Under penalties of perjury, I certify that:
- 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
- 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
- I am a U.S. citizen or other U.S. person (defined below); and
*A citizen or resident of the United States. A domestic partnership. A domestic corporation.
- The FATCA code(s) entered on this form (if any) indicated that I am exempt from FATCA reporting is correct.
Inquires contact ETANA at:email@example.com