EMPLOYEE SAMPLE PDF FORMS by NikFozzar

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									***EMPLOYEE COMPLETE FORM FOR DIRECT DEPOSIT
             CONSUMER/EMPLOYER REPRESENTATIVE




                        EMPLOYEE


                          DATE OF AGREEMENT




                                      EMPLOYEE PAY




EMPLOYEE SIGNATURE                              TODAY'S DATE


CONSUMER SIGNATURE                              TODAY'S DATE
***EMPLOYEE FILL-OUT FORM COMPLETELY
                                                                                                                                OMB No. 1615-0047; Expires 06/30/08
Department of Homeland Security                                                                                                    Form I-9, Employment
U.S. Citizenship and Immigration Services                                                                                          Eligibility Verification
Please read instructions carefully before completing this form. The instructions must be available during completion of this form.

ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work eligible individuals. Employers CANNOT
specify which document(s) they will accept from an employee. The refusal to hire an individual because the documents have a
future expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Verification. To be completed and signed by employee at the time employment begins.
Print Name:     Last                                             First                                  Middle Initial         Maiden Name


Address (Street Name and Number)                                                                        Apt. #                 Date of Birth (month/day/year)


City                                                     State                                          Zip Code               Social Security #


                                                                           I attest, under penalty of perjury, that I am (check one of the following):
I am aware that federal law provides for                                              A citizen or national of the United States
imprisonment and/or fines for false statements or                                    A lawful permanent resident (Alien #) A
use of false documents in connection with the                                      An alien authorized to work until
completion of this form.
                                                                                   (Alien # or Admission #)
Employee's Signature                                                                                                           Date (month/day/year)


Preparer and/or Translator Certification. (To be completed and signed if Section 1 is prepared by a person other than the employee.) I attest, under
penalty of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the information is true and correct.
            Preparer's/Translator's Signature                                              Print Name


            Address (Street Name and Number, City, State, Zip Code)                                                          Date (month/day/year)


Section 2. Employer Review and Verification. To be completed and signed by employer. Examine one document from List A OR
examine one document from List B and one from List C, as listed on the reverse of this form, and record the title, number and
expiration date, if any, of the document(s).
                   List A                    OR                List B                    AND                       List C
Document title:

Issuing authority: EMPLOYER MUST COMPLETE THIS SECTION USING THE LIST OF ACCEPTED
Document #:
                    DOCUMENTS ON THE FOLLOWING PAGE.
       Expiration Date (if any):
Document #:

       Expiration Date (if any):
CERTIFICATION - I attest, under penalty of perjury, that I have examined the document(s) presented by the above-named employee, that
the above-listed document(s) appear to be genuine and to relate to the employee named, that the employee began employment on
(month/day/year)                  and that to the best of my knowledge the employee is eligible to work in the United States. (State
employment agencies may omit the date the employee began employment.)
Signature of Employer or Authorized Representative                   Print Name                                                  Title

EMPLOYER MUST SIGN CERTIFYING THAT THE ABOVE INFORMATION IS TRUE TO THE BEST
                                                      Date (month/day/year)
Business or Organization Name and Address (Street Name and Number, City, State, Zip Code)
OF HIS/HER KNOWLEDGE.
Section 3. Updating and Reverification. To be completed and signed by employer.
A. New Name (if applicable)                                                                                      B. Date of Rehire (month/day/year) (if applicable)


C. If employee's previous grant of work authorization has expired, provide the information below for the document that establishes current employment eligibility.
            Document Title:                                                  Document #:                                      Expiration Date (if any):
l attest, under penalty of perjury, that to the best of my knowledge, this employee is eligible to work in the United States, and if the employee presented
document(s), the document(s) l have examined appear to be genuine and to relate to the individual.
Signature of Employer or Authorized Representative                                                                     Date (month/day/year)


