Fillable Supplie r Wire Transfer Form (Washington University, Saint Louis)

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Supplie r Wire Transfer Form (Washington University, Saint Louis)

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Supplie

r Wire Transfer Form

Date: ______________________

Requesting Department Information:

Department Name: __________________________________________ Phone #: ________________________________________

Prepared by: _______________________________________________ Email address: ___________________________________

New Workday Supplier Yes No Update to Current Workday Supplier ID (if known) SU: _______________________

Supplier Name: _____________________________________________________________________________________________

Bank Information:

Bank Name: ________________________________________________________________________________________________

Bank Address: _______________________________________________________________________________________________

Bank City, State, Zip, Country/Prov: ______________________________________________________________________________

Account Name: _____________________________________________ Account Number: _________________________________

IBAN Number (European Transfer): ______________________________________________________________________________

Routing/ABA Number (Domestic/US Wire): _______________________________________________________________________

Swift/BIC Code: _____________________________________________ Sort Code: _______________________________________

Intermediary Bank Name:______________________________________________________________________________________

Intermediary Routing/ABA Number: _____________________________________________________________________________

Account Number (May be provided if intermediary bank is given): _____________________________________________________

Currency Type: ______________________________________________________________________________________________

Additional Information required (based on Country)

Australia BSB Code: __________________________________________________________________________________________

Canada Transit Code: _________________________________________________________________________________________

Canada Beneficiary Name: _____________________________________________________________________________________

Canada Beneficiary Address (no PO Box): _________________________________________________________________________

China CNAPS Code (CNY currency only): __________________________________________________________________________

Columbia NIT, contact name & phone number: ____________________________________________________________________

Germany BLZ Code: __________________________________________________________________________________________

India IFSC Code: _____________________________________________________________________________________________

Mexico CLABE number: _______________________________________________________________________________________

Supplier Contact

Name: ____________________________________________________ Title: ___________________________________________

Address: ___________________________________________________________________________________________________

City, State, Zip, Country/Prov: __________________________________________________________________________________

Phone #: __________________________________________________ Fax #: __________________________________________

Email address: ______________________________________________________________________________________________

Remittance Email Address: ____________________________________________________________________________________

The university’s standard payment terms are net 30 days. Requested payment terms _________. Why are different payment

terms needed: __________________________________________________________________________________________.

Once the supplier file is created in Workday with the wire information above, next step for non-PO suppliers is to create a Supplier

Invoice Request or Miscellaneous Payment Request.

Please send questions to CFU_AP_ACH@wustl.edu.

Please attach this form and a completed W-9 / W-8 to the create Miscellaneous Payee or Supplier function in Workday.

FAQ’s

What

is the IBAN?

The IBAN (International Bank Account Number) is used to uniquely identify a customer’s account held at a bank. It is a series of

alpha numeric characters that includes the bank account number and can be up to 34 characters long. Not all countries require an

IBAN. This is generally used for European countries.

What is intermediary bank and when is it necessary?

An intermediary bank is a large bank that serves on behalf of the beneficiary bank. In most cases, it has a relationship with a

smaller bank to assist in receiving foreign currency. This is necessary when US dollars are being sent to a small bank in a third-world

country. The intermediary bank exchanges the funds into foreign currency in order for the smaller bank to accept the wire transfer.

If your banking instructions provide an intermediary bank name, account numbers, and SWIFT code/ABA, please include that

information on the wire transfer request form.

Supplier Wire Transfer Form 12/21

Form W-9

(Rev. October 2018)

Department of the Treasury

Internal Revenue Service

Request for Taxpayer

Identification Number and Certification

Go to www.irs.gov/FormW9 for instructions and the latest information.

Give Form to the

requester. Do not

send to the IRS.

Print or type.

See Specific Instructions on page 3.

1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.

2 Business name/disregarded entity name, if different from above

3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the

following seven boxes.

Individual/sole proprietor or

single-member LLC

C Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)

Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check

LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is

another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that

is disregarded from the owner should check the appropriate box for the tax classification of its owner.

Other (see instructions)

4 Exemptions (codes apply only to

certain entities, not individuals; see

instructions on page 3):

Exempt payee code (if any)

Exemption from FATCA reporting

code (if any)

(Applies to accounts maintained outside the U.S.)

5 Address (number, street, and apt. or suite no.) See instructions.

6 City, state, and ZIP code

Requester’s name and address (optional)

7 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

backup withholding. For individuals, this is generally your social security number (SSN). However, for a

resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other

entities, it is your employer identification number (EIN). If you do not have a number, see How to get a

TIN, later.

Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and

Number To Give the Requester for guidelines on whose number to enter.

Social security number

––

Employer identification number

–

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); and

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

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 for Part II, later.

Sign

Here

Signature of

U.S. person

Date

General Instructions

Section references are to the Internal Revenue Code unless otherwise

noted.

Future developments. For the latest information about developments

related to Form W-9 and its instructions, such as legislation enacted

after they were published, go to www.irs.gov/FormW9.

Purpose of Form

An individual or entity (Form W-9 requester) who is required to file an

information return with the IRS must obtain your correct taxpayer

identification number (TIN) which may be your social security number

(SSN), individual taxpayer identification number (ITIN), adoption

taxpayer identification number (ATIN), or employer identification number

(EIN), to report on an information return the amount paid to you, or other

amount reportable on an information return. Examples of information

returns include, but are not limited to, the following.

