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Federal tax classification *

Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate Limited liability company (LLC) Other

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; and
The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

I certify that the information provided above is true and correct *

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