                                                                                                                                                   Form I-9 (Rev. 06/05/07) N
                                      LISTS OF ACCEPTABLE DOCUMENTS

               LIST A                                      LIST B                                      LIST C
     Documents that Establish Both                Documents that Establish                      Documents that Establish
       Identity and Employment                           Identity                                Employment Eligibility
               Eligibility         OR                                                AND
1. U.S. Passport (unexpired or expired)   1. Driver's license or ID card issued by     1. U.S. Social Security card issued by
                                             a state or outlying possession of the        the Social Security Administration
                                             United States provided it contains a         (other than a card stating it is not
                                             photograph or information such as            valid for employment)
                                             name, date of birth, gender, height,
                                             eye color and address

2. Permanent Resident Card or Alien       2. ID card issued by federal, state or       2. Certification of Birth Abroad
   Registration Receipt Card (Form           local government agencies or                 issued by the Department of State
   I-551)                                    entities, provided it contains a             (Form FS-545 or Form DS-1350)
                                             photograph or information such as
                                             name, date of birth, gender, height,
                                             eye color and address
3. An unexpired foreign passport with a   3. School ID card with a photograph          3. Original or certified copy of a birth
   temporary I-551 stamp                                                                  certificate issued by a state,
                                                                                          county, municipal authority or
                                                                                          outlying possession of the United
                                                                                          States bearing an official seal
4. An unexpired Employment                4. Voter's registration card                 4. Native American tribal document
   Authorization Document that contains
   a photograph
   (Form I-766, I-688, I-688A, I-688B)    5. U.S. Military card or draft record        5. U.S. Citizen ID Card (Form I-197)

5. An unexpired foreign passport with     6. Military dependent's ID card              6. ID Card for use of Resident
   an unexpired Arrival-Departure                                                         Citizen in the United States (Form
   Record, Form I-94, bearing the same    7. U.S. Coast Guard Merchant Mariner            I-179)
   name as the passport and containing       Card
   an endorsement of the alien's
   nonimmigrant status, if that status    8. Native American tribal document           7. Unexpired employment
   authorizes the alien to work for the                                                   authorization document issued by
   employer                               9. Driver's license issued by a Canadian        DHS (other than those listed under
                                             government authority                         List A)


                                               For persons under age 18 who
                                                  are unable to present a
                                                  document listed above:

                                          10. School record or report card

                                          11. Clinic, doctor or hospital record


                                          12. Day-care or nursery school record

  Illustrations of many of these documents appear in Part 8 of the Handbook for Employers (M-274)
                                                                                                    Form I-9 (Rev. 06/05/07) N Page 2
***EMPLOYEE PLEASE READ THIS AND FILL-OUT SECTION I AND II ACCORDINGLY