• Form 1099-INT (interest earned or paid)

• Form 1099-DIV (dividends, including those from stocks or mutual

funds)

• Form 1099-MISC (various types of income, prizes, awards, or gross

proceeds)

• Form 1099-B (stock or mutual fund sales and certain other

transactions by brokers)

• Form 1099-S (proceeds from real estate transactions)

• Form 1099-K (merchant card and third party network transactions)

• Form 1098 (home mortgage interest), 1098-E (student loan interest),

1098-T (tuition)

• Form 1099-C (canceled debt)

• Form 1099-A (acquisition or abandonment of secured property)

Use Form W-9 only if you are a U.S. person (including a resident

alien), to provide your correct TIN.

If you do not return Form W-9 to the requester with a TIN, you might

be subject to backup withholding. See What is backup withholding,

later.

Cat. No. 10231X

Form W-9 (Rev. 10-2018)

Page 2

By signing the filled-out form, you:

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. If applicable, you are also certifying that as a U.S. person, your

allocable share of any partnership income from a U.S. trade or business

is not subject to the withholding tax on foreign partners' share of

effectively connected income, and

4. Certify that FATCA code(s) entered on this form (if any) indicating

that you are exempt from the FATCA reporting, is correct. See What is

FATCA reporting, later, for further information.

Note: If you are a U.S. person and a requester gives you a form other

than Form W-9 to request your TIN, you must use the requester’s form if

it is substantially similar to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are

considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien;

• A partnership, corporation, company, or association created or

organized in the United States or under the laws of the United States;

• An estate (other than a foreign estate); or

• A domestic trust (as defined in Regulations section 301.7701-7).

Special rules for partnerships. Partnerships that conduct a trade or

business in the United States are generally required to pay a withholding

tax under section 1446 on any foreign partners’ share of effectively

connected taxable income from such business. Further, in certain cases

where a Form W-9 has not been received, the rules under section 1446

require a partnership to presume that a partner is a foreign person, and

pay the section 1446 withholding tax. Therefore, if you are a U.S. person

that is a partner in a partnership conducting a trade or business in the

United States, provide Form W-9 to the partnership to establish your

U.S. status and avoid section 1446 withholding on your share of

partnership income.

In the cases below, the following person must give Form W-9 to the

partnership for purposes of establishing its U.S. status and avoiding

withholding on its allocable share of net income from the partnership

conducting a trade or business in the United States.

• In the case of a disregarded entity with a U.S. owner, the U.S. owner

of the disregarded entity and not the entity;

• In the case of a grantor trust with a U.S. grantor or other U.S. owner,

generally, the U.S. grantor or other U.S. owner of the grantor trust and

not the trust; and

• In the case of a U.S. trust (other than a grantor trust), the U.S. trust

(other than a grantor trust) and not the beneficiaries of the trust.

Foreign person. If you are a foreign person or the U.S. branch of a

foreign bank that has elected to be treated as a U.S. person, do not use

Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see

Pub. 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 payee 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 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 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, give the requester the

appropriate completed Form W-8 or Form 8233.

Backup Withholding

What is backup withholding? Persons making certain payments to you

must under certain conditions withhold and pay to the IRS 24% of such

payments. This is called “backup withholding.” Payments that may be

subject to backup withholding include interest, tax-exempt interest,

dividends, broker and barter exchange transactions, rents, royalties,

nonemployee pay, payments made in settlement of payment card and

third party network transactions, 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,

2. You do not certify your TIN when required (see the instructions for

Part II for details),

3. The IRS tells the requester that you furnished an incorrect TIN,

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 Exempt payee code, later, and the separate Instructions for the

Requester of Form W-9 for more information.

Also see Special rules for partnerships, earlier.

What is FATCA Reporting?

The Foreign Account Tax Compliance Act (FATCA) requires a

participating foreign financial institution to report all United States

account holders that are specified United States persons. Certain

payees are exempt from FATCA reporting. See Exemption from FATCA

reporting code, later, and the Instructions for the Requester of Form

W-9 for more information.

Updating Your Information

You must provide updated information to any person to whom you

claimed to be an exempt payee if you are no longer an exempt payee

and anticipate receiving reportable payments in the future from this

person. For example, you may need to provide updated information if

you are a C corporation that elects to be an S corporation, or if you no

longer are tax exempt. In addition, you must furnish a new Form W-9 if

the name or TIN changes for the account; for example, if the grantor of a

grantor trust dies.

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.

Form W-9 (Rev. 10-2018)

Page 3

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

Line 1

You must enter one of the following on this line; do not leave this line

blank. The name should match the name on your tax return.

If this Form W-9 is for a joint account (other than an account

maintained by a foreign financial institution (FFI)), list first, and then

circle, the name of the person or entity whose number you entered in

Part I of Form W-9. If you are providing Form W-9 to an FFI to document

a joint account, each holder of the account that is a U.S. person must

provide a Form W-9.

a. Individual. Generally, enter the name shown on your tax return. If

you have changed your last name without informing the Social Security

Administration (SSA) of the name change, enter your first name, the last

name as shown on your social security card, and your new last name.

