Form W-8 Certificate of Foreign Status

1 INSTRUCTIONS TO PRINTERSFORM W-8, PAGE 1 of 2 MARGINS: TOP 1 2", CENTER : HEAD to HEADPAPER: WHITE WRITING, SUB. : BLACKFLAT SIZE: 81 2" 3 11"PERFORATE: (NONE) Certificate of Foreign StatusW-8 Form(Rev. November 1992)Department of the TreasuryInternal Revenue ServiceName of owner (If joint account, also give joint owner s name.) (See Specific Instructions.) taxpayer identification number (if any)Permanent address (See Specific Instructions.) (Include apt. or suite no.)City, province or state, postal code, and countryCurrent mailing address, if different from permanent address (Include apt. or suite no., or box if mail is not delivered to street address.)Please print or typeCity, town or post office, state, and ZIP code (If Foreign address, enter city, province or state, postal code, and country.)

2 List account informationhere (Optional, seeSpecific Instructions.)Account typeAccount numberNotice of Change in Status . To notify the payer, mortgage interest recipient, broker, or barter exchange that you no longerqualify for exemption, check here If you check this box, reporting will begin on the account(s) (Check applicable box(es)). Under penalties of perjury, I certify that:For INTEREST PAYMENTS, I am not a citizen or resident (or I am filing for a Foreign corporation, partnership,estate, or trust).PleaseSignHereFor BROKER TRANSACTIONS or BARTER EXCHANGES, I am an exempt Foreign person as defined in theinstructions Pub. 519, Tax Guide for Aliens,for more information on resident andnonresident alien taxpayer identification number orForm W-8 or substitute form must be givento the payers of certain income.

3 If ataxpayer identification number or FormW-8 or substitute form is not provided orthe wrong taxpayer identification number isprovided, these payers may have towithhold 20% of each payment ortransaction. This is called Instructions(Section references are to the InternalRevenue Code unless otherwise noted.)Exempt Foreign PersonUse Form W-8 or a substitute formcontaining a substantially similar statementto tell the payer, mortgage interestrecipient, middleman, broker, or barterexchange that you are a nonresident alienindividual, Foreign entity, or exempt foreignperson not subject to certain return reporting or backupwithholding You are a nonresident alien individualor a Foreign corporation, partnership,estate, or trust,3.

4 You are neither engaged, nor plan tobe engaged during the year, in a or business that has effectivelyconnected gains from transactions with abroker or barter payments subject to backupwithholding rules are: Interest payments under section 6049(a).Caution: Form W-8 does not exempt thepayee from the 30% (or lower treaty)nonresident withholding rates. Dividend payments under sections6042(a) and 6044. Other payments ( , royalties andpayments from brokers and barterexchanges) under sections 6041, 6041A(a),6045, 6050A, and Alien IndividualNote: If you are a nonresident alienindividual married to a citizen orresident and have made an election undersection 6013(g) or (h), you are treated as resident and may not use Form backup withholding occurs, an exemptforeign person who is a nonresident alienindividual may get a refund by filing Form1040NR, Nonresident Alien IncomeTax Return, with the Internal Revenue The individual was a lawful permanentresident of the United States at any timeduring the calendar year, that is, the alienheld an immigrant visa (a green card ), orWhen To File.

5 File Form W-8 orsubstitute form before a payment is , the payer may have to withholdand send part of the payment to theInternal Revenue Service (see BackupWithholding below). This Certificate The individual was physically present inthe United States on:(1) atleast 31 days during the calendaryear, and(2) 183 days or more during the currentyear and the 2 preceding calendar years(counting all the days of physical presencein the current year, one-third the number ofdays of presence in the first precedingyear, and only one-sixth of the number ofdays in the second preceding year).Where To File. File this form with thepayer of the qualifying income who is thewithholding agent (see Withholding Agenton page 2). Keep a copy for your ownrecords.