 EMPLOYEE PRINT NAME                        EMPLOYEE SIGNATURE


                                               TODAY'S DATE
           EMPLOYEE NAME
              START DATE




EMPLOYEE SIGNATURE                                    TODAY'S DATE


EMPLOYEE PRINT NAME




                     AND DEVELOPMENTAL DISABILITIES
***EMPLOYEE FILL-OUT THIS SECTION COMPLETELY




CONSUMER/EMPLOYER REPRESENTATIVE INFORMATION




  EMPLOYEE SIGNATURE                           TODAY'S DATE
                                                             adjustments to income, or two-earner/multiple                  payments using Form 1040-ES, Estimated Tax
  Form W-4 (2008)                                            job situations. Complete all worksheets that                   for Individuals. Otherwise, you may owe
                                                             apply. However, you may claim fewer (or zero)                  additional tax. If you have pension or annuity
  Purpose. Complete Form W-4 so that your                    allowances.                                                    income, see Pub. 919 to find out if you should
  employer can withhold the correct federal income           Head of household. Generally, you may claim                    adjust your withholding on Form W-4 or W-4P.
  tax from your pay. Consider completing a new               head of household filing status on your tax                   Two earners or multiple jobs. If you have a
  Form W-4 each year and when your personal or               return only if you are unmarried and pay more                 working spouse or more than one job, figure
  financial situation changes.                               than 50% of the costs of keeping up a home                    the total number of allowances you are entitled
  Exemption from withholding. If you are                     for yourself and your dependent(s) or other                   to claim on all jobs using worksheets from only
  exempt, complete only lines 1, 2, 3, 4, and 7              qualifying individuals. See Pub. 501,                         one Form W-4. Your withholding usually will
  and sign the form to validate it. Your exemption           Exemptions, Standard Deduction, and Filing                    be most accurate when all allowances are
  for 2008 expires February 16, 2009. See                    Information, for information.                                 claimed on the Form W-4 for the highest
  Pub. 505, Tax Withholding and Estimated Tax.               Tax credits. You can take projected tax                       paying job and zero allowances are claimed on
                                                             credits into account in figuring your allowable               the others. See Pub. 919 for details.
  Note. You cannot claim exemption from
  withholding if (a) your income exceeds $900                number of withholding allowances. Credits for                 Nonresident alien. If you are a nonresident
  and includes more than $300 of unearned                    child or dependent care expenses and the                      alien, see the Instructions for Form 8233
  income (for example, interest and dividends)               child tax credit may be claimed using the                     before completing this Form W-4.
  and (b) another person can claim you as a                  Personal Allowances Worksheet below. See                      Check your withholding. After your Form W-4
  dependent on their tax return.                             Pub. 919, How Do I Adjust My Tax                              takes effect, use Pub. 919 to see how the
  Basic instructions. If you are not exempt,                 Withholding, for information on converting                    dollar amount you are having withheld
  complete the Personal Allowances                           your other credits into withholding allowances.               compares to your projected total tax for 2008.
  Worksheet below. The worksheets on page 2                  Nonwage income. If you have a large amount                    See Pub. 919, especially if your earnings
  adjust your withholding allowances based on                of nonwage income, such as interest or                        exceed $130,000 (Single) or $180,000
  itemized deductions, certain credits,                      dividends, consider making estimated tax                      (Married).
                                             Personal Allowances Worksheet (Keep for your records.)
  A Enter “1” for yourself if no one else can claim you as a dependent                                                                                                       A
                     ● You are single and have only one job; or
  B Enter “1” if:    ● You are married, have only one job, and your spouse does not work; or                                                                                 B
                     ● Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 or less.
  C Enter “1” for your spouse. But, you may choose to enter “-0-” if you are married and have either a working spouse or
    more than one job. (Entering “-0-” may help you avoid having too little tax withheld.)                                                    C
  D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return                                         D
  E Enter “1” if you will file as head of household on your tax return (see conditions under Head of household above)                         E
  F Enter “1” if you have at least $1,500 of child or dependent care expenses for which you plan to claim a credit                            F
    (Note. Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.)
  G Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.
    ● If your total income will be less than $58,000 ($86,000 if married), enter “2” for each eligible child.
    ● If your total income will be between $58,000 and $84,000 ($86,000 and $119,000 if married), enter “1” for each eligible
      child plus “1” additional if you have 4 or more eligible children.                                                                      G
  H Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.)     H
    For accuracy,      ● If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions
    complete all         and Adjustments Worksheet on page 2.
    worksheets         ● If you have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed
    that apply.          $40,000 ($25,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld.
                       ● If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.

                                    Cut here and give Form W-4 to your employer. Keep the top part for your records.

  Form     W-4                             Employee’s Withholding Allowance Certificate                                                                               OMB No. 1545-0074


  Department of the Treasury
  Internal Revenue Service
                                     Whether you are entitled to claim a certain number of allowances or exemption from withholding is
                                   subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.
                                                                                                                                                                        2008
   1     Type or print your first name and middle initial.    Last name                                                                      2    Your social security number
                 EMPLOYEE FILL OUT SECTION                                                                                 *
         Home address (number and street or rural route)                                   3
                                                                                                    Single         Married           Married, but withhold at higher Single rate.
                                                                                           Note. If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.
         City or town, state, and ZIP code                                                 4 If your last name differs from that shown on your social security card,
                                                                                             check here. You must call 1-800-772-1213 for a replacement card.