Note: ITIN applicant: Enter your individual name as it was entered on

your Form W-7 application, line 1a. This should also be the same as the

name you entered on the Form 1040/1040A/1040EZ you filed with your

application.

b. Sole proprietor or single-member LLC. Enter your individual

name as shown on your 1040/1040A/1040EZ on line 1. You may enter

your business, trade, or “doing business as” (DBA) name on line 2.

c. Partnership, LLC that is not a single-member LLC, C

corporation, or S corporation. Enter the entity's name as shown on the

entity's tax return on line 1 and any business, trade, or DBA name on

line 2.

d. Other entities. Enter your name as shown on required U.S. federal

tax documents on line 1. 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 line 2.

e. Disregarded entity. For U.S. federal tax purposes, an entity that is

disregarded as an entity separate from its owner is treated as a

“disregarded entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter

the owner's name on line 1. The name of the entity entered on line 1

should never be a disregarded entity. The name on line 1 should be the

name shown on the income tax return on which the income should be

reported. For example, if a foreign LLC that is treated as a disregarded

entity for U.S. federal tax purposes has a single owner that is a U.S.

person, the U.S. owner's name is required to be provided on line 1. 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 line 2, “Business name/disregarded entity

name.” If the owner of the disregarded entity is a foreign person, the

owner must complete an appropriate Form W-8 instead of a Form W-9.

This is the case even if the foreign person has a U.S. TIN.

Line 2

If you have a business name, trade name, DBA name, or disregarded

entity name, you may enter it on line 2.

Line 3

Check the appropriate box on line 3 for the U.S. federal tax

classification of the person whose name is entered on line 1. Check only

one box on line 3.

IF the entity/person on line 1 is

a(n) . . .

THEN check the box for . . .

• Corporation Corporation

• Individual

• Sole proprietorship, or

• Single-member limited liability

company (LLC) owned by an

individual and disregarded for U.S.

federal tax purposes.

Individual/sole proprietor or single-

member LLC

• LLC treated as a partnership for

U.S. federal tax purposes,

• LLC that has filed Form 8832 or

2553 to be taxed as a corporation,

• LLC that is disregarded as an

entity separate from its owner but

the owner is another LLC that is

not disregarded for U.S. federal tax

purposes.

Limited liability company and enter

the appropriate tax classification.

(P= Partnership; C= C corporation;

or S= S corporation)

• Partnership Partnership

• Trust/estate Trust/estate

Line 4, Exemptions

If you are exempt from backup withholding and/or FATCA reporting,

enter in the appropriate space on line 4 any code(s) that may apply to

you.

Exempt payee code.

• Generally, individuals (including sole proprietors) are not exempt from

backup withholding.

• Except as provided below, corporations are exempt from backup

withholding for certain payments, including interest and dividends.

• Corporations are not exempt from backup withholding for payments

made in settlement of payment card or third party network transactions.

• Corporations are not exempt from backup withholding with respect to

attorneys’ fees or gross proceeds paid to attorneys, and corporations

that provide medical or health care services are not exempt with respect

to payments reportable on Form 1099-MISC.

The following codes identify payees that are exempt from backup

withholding. Enter the appropriate code in the space in line 4.

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 U.S. commonwealth or

possession, or any of their political subdivisions or instrumentalities

4—A foreign government or any of its political subdivisions, agencies,

or instrumentalities

5—A corporation

6—A dealer in securities or commodities required to register in the

United States, the District of Columbia, or a U.S. commonwealth or

possession

7—A futures commission merchant registered with the Commodity

Futures Trading Commission

8—A real estate investment trust

9—An entity registered at all times during the tax year under the

Investment Company Act of 1940

10—A common trust fund operated by a bank under section 584(a)

11—A financial institution

12—A middleman known in the investment community as a nominee or

custodian

13—A trust exempt from tax under section 664 or described in section

4947

Form W-9 (Rev. 10-2018)

Page 4

The following chart shows types of payments that may be exempt

from backup withholding. The chart applies to the exempt payees listed

above, 1 through 13.

IF the payment is for . . . THEN the payment is exempt

for . . .

Interest and dividend payments All exempt payees except

for 7

Broker transactions Exempt payees 1 through 4 and 6

through 11 and all C corporations.

S corporations must not enter an

exempt payee code because they

are exempt only for sales of

noncovered securities acquired

prior to 2012.

Barter exchange transactions and

patronage dividends

Exempt payees 1 through 4

Payments over $600 required to be

reported and direct sales over

$5,000

Generally, exempt payees

1 through 5

Payments made in settlement of

payment card or third party network

transactions

Exempt payees 1 through 4

See Form 1099-MISC, Miscellaneous Income, and its instructions.

However, the following payments made to a corporation and

reportable on Form 1099-MISC are not exempt from backup

withholding: medical and health care payments, attorneys’ fees, gross

proceeds paid to an attorney reportable under section 6045(f), and

payments for services paid by a federal executive agency.

Exemption from FATCA reporting code. The following codes identify

payees that are exempt from reporting under FATCA. These codes

apply to persons submitting this form for accounts maintained outside

of the United States by certain foreign financial institutions. Therefore, if

you are only submitting this form for an account you hold in the United

States, you may leave this field blank. Consult with the person

requesting this form if you are uncertain if the financial institution is

subject to these requirements. A requester may indicate that a code is

not required by providing you with a Form W-9 with “Not Applicable” (or

any similar indication) written or printed on the line for a FATCA

exemption code.