6 (Continued on back.)FormW-8(Rev. 11-92)5 Cat. No. 10230 MAccount numberAccount typeFor DIVIDENDS, I am not a citizen or resident (or I am filing for a Foreign corporation, partnership, estate, ortrust).Filing Instructions2. You are an individual who has notbeen, and plans not to be, present in theUnited States for a total of 183 days ormore during the calendar year, andIf you do not meet the requirements of 2or 3 above, you may instead certify onForm 1001, Ownership, Exemption, orReduced Rate Certificate , that your countryhas a tax treaty with the United States thatexempts your transactions from : On January 1, 1993, the backupwithholding rate increases from 20% to31%.Backup SPECIFICATIONSTO BE REMOVED BEFORE PRINTINGDO NOT PRINT DO NOT PRINT DO NOT PRINT DO NOT PRINTTLS, have youtransmitted all Rtext files for thiscycle update?

7 DateActionRevised to printFor income tax purposes, nonresidentalien individual means an individual who isneither a citizen nor , an alien is considered to be resident if:For purposes of this form, you are an exempt Foreign person for a calendaryear in which:generally remains in effect for threecalendar years. However, the payer mayrequire you to file a new Certificate eachtime a payment is made to TO PRINTERSFORM W-8, PAGE 2 of 2 MARGINS: TOP 1 2", CENTER : HEAD TO HEADPAPER: WHITE WRITING, SUB. : BLACKFLAT SIZE: 81 2" 3 11"PERFORATE: NONEPage2 Form W-8 (Rev. 11-92)Payments to account holders who areforeign persons (nonresident alienindividuals, Foreign corporations,partnerships, estates, or trusts) generallyare not subject to reportingrequirements.

8 Also, Foreign persons are notgenerally required to have a TIN, nor arethey subject to any backup withholdingbecause they do not furnish a TIN to apayer or each owner of a joint account is aforeign person, each should sign aseparate Form obligations. The interest frombearer obligations targeted to foreignmarkets is treated as portfolio interest andis not subject to 30% withholding. FormW-8 or substitute form is not of Change in Status . If youbecome a citizen or resident after youhave filed Form W-8 or substitute form, oryou cease to be an exempt Foreign person,you must notify the payer in writing within30 days of your change in or Barter Exchanges. Incomefrom transactions with a broker or barterexchanges is subject to reporting rules andbackup withholding unless Form W-8 orsubstitute form is filed to notify the brokeror barter exchange that you are an exemptforeign person as defined on page notify the payer, you may check thebox in the space provided on this form oruse the method prescribed by the , Foreign persons with incomeeffectively connected with a trade orbusiness in the United States (incomesubject to regular (graduated) income tax),must have a TIN.

9 To apply for a TIN, useForm SS-4, Application for EmployerIdentification Number, available from localInternal Revenue Service offices, or FormSS-5, Application for a Social SecurityCard, available from local Social SecurityAdministration will then begin on theaccount(s) listed and backup withholdingmay also begin unless you certify to thepayer that:(1) The taxpayer identificationnumber you have given is correct, and(2) The Internal Revenue Service has notnotified you that you are subject to backupwithholding because you failed to reportcertain RulesYou may use Form W-9, Request forTaxpayer Identification Number andCertification, to make these Interest. For purposes of thereporting rules, mortgage interest isinterest paid on a mortgage to a personengaged in a trade or business originatingmortgages in the course of that trade orbusiness.

10 A mortgage interest recipient isone who receives interest on a mortgagethat was acquired in the course of a tradeor an account is no longer active, you donot have to notify a payer of your changein Status unless you also have anotheraccount with the same payer that is Taxpayer Identification Number. Ifyou have a taxpayer identificationnumber, enter your number in this space(see the discussion earlier).False Certificate . If you file a falsecertificate when you are not entitled to theexemption from withholding or reporting,you may be subject to fines and/orimprisonment under perjury Address. Enter yourcomplete address in the country where youreside permanently for income interest is not subject tobackup withholding rules, but is subject toreporting requirements under section6050H.