   5     Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) NUMBER    5                                                    FROM H
   6     Additional amount, if any, you want withheld from each paycheck                                                      6 $
   7     I claim exemption from withholding for 2008, and I certify that I meet both of the following conditions for exemption.
         ● Last year I had a right to a refund of all federal income tax withheld because I had no tax liability and
         ● This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.
         If you meet both conditions, write “Exempt” here                                                      7
  Under penalties of perjury, I declare that I have examined this certificate and to the best of my knowledge and belief, it is true, correct, and complete.
  Employee’s signature
  (Form is not valid
  unless you sign it.)                       EMPLOYEE SIGNATURE                                                 Date                          TODAY'S DATE
   8     Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.)             9 Office code (optional) 10      Employer identification number (EIN)
RESERVED FOR ASI WORKS, INC.                                                                                                                                                                    *
  For Privacy Act and Paperwork Reduction Act Notice, see page 2.                                               Cat. No. 10220Q                                      Form    W-4      (2008)
                                                                                                                                                                    Reset Form                       Print Form
                 MISSOURI DEPARTMENT OF REVENUE                                                                                                                          This certificate is for income tax withholding
                 TAXATION BUREAU                                                                                                                MO W-4                   and child support enforcement purposes only.
                                                                                                                                                  (REV. 11-2007)         PLEASE TYPE OR PRINT.
                 EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE
FULL NAME                                                                                                         SOCIAL SECURITY NUMBER                                                           SINGLE
                                                                                                                                                                            FILING
   EMPLOYEE FILL-OUT FORM COMPLETELY                                                                                                                                        STATUS                 MARRIED
                                                                                                                                                                                                   HEAD OF HOUSEHOLD
HOME ADDRESS (NUMBER AND STREET OR RURAL ROUTE)                                                                   CITY OR TOWN, STATE AND ZIP CODE




1. ALLOWANCE FOR YOURSELF: Enter 1 for yourself if your filing status
   is single, married, OR head of household. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. ALLOWANCE FOR YOUR SPOUSE: Does your spouse work?                                 Yes            No
   If YES, enter 0. If NO, enter 1 for your spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3. ALLOWANCE FOR DEPENDENTS: Enter the number of dependents you will claim on your tax return. Do not claim
   yourself or your spouse or dependents that your spouse has already claimed on his or her Form MO W-4. . . . . . . . . . . . . . . . . . . . 3

4. ADDITIONAL ALLOWANCES: You may claim additional allowances if you itemize your deductions
   or have other state tax deductions or credits that lower your tax. Enter the number of additional
   allowances you would like to claim. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

5. TOTAL NUMBER OF ALLOWANCES YOU ARE CLAIMING: Add Lines 1 through 4 and enter total here. . . . . . . . . . . . . . . . . . . . 5
6. ADDITIONAL WITHHOLDING: If you expect to have a balance due (as a result of interest income, dividends, income from a
   part-time job, etc.) on your tax return, you may request your employer to withhold an additional amount of tax from each
   pay period. To calculate the amount needed, divide the amount of the expected balance due by the number of pay periods
   in a year. Enter the additional amount to be withheld each pay period here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6                              $
7. EXEMPT STATUS: If you had a right to a refund of ALL of your Missouri income tax withheld last year because you had NO
   tax liability and this year you expect a refund of ALL Missouri income tax withheld because you expect to have NO tax liability,
   write “EXEMPT” on Line 7. See information below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Under penalties of perjury, I certify that I am entitled to the number of withholding allowances claimed on this certificate, or I am entitled to claim exempt status.
EMPLOYEE’S SIGNATURE (Form is not valid unless you sign it.)                                                                                                             DATE

   EMPLOYEE SIGNATURE                                                                                                                                                    TODAY'S DATE
                                                                                                                                                                         ___ ___ / ___ ___ / ___ ___ ___ ___
EMPLOYER’S NAME                                                                                                                                                          FEDERAL EMPLOYER IDENTIFICATION NUMBER
 RESERVED FOR ASI WORKS, INC.                                                                                                                                            ___ ___ ___ ___ ___ ___ ___ ___ ___
EMPLOYER’S ADDRESS                                                                                                                                                       MISSOURI TAX IDENTIFICATION NUMBER
                                                                                                                                                                         ___ ___ ___ ___ ___ ___ ___ ___
             NOTICE TO EMPLOYER: Within 20 days of hiring a new employee, send a copy of Form MO W-4 to the: Missouri Department of Revenue, P.O. Box 3340,
            Jefferson City, MO 65105-3340 or fax to (573) 526-8079. For additional information regarding new hire reporting, please visit www.dss.mo.gov/cse/newhire.htm.