A—An organization exempt from tax under section 501(a) or any

individual retirement plan as defined in section 7701(a)(37)

B—The United States or any of its agencies or instrumentalities

C—A state, the District of Columbia, a U.S. commonwealth or

possession, or any of their political subdivisions or instrumentalities

D—A corporation the stock of which is regularly traded on one or

more established securities markets, as described in Regulations

section 1.1472-1(c)(1)(i)

E—A corporation that is a member of the same expanded affiliated

group as a corporation described in Regulations section 1.1472-1(c)(1)(i)

F—A dealer in securities, commodities, or derivative financial

instruments (including notional principal contracts, futures, forwards,

and options) that is registered as such under the laws of the United

States or any state

G—A real estate investment trust

H—A regulated investment company as defined in section 851 or an

entity registered at all times during the tax year under the Investment

Company Act of 1940

I—A common trust fund as defined in section 584(a)

J—A bank as defined in section 581

K—A broker

L—A trust exempt from tax under section 664 or described in section

4947(a)(1)

M—A tax exempt trust under a section 403(b) plan or section 457(g)

plan

Note: You may wish to consult with the financial institution requesting

this form to determine whether the FATCA code and/or exempt payee

code should be completed.

Line 5

Enter your address (number, street, and apartment or suite number).

This is where the requester of this Form W-9 will mail your information

returns. If this address differs from the one the requester already has on

file, write NEW at the top. If a new address is provided, there is still a

chance the old address will be used until the payor changes your

address in their records.

Line 6

Enter your city, state, and ZIP code.

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.

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 classified as

a corporation or partnership, enter the entity’s EIN.

Note: See What Name and Number To Give the Requester, later, 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 SSA office or get this form online at

www.SSA.gov. 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 Number (EIN) under Starting a

Business. Go to www.irs.gov/Forms to view, download, or print Form

W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to

place an order and have Form W-7 and/or SS-4 mailed to you within 10

business days.

If you are asked to complete Form W-9 but do not have a TIN, apply

for a TIN and write “Applied For” in the space for the TIN, sign and date

the form, and give it to the requester. For interest and dividend

payments, and certain payments made with respect to readily tradable

instruments, generally you will have 60 days to get a TIN and give it to

the requester before you are subject to backup withholding on

payments. The 60-day rule does not apply to other types of payments.

You will be subject to backup withholding on all such payments until

you provide your TIN to the requester.

Note: Entering “Applied For” means that you have already applied for a

TIN or that you intend to apply for one soon.

Caution: A disregarded U.S. 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 Form W-9. You may be requested to sign by the

withholding agent even if item 1, 4, or 5 below indicates otherwise.

For a joint account, only the person whose TIN is shown in Part I

should sign (when required). In the case of a disregarded entity, the

person identified on line 1 must sign. Exempt payees, see

Exempt payee

code,

earlier.

Signature requirements. Complete the certification as indicated in

items 1 through 5 below.

Form W-9 (Rev. 10-2018)

Page 5

1. Interest, dividend, and barter exchange accounts opened

before 1984 and broker accounts considered active during 1983.

You must give your correct TIN, but you do not have to sign the

certification.

2. Interest, dividend, broker, and barter exchange accounts

opened after 1983 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.

3. Real estate transactions. You must sign the certification. You may

cross out item 2 of the certification.

4. 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 made in settlement of payment

card and third party network transactions, payments to certain fishing

boat crew members and fishermen, and gross proceeds paid to

attorneys (including payments to corporations).

5. Mortgage interest paid by you, acquisition or abandonment of

secured property, cancellation of debt, qualified tuition program

payments (under section 529), ABLE accounts (under section 529A),

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

For this type of account: Give name and SSN of:

1. Individual The individual

2. Two or more individuals (joint

account) other than an account

maintained by an FFI

The actual owner of the account or, if

combined funds, the first individual on

the account

3. Two or more U.S. persons

(joint account maintained by an FFI)

Each holder of the account

4. Custodial account of a minor

(Uniform Gift to Minors Act)

The minor

5. a. The usual revocable savings trust

(grantor is also trustee)

b. So-called trust account that is not

a legal or valid trust under state law

The grantor-trustee

The actual owner

6. Sole proprietorship or disregarded

entity owned by an individual

The owner

7. Grantor trust filing under Optional

Form 1099 Filing Method 1 (see

Regulations section 1.671-4(b)(2)(i)

(A))

The grantor*

For this type of account: Give name and EIN of:

8. Disregarded entity not owned by an

individual

The owner

9. A valid trust, estate, or pension trust

Legal entity

10. Corporation or LLC electing

corporate status on Form 8832 or

Form 2553

The corporation

11. Association, club, religious,

charitable, educational, or other tax-

exempt organization

The organization

12. Partnership or multi-member LLC

The partnership

13. A broker or registered nominee

The broker or nominee

For this type of account: Give name and EIN of:

14. 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

The public entity

15.

Grantor trust filing under the Form

1041 Filing Method or the Optional

Form 1099 Filing Method 2 (see

Regulations section 1.671-4(b)(2)(i)(B))

The trust

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.

Circle the minor’s name and furnish the minor’s SSN.

You must show your individual name and you may also enter your

business or DBA name on the “Business name/disregarded entity”

name line. You may use either your SSN or EIN (if you have one), but the

IRS encourages you to use your SSN.

List first and circle the name of the 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.) Also see Special

rules for partnerships, earlier.

*Note: The grantor also must provide a Form W-9 to trustee of trust.

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.

Secure Your Tax Records From Identity Theft

Identity theft occurs when someone uses your personal information

such as your name, SSN, or other identifying information, without your

permission, to commit fraud or other crimes. An identity thief may use

your SSN to get a job or may file a tax return using your SSN to receive

a refund.

To reduce your risk:

• Protect your SSN,

• Ensure your employer is protecting your SSN, and

• Be careful when choosing a tax preparer.

If your tax records are affected by identity theft and you receive a

notice from the IRS, respond right away to the name and phone number

printed on the IRS notice or letter.

