriate tax
classification of the owner identified on the “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/disregarded entity name” line.
Exempt From Backup Withholding
If you are exempt, enter your name as described above and check
the appropriate box for your status, then check the
“Exempt” box under the taxpayer identification number
and 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.
Exempt payees. Backup withholding is not
required on any payments made to the following payees:
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
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5.
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An international organization or any of its agencies or
instrumentalities.
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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.
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The chart below shows types of payments that may be exempt from
backup withholding. The chart applies to the exempt recipients
listed above, 1 through 15.
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THEN the payment is exempt
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IF the payment is for . . .
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for . . .
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Interest and dividend payments
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All exempt recipients except for 9
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Broker transactions
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Exempt recipients 1 through 5 and 7 through 13. Also C
Corporations.
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Barter exchange transactions and patronage dividends
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Exempt recipients 1 through 5
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Payments over $600 required to be reported and direct sales over
$5,000(1)
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Generally, exempt recipients 1 through 7 (2)
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See
Form 1099-MISC,
Miscellaneous Income, and its instructions. |
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However, 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. |
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, enter the owner’s SSN (or EIN, if
the owner has one). Do not enter the disregarded entity’s
EIN. If the LLC is a corporation or partnership, enter the
entity’s EIN.
Note. See the chart below 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.socialsecurity.gov/online/ss-5.pdf. 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 Numbers (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 Substitute
Form W-9
but do not have a TIN, fill out the box entitled
“CERTIFICATE OF AWAITING TAXPAYER IDENTIFICATION
NUMBER.”
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 Substitute
Form W-9.
For a joint account, only the person whose TIN is shown in
Part I should sign (when required). Exempt recipients, see
Exempt From Backup Withholding above.
Signature requirements. Complete the
certification as indicated in 1 through 4 below.
1. Interest, dividend, broker, and barter exchange
accounts opened after 1984 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.
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2. Real estate transactions. You must
sign the certification. You may cross out item 2 of the
certification.
3. 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).
4. 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.
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.
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Individual
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The individual
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2.
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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 account(1)
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3.
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Custodian account of a minor (Uniform Gift to Minors Act)
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The minor(2)
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4.
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a. The usual revocable savings trust (grantor is also trustee)
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The grantor-trustee(1)
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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 owner(1)
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5.
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Sole proprietorship or disregarded entity owned by an individual
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The owner(3)
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6.
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Grantor trust filing under Optional Form 1099 Filing Method 1
(see Regulation section 1.671-4(b)(2)(i)(A))
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The grantor(*)
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For this type of account:
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Give name and EIN of:
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7.
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Disregarded entity not owned by an individual
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The owner(3)
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8.
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A valid trust, estate, or pension trust
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Legal entity(4)
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9.
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Corporate or LLC electing corporate status on Form 8832
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The corporation
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10.
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Association, club, religious, charitable, educational, or other
tax-exempt organization
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The organization
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11.
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Partnership or multi-member LLC
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The partnership
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12.
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A broker or registered nominee
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The broker or nominee
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13.
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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
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The public entity
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14.
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Grantor trust filing under the Form 1041 Filing Method or the
Optional Form 1099 Filing Method 2 (see Regulation section
1.671-4(b)(2)(i)(B))
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The trust
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(1)
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List first and circle the name of
the person whose number you furnish. If only one person on a
joint account has an SSN, that person’s number must be
furnished.
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(2)
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Circle the minor’s name and
furnish the minor’s SSN.
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(3)
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You must show your individual name
and you may also enter your business or “DBA” name on
the second name line. You may use either your SSN or EIN (if you
have one). If you are a sole proprietor, the IRS encourages you
to use your SSN.
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(4)
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List first and circle the name of
the legal trust, estate, or pension trust. (Do not furnish the
TIN of the personal representative or trustee unless the legal
entity itself is not designated in the account title.)
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(*)
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Note. Grantor also must provide a
Form W-9
to trustee of trust.
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Note. If no name is circled when more than one
name is listed, the number will be considered to be that of the
first name listed.
18
Privacy
Act Notice
Section 6109 of the Internal Revenue Code requires you to
provide your correct IN to persons who must file information
returns with the IRS to report interest, dividends, and certain
other income paid to you, mortgage interest you paid, the
acquisition or abandonment of secured property, cancellation of
debt, or contributions you made to an IRA, or Archer MSA or HSA.
The IRS uses the numbers for identification purposes and to help
verify the accuracy of your tax return. The IRS may also provide
this information to the Department of Justice for civil and
criminal litigation, and to cities, states, and the District of
Columbia to carry out their tax laws. The IRS may also disclose
this information to other countries under a tax treaty, to
federal and state agencies to enforce federal nontax criminal
laws, or to federal law enforcement and intelligence agencies to
combat terrorism. You must provide your TIN whether or not you
are required to file a tax return. Payers must generally
withhold a percentage of taxable interest, dividend, and certain
other payments to a payee who does not give a TIN to a payer.
FOR ADDITIONAL INFORMATION CONTACT YOUR TAX ADVISOR OR THE
INTERNAL REVENUE SERVICE.
19
ANNEX A
Guarantors
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Jurisdiction of Incorporation or
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Guarantor
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Organization
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Grifols, S.A.
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Spain
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Grifols Biologicals Inc.
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Delaware, United States
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Biomat USA, Inc.
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Delaware, United States
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Grifols Therapeutics Inc.
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Delaware, United States
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Talecris Plasma Resources, Inc.
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Delaware, United States
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Instituto Grifols, S.A.
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Spain
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Diagnostic Grifols, S.A.
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Spain
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Movaco, S.A.
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Spain
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Laboratorios Grifols, S.A.
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Spain
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Grifols Italia, S.p.A.
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Italy
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Grifols Deutschland GmbH
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Germany
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20