                                                                                —EMPLOYEE INFORMATION—
                              YOU DO NOT PAY MISSOURI INCOME TAX ON ALL OF THE INCOME YOU EARN!
                                                 Visit www.dor.mo.gov to try our online withholding calculator.
  Deductions and exemptions reduce the amount of your taxable income. Form MO W-4 is completed so you can have as much “take-home pay” as possible with-
  out an income tax liability due to the state of Missouri when you file your return. Deductions and exemptions reduce the amount of your taxable income. If your
  income is less than the total of your personal exemption plus your standard deduction, you should mark “EXEMPT” on Line 7 above. The following amounts of
  your annual Missouri adjusted gross income will not be taxed by the state of Missouri when you file your individual income tax return.
                        Single                                                           Married Filing Combined                                                            Head of Household
        $2,100 — personal exemption                                          $ 4,200 — personal exemption                                                                 $ 3,500 — personal exemption
        $5,450 — standard deduction                                          $10,900 — standard deduction                                                                 $ 8,000 — standard deduction
        $7,550 — Total                                                       $15,100 — Combined Total (For both spouses)                                                  $11,500 — Total
        + $1,200 for each dependent                                          + $1,200 for each dependent                                                                  + $1,200 for each dependent
        + up to $5,000 for federal tax                                       + up to $10,000 for federal tax                                                              + up to $5,000 for federal tax
                                                                                              Items to Remember:
  • If your filing status is married filing combined and your spouse works, do not                                  • If you have more than one employer, you should claim a smaller number or no
    claim an exemption on Form MO W-4 for your spouse.                                                                allowances on each Form MO W-4 filed with employers other than your principal
  • If you and your spouse have dependents, please be sure only one of you claim                                      employer so the amount withheld will be closer to your amount of total tax.
    the dependents on your Form MO W-4. If both spouses claim the dependents as                                     • If you itemize your deductions, instead of using the standard deduction, the
    an allowance on Form MO W-4, it may cause you to owe additional Missouri                                          amount not taxed by Missouri may be a greater or lesser amount.
    income tax when you file your return.
MO 860-1598 (11-2007)
               MISSOURI DEPARTMENT OF REVENUE                                         FORM                       Reset Form               Print Form
               TAXATION BUREAU
               CERTIFICATE OF NONRESIDENCE/                                    MO W-4A                  THIS FORM MUST BE FILLED OUT
               ALLOCATION OF WITHHOLDING TAX                                     (REV. 11-2007)         BY OUT OF STATE EMPLOYEES
This form is to be completed by a nonresident who performs a determinable percentage of services within Missouri.
NAME                                                                            SOCIAL SECURITY NUMBER

                                                                                ___ ___ ___ - ___ ___ - ___ ___ ___ ___
ADDRESS                                                                         CITY, STATE, ZIP CODE



EMPLOYEE: THIS FORM TO BE FILED WITH EMPLOYER — DO NOT SEND TO DEPARTMENT OF REVENUE
I hereby certify that I am a nonresident of the State of Missouri, and reside at the address stated above and perform services partly within and partly without
Missouri. I estimate the proportion of services performed within Missouri and subject to the withholding tax to be        %. I will notify my employer within
10 days of any substantial change in proportion, or a change in status to resident of Missouri.
SIGNATURE                                                                                                                  DATE

                                                                                                                          __ __ / __ __ / __ __ __ __
EMPLOYER: For information on how this allocation may be determined, please refer to the Employer’s Tax Guide at www.dor.mo.gov/tax.