If your tax records are not currently affected by identity theft but you

think you are at risk due to a lost or stolen purse or wallet, questionable

credit card activity or credit report, contact the IRS Identity Theft Hotline

at 1-800-908-4490 or submit Form 14039.

For more information, see Pub. 5027, Identity Theft Information for

Taxpayers.

Victims of identity theft who are experiencing economic harm or a

systemic problem, or are seeking help in resolving tax problems that

have not been resolved through normal channels, may be eligible for

Taxpayer Advocate Service (TAS) assistance. You can reach TAS by

calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD

1-800-829-4059.

Protect yourself from suspicious emails or phishing schemes.

Phishing is the creation and use of email and websites designed to

mimic legitimate business emails and websites. The most common act

is sending an email to a user falsely claiming to be an established

legitimate enterprise in an attempt to scam the user into surrendering

private information that will be used for identity theft.

Form W-9 (Rev. 10-2018)

Page 6

The IRS does not initiate contacts with taxpayers via emails. Also, the

IRS does not request personal detailed information through email or ask

taxpayers for the PIN numbers, passwords, or similar secret access

information for their credit card, bank, or other financial accounts.

If you receive an unsolicited email claiming to be from the IRS,

forward this message to phishing@irs.gov. You may also report misuse

of the IRS name, logo, or other IRS property to the Treasury Inspector

General for Tax Administration (TIGTA) at 1-800-366-4484. You can

forward suspicious emails to the Federal Trade Commission at

spam@uce.gov or report them at www.ftc.gov/complaint. You can

contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338).

If you have been the victim of identity theft, see www.IdentityTheft.gov

and Pub. 5027.

Visit www.irs.gov/IdentityTheft to learn more about identity theft and

how to reduce your risk.

Privacy Act Notice

Section 6109 of the Internal Revenue Code requires you to provide your

correct TIN to persons (including federal agencies) who are required to

file information returns with the IRS to report interest, dividends, or

certain other income paid to you; mortgage interest you paid; the

acquisition or abandonment of secured property; the cancellation of

debt; or contributions you made to an IRA, Archer MSA, or HSA. The

person collecting this form uses the information on the form to file

information returns with the IRS, reporting the above information.

Routine uses of this information include giving it to the Department of

Justice for civil and criminal litigation and to cities, states, the District of

Columbia, and U.S. commonwealths and possessions for use in

administering their laws. The information also may be disclosed to other

countries under a treaty, to federal and state agencies to enforce civil

and 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. Under section 3406, payers

must generally withhold a percentage of taxable interest, dividend, and

certain other payments to a payee who does not give a TIN to the payer.

Certain penalties may also apply for providing false or fraudulent

information.

Form W-8BEN

(Rev. October 2021)

Department of the Treasury

Internal Revenue Service

Certificate of Foreign Status of Beneficial Owner for United

States Tax Withholding and Reporting (Individuals)

▶

For use by individuals. Entities must use Form W-8BEN-E.

▶

Go to www.irs.gov/FormW8BEN for instructions and the latest information.

▶

Give this form to the withholding agent or payer. Do not send to the IRS.

OMB No. 1545-1621

Do NOT use this form if: Instead, use Form:

• You are NOT an individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8BEN-E

• You are a U.S. citizen or other U.S. person, including a resident alien individual . . . . . . . . . . . . . . . . . . . W-9

• You are a beneficial owner claiming that income is effectively connected with the conduct of trade or business within the United States

(other than personal services) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8ECI

• You are a beneficial owner who is receiving compensation for personal services performed in the United States . . . . . . . 8233 or W-4

• You are a person acting as an intermediary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8IMY

Note: If you are resident in a FATCA partner jurisdiction (that is, a Model 1 IGA jurisdiction with reciprocity), certain tax account information may be

provided to your jurisdiction of residence.

Part I Identification of Beneficial Owner (see instructions)

1 Name of individual who is the beneficial owner 2 Country of citizenship

3 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.

City or town, state or province. Include postal code where appropriate. Country

4 Mailing address (if different from above)

City or town, state or province. Include postal code where appropriate. Country

5 U.S. taxpayer identification number (SSN or ITIN), if required (see instructions)

6a Foreign tax identifying number (see instructions)

6b Check if FTIN not legally required . . . . . . . . . . .

7 Reference number(s) (see instructions)

8 Date of birth (MM-DD-YYYY) (see instructions)

Part II Claim of Tax Treaty Benefits (for chapter 3 purposes only) (see instructions)

I certify that the beneficial owner is a resident of

within the meaning of the income tax

treaty between the United States and that country.

Special rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of Article and paragraph

of the treaty identified on line 9 above to claim a

% rate of withholding on (specify type of income):

Explain the additional conditions in the Article and paragraph the beneficial owner meets to be eligible for the rate of withholding:

Part III Certification

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that:

• I am the individual that is the beneficial owner (or am authorized to sign for the individual that is the beneficial owner) of all the income or proceeds to which this form

relates or am using this form to document myself for chapter 4 purposes;

• The person named on line 1 of this form is not a U.S. person;

• This form relates to:

(a) income not effectively connected with the conduct of a trade or business in the United States;

(b) income effectively connected with the conduct of a trade or business in the United States but is not subject to tax under an applicable income tax treaty;

(d) the partner’s amount realized from the transfer of a partnership interest subject to withholding under section 1446(f);

•

The person named on line 1 of this form is a resident of the treaty country listed on line 9 of the form (if any) within the meaning of the income tax treaty between the United States and that country; and

• For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can

disburse or make payments of the income of which I am the beneficial owner. I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.

Sign Here

▲

I certify that I have the capacity to sign for the person identified on line 1 of this form.

Signature of beneficial owner (or individual authorized to sign for beneficial owner)

Date (MM-DD-YYYY)

Print name of signer

For Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 25047Z

Form W-8BEN (Rev. 10-2021)

click to sign

signature

click to edit

Form W-8BEN-E

(Rev. October 2021)

Department of the Treasury

Internal Revenue Service

Certificate of Status of Beneficial Owner for

United States Tax Withholding and Reporting (Entities)

▶

For use by entities. Individuals must use Form W-8BEN.

▶

Section references are to the Internal Revenue Code.

▶

Go to www.irs.gov/FormW8BENE for instructions and the latest information.

▶

Give this form to the withholding agent or payer. Do not send to the IRS.

OMB No. 1545-1621

Do NOT use this form for:

Instead use Form:

• U.S. entity or U.S. citizen or resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-9

• A foreign individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8BEN (Individual) or Form 8233

• A foreign individual or entity claiming that income is effectively connected with the conduct of trade or business within the United States

(unless claiming treaty benefits) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8ECI

• A foreign partnership, a foreign simple trust, or a foreign grantor trust (unless claiming treaty benefits) (see instructions for exceptions) . . W-8IMY

• A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or

government of a U.S. possession claiming that income is effectively connected U.S. income or that is claiming the applicability of section(s) 115(2),

501(c), 892, 895, or 1443(b) (unless claiming treaty benefits) (see instructions for other exceptions) . . . . . . . . .

W-8ECI or W-8EXP

• Any person acting as an intermediary (including a qualified intermediary acting as a qualified derivatives dealer) . . . . . . . . . W-8IMY

Part I Identification of Beneficial Owner

1 Name of organization that is the beneficial owner 2 Country of incorporation or organization

3 Name of disregarded entity receiving the payment (if applicable, see instructions)

4 Chapter 3 Status (entity type) (Must check one box only):

Corporation Partnership

Simple trust

Tax-exempt organization

Complex trust Foreign Government - Controlled Entity

Central Bank of Issue Private foundation Estate Foreign Government - Integral Part

Grantor trust Disregarded entity International organization

If you entered disregarded entity, partnership, simple trust, or grantor trust above, is the entity a hybrid making a treaty claim? If “Yes,” complete Part III.

Yes No

5 Chapter 4 Status (FATCA status) (See instructions for details and complete the certification below for the entity's applicable status.)

Nonparticipating FFI (including an FFI related to a Reporting IGA

FFI other than a deemed-compliant FFI, participating FFI, or

exempt beneficial owner).

Participating FFI.

Reporting Model 1 FFI.

Reporting Model 2 FFI.

Registered deemed-compliant FFI (other than a reporting Model 1

FFI, sponsored FFI, or nonreporting IGA FFI covered in Part XII).

See instructions.

Sponsored FFI. Complete Part IV.

Certified deemed-compliant nonregistering local bank. Complete

Part V.

Certified deemed-compliant FFI with only low-value accounts.

Complete Part VI.

Certified deemed-compliant sponsored, closely held investment

vehicle. Complete Part VII.

Certified deemed-compliant limited life debt investment entity.

Complete Part VIII.

Certain investment entities that do not maintain financial accounts.

Complete Part IX.

Owner-documented FFI. Complete Part X.

Restricted distributor. Complete Part XI.

Nonreporting IGA FFI. Complete Part XII.

Foreign government, government of a U.S. possession, or foreign

central bank of issue. Complete Part XIII.

International organization. Complete Part XIV.

Exempt retirement plans. Complete Part XV.

Entity wholly owned by exempt beneficial owners. Complete Part XVI.

Territory financial institution. Complete Part XVII.

Excepted nonfinancial group entity. Complete Part XVIII.

Excepted nonfinancial start-up company. Complete Part XIX.

Excepted nonfinancial entity in liquidation or bankruptcy.

Complete Part XX.

501(c) organization. Complete Part XXI.

Nonprofit organization. Complete Part XXII.

Publicly traded NFFE or NFFE affiliate of a publicly traded

corporation. Complete Part XXIII.

Excepted territory NFFE. Complete Part XXIV.

Active NFFE. Complete Part XXV.

Passive NFFE. Complete Part XXVI.

Excepted inter-affiliate FFI. Complete Part XXVII.

Direct reporting NFFE.

Sponsored direct reporting NFFE. Complete Part XXVIII.

Account that is not a financial account.

Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a registered address).

City or town, state or province. Include postal code where appropriate.

Country

7 Mailing address (if different from above)

City or town, state or province. Include postal code where appropriate. Country

For Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 59689N

Form W-8BEN-E (Rev. 10-2021)

Page 2

Part I Identification of Beneficial Owner (continued)

U.S. taxpayer identification number (TIN), if required

GIIN b Foreign TIN

Check if FTIN not legally required . . . . . .

▶

Reference number(s) (see instructions)

Note: Please complete remainder of the form including signing the form in Part XXX.

Part II

Disregarded Entity or Branch Receiving Payment. (Complete only if a disregarded entity with a GIIN or a

branch of an FFI in a country other than the FFI’s country of residence. See instructions.)

11 Chapter 4 Status (FATCA status) of disregarded entity or branch receiving payment

Branch treated as nonparticipating FFI.

Participating FFI.

Reporting Model 1 FFI.

Reporting Model 2 FFI.

U.S. Branch.