MO 860-2177 (11-2007)     This publication is available upon request in alternative accessible format(s). TDD (800) 735-2966
             EMPLOYEE NAME
***EMPLOYEE MUST SELECT BOX THAT APPLIES




 EMPLOYEE SIGNATURE                        TODAY'S DATE
AGENCY EMPLOYEES MUST FILL THIS FORM OUT
Form
(Rev. October 2007)
                                       W-9                                          Request for Taxpayer                                                                 Give form to the
                                                                                                                                                                         requester. Do not
Department of the Treasury
                                                                          Identification Number and Certification                                                        send to the IRS.
Internal Revenue Service
                                       Name (as shown on your income tax return)
                                                       AGENCY EMPLOYEE FILL-OUT ALL FORM
See Specific Instructions on page 2.




                                       Business name, if different from above
           Print or type




                                       Check appropriate box:       Individual/Sole proprietor          Corporation         Partnership
                                                                                                                                                                           Exempt
                                          Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership)                     payee
                                           Other (see instructions)
                                       Address (number, street, and apt. or suite no.)                                                        Requester’s name and address (optional)


                                       City, state, and ZIP code


                                       List account number(s) here (optional)


       Part I                                Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid                                                     Social security number
backup withholding. For individuals, this is 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.                                                                   or
 Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose                                                          Employer identification number
 number to enter.
      Part II                                Certification
Under penalties of perjury, I certify that:
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
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
3. I am a U.S. citizen or other U.S. person (defined below).
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.

Sign                                       Signature of
Here                                       U.S. person                AGENCY EMPLOYEE SIGNATURE                                            Date           TODAY'S DATE                               *
General Instructions                                                                                                 Definition of a U.S. person. For federal tax purposes, you are
                                                                                                                     considered a U.S. person if you are:
Section references are to the Internal Revenue Code unless
otherwise noted.                                                                                                     ● An individual who is a U.S. citizen or U.S. resident alien,
                                                                                                                     ● A partnership, corporation, company, or association created or
Purpose of Form                                                                                                      organized in the United States or under the laws of the United
A person who is required to file an information return with the                                                      States,
IRS must obtain your correct taxpayer identification number (TIN)                                                    ● An estate (other than a foreign estate), or
to report, for example, income paid to you, real estate                                                              ● A domestic trust (as defined in Regulations section
transactions, mortgage interest you paid, acquisition or                                                             301.7701-7).
abandonment of secured property, cancellation of debt, or
                                                                                                                     Special rules for partnerships. Partnerships that conduct a
contributions you made to an IRA.
                                                                                                                     trade or business in the United States are generally required to
   Use Form W-9 only if you are a U.S. person (including a                                                           pay a withholding tax on any foreign partners’ share of income
resident alien), to provide your correct TIN to the person                                                           from such business. Further, in certain cases where a Form W-9
requesting it (the requester) and, when applicable, to:                                                              has not been received, a partnership is required to presume that
  1. Certify that the TIN you are giving is correct (or you are                                                      a partner is a foreign person, and pay the withholding tax.
waiting for a number to be issued),                                                                                  Therefore, if you are a U.S. person that is a partner in a
                                                                                                                     partnership conducting a trade or business in the United States,
   2. Certify that you are not subject to backup withholding, or                                                     provide Form W-9 to the partnership to establish your U.S.
   3. Claim exemption from backup withholding if you are a U.S.                                                      status and avoid withholding on your share of partnership
exempt payee. If applicable, you are also certifying that as a                                                       income.
U.S. person, your allocable share of any partnership income from                                                        The person who gives Form W-9 to the partnership for
a U.S. trade or business is not subject to the withholding tax on                                                    purposes of establishing its U.S. status and avoiding withholding
foreign partners’ share of effectively connected income.                                                             on its allocable share of net income from the partnership
Note. If a requester gives you a form other than Form W-9 to                                                         conducting a trade or business in the United States is in the
request your TIN, you must use the requester’s form if it is                                                         following cases:
substantially similar to this Form W-9.
                                                                                                                     ● The U.S. owner of a disregarded entity and not the entity,
                                                                                                         Cat. No. 10231X                                               Form   W-9   (Rev. 10-2007)

								
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