12 Address of disregarded entity or branch (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a

registered address).

City or town, state or province. Include postal code where appropriate.

Country

GIIN (if any)

Part III Claim of Tax Treaty Benefits (if applicable). (For chapter 3 purposes only.)

14 I certify that (check all that apply):

The beneficial owner is a resident of

within the meaning of the income tax

treaty between the United States and that country.

The beneficial owner derives the item (or items) of income for which the treaty benefits are claimed, and, if applicable, meets the

requirements of the treaty provision dealing with limitation on benefits. The following are types of limitation on benefits provisions that may

be included in an applicable tax treaty (check only one; see instructions):

Government

Tax-exempt pension trust or pension fund

Other tax-exempt organization

Publicly traded corporation

Subsidiary of a publicly traded corporation

Company that meets the ownership and base erosion test

Company that meets the derivative benefits test

Company with an item of income that meets active trade or business test

Favorable discretionary determination by the U.S. competent authority received

No LOB article in treaty

Other (specify Article and paragraph):

The beneficial owner is claiming treaty benefits for U.S. source dividends received from a foreign corporation or interest from a U.S. trade

or business of a foreign corporation and meets qualified resident status (see instructions).

Special rates and conditions (if applicable—see instructions):

The beneficial owner is claiming the provisions of Article and paragraph

of the treaty identified on line 14a above to claim a

% rate of withholding on (specify type of income):

Explain the additional conditions in the Article the beneficial owner meets to be eligible for the rate of withholding:

Part IV Sponsored FFI

16 Name of sponsoring entity:

17 Check whichever box applies.

I certify that the entity identified in Part I:

• Is an investment entity;

• Is not a QI, WP (except to the extent permitted in the withholding foreign partnership agreement), or WT; and

• Has agreed with the entity identified above (that is not a nonparticipating FFI) to act as the sponsoring entity for this entity.

I certify that the entity identified in Part I:

• Is a controlled foreign corporation as defined in section 957(a);

• Is not a QI, WP, or WT;

•

Is wholly owned, directly or indirectly, by the U.S. financial institution identified above that agrees to act as the sponsoring entity for this entity; and

•

Shares a common electronic account system with the sponsoring entity (identified above) that enables the sponsoring entity to identify all

account holders and payees of the entity and to access all account and customer information maintained by the entity including, but not limited

to, customer identification information, customer documentation, account balance, and all payments made to account holders or payees.

Form W-8BEN-E (Rev. 10-2021)

Page 3

Part V Certified Deemed-Compliant Nonregistering Local Bank

I certify that the FFI identified in Part I:

• Operates and is licensed solely as a bank or credit union (or similar cooperative credit organization operated without profit) in its country of

incorporation or organization;

• Engages primarily in the business of receiving deposits from and making loans to, with respect to a bank, retail customers unrelated to such

bank and, with respect to a credit union or similar cooperative credit organization, members, provided that no member has a greater than 5%

interest in such credit union or cooperative credit organization;

• Does not solicit account holders outside its country of organization;

• Has no fixed place of business outside such country (for this purpose, a fixed place of business does not include a location that is not

advertised to the public and from which the FFI performs solely administrative support functions);

• Has no more than $175 million in assets on its balance sheet and, if it is a member of an expanded affiliated group, the group has no more

than $500 million in total assets on its consolidated or combined balance sheets; and

• Does not have any member of its expanded affiliated group that is a foreign financial institution, other than a foreign financial institution that

is incorporated or organized in the same country as the FFI identified in Part I and that meets the requirements set forth in this part.

Part VI Certified Deemed-Compliant FFI with Only Low-Value Accounts

19 I certify that the FFI identified in Part I:

• Is not engaged primarily in the business of investing, reinvesting, or trading in securities, partnership interests, commodities, notional

principal contracts, insurance or annuity contracts, or any interest (including a futures or forward contract or option) in such security,

partnership interest, commodity, notional principal contract, insurance contract or annuity contract;

• No financial account maintained by the FFI or any member of its expanded affiliated group, if any, has a balance or value in excess of

$50,000 (as determined after applying applicable account aggregation rules); and

• Neither the FFI nor the entire expanded affiliated group, if any, of the FFI, have more than $50 million in assets on its consolidated or

combined balance sheet as of the end of its most recent accounting year.

Part VII Certified Deemed-Compliant Sponsored, Closely Held Investment Vehicle

20 Name of sponsoring entity:

I certify that the entity identified in Part I:

• Is an FFI solely because it is an investment entity described in Regulations section 1.1471-5(e)(4);

• Is not a QI, WP, or WT;

• Will have all of its due diligence, withholding, and reporting responsibilities (determined as if the FFI were a participating FFI) fulfilled by the

sponsoring entity identified on line 20; and

• 20 or fewer individuals own all of the debt and equity interests in the entity (disregarding debt interests owned by U.S. financial institutions,

participating FFIs, registered deemed-compliant FFIs, and certified deemed-compliant FFIs and equity interests owned by an entity if that

entity owns 100% of the equity interests in the FFI and is itself a sponsored FFI).

Part VIII Certified Deemed-Compliant Limited Life Debt Investment Entity

22 I certify that the entity identified in Part I:

• Was in existence as of January 17, 2013

;

•

Issued all classes of its debt or equity interests to investors on or before January 17, 2013, pursuant to a trust indenture or similar agreement; and

• Is certified deemed-compliant because it satisfies the requirements to be treated as a limited life debt investment entity (such as the

restrictions with respect to its assets and other requirements under Regulations section 1.1471-5(f)(2)(iv)).

Part IX Certain Investment Entities that Do Not Maintain Financial Accounts

23 I certify that the entity identified in Part I:

• Is a financial institution solely because it is an investment entity described in Regulations section 1.1471-5(e)(4)(i)(A), and

• Does not maintain financial accounts.

Part X Owner-Documented FFI

Note: This status only applies if the U.S. financial institution, participating FFI, or reporting Model 1 FFI to which this form is given has agreed that it will

treat the FFI as an owner-documented FFI (see instructions for eligibility requirements). In addition, the FFI must make the certifications below.

24a

(All owner-documented FFIs check here) I certify that the FFI identified in Part I:

• Does not act as an intermediary;

• Does not accept deposits in the ordinary course of a banking or similar business;

• Does not hold, as a substantial portion of its business, financial assets for the account of others;

• Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with respect to

a financial account;

• Is not owned by or in an expanded affiliated group with an entity that accepts deposits in the ordinary course of a banking or similar

business, holds, as a substantial portion of its business, financial assets for the account of others, or is an insurance company (or the holding

company of an insurance company) that issues or is obligated to make payments with respect to a financial account;

• Does not maintain a financial account for any nonparticipating FFI; and

• Does not have any specified U.S. persons that own an equity interest or debt interest (other than a debt interest that is not a financial

account or that has a balance or value not exceeding $50,000) in the FFI other than those identified on the FFI owner reporting statement.

Form W-8BEN-E (Rev. 10-2021)

Page 4

Part X Owner-Documented FFI (continued)

Check box 24b or 24c, whichever applies.

I certify that the FFI identified in Part I:

• Has provided, or will provide, an FFI owner reporting statement that contains:

(i)

The name, address, TIN (if any), chapter 4 status, and type of documentation provided (if required) of every individual and specified

U.S. person that owns a direct or indirect equity interest in the owner-documented FFI (looking through all entities other than specified

U.S. persons);

(ii)

The name, address, TIN (if any), and chapter 4 status of every individual and specified U.S. person that owns a debt interest in the

owner-documented FFI (including any indirect debt interest, which includes debt interests in any entity that directly or indirectly owns

the payee or any direct or indirect equity interest in a debt holder of the payee) that constitutes a financial account in excess of

$50,000 (disregarding all such debt interests owned by participating FFIs, registered deemed-compliant FFIs, certified deemed-

compliant FFIs, excepted NFFEs, exempt beneficial owners, or U.S. persons other than specified U.S. persons); and

(iii)

Any additional information the withholding agent requests in order to fulfill its obligations with respect to the entity.

• Has provided, or will provide, valid documentation meeting the requirements of Regulations section 1.1471-3(d)(6)(iii) for each person

identified in the FFI owner reporting statement.

I certify that the FFI identified in Part I has provided, or will provide, an auditor's letter, signed within 4 years of the date of payment,

from an independent accounting firm or legal representative with a location in the United States stating that the firm or representative has

reviewed the FFI’s documentation with respect to all of its owners and debt holders identified in Regulations section 1.1471-3(d)(6)(iv)(A)(2),

and that the FFI meets all the requirements to be an owner-documented FFI. The FFI identified in Part I has also provided, or will provide,

an FFI owner reporting statement of its owners that are specified U.S. persons and Form(s) W-9, with applicable waivers.

Check box 24d if applicable (optional, see instructions).

I certify that the entity identified on line 1 is a trust that does not have any contingent beneficiaries or designated classes with unidentified

beneficiaries.

Part XI Restricted Distributor

25a (All restricted distributors check here) I certify that the entity identified in Part I:

• Operates as a distributor with respect to debt or equity interests of the restricted fund with respect to which this form is furnished;

• Provides investment services to at least 30 customers unrelated to each other and less than half of its customers are related to each other;

• Is required to perform AML due diligence procedures under the anti-money laundering laws of its country of organization (which is an FATF-

compliant jurisdiction);

• Operates solely in its country of incorporation or organization, has no fixed place of business outside of that country, and has the same

country of incorporation or organization as all members of its affiliated group, if any;

• Does not solicit customers outside its country of incorporation or organization;

• Has no more than $175 million in total assets under management and no more than $7 million in gross revenue on its income statement for

the most recent accounting year;

• Is not a member of an expanded affiliated group that has more than $500 million in total assets under management or more than $20 million

in gross revenue for its most recent accounting year on a combined or consolidated income statement; and

• Does not distribute any debt or securities of the restricted fund to specified U.S. persons, passive NFFEs with one or more substantial U.S.

owners, or nonparticipating FFIs.

Check box 25b or 25c, whichever applies.

I further certify that with respect to all sales of debt or equity interests in the restricted fund with respect to which this form is furnished that are made

after December 31, 2011, the entity identified in Part I:

Has been bound by a distribution agreement that contained a general prohibition on the sale of debt or securities to U.S. entities and U.S.

resident individuals and is currently bound by a distribution agreement that contains a prohibition of the sale of debt or securities to any

specified U.S. person, passive NFFE with one or more substantial U.S. owners, or nonparticipating FFI.

Is currently bound by a distribution agreement that contains a prohibition on the sale of debt or securities to any specified U.S. person,

passive NFFE with one or more substantial U.S. owners, or nonparticipating FFI and, for all sales made prior to the time that such a

restriction was included in its distribution agreement, has reviewed all accounts related to such sales in accordance with the procedures

identified in Regulations section 1.1471-4(c) applicable to preexisting accounts and has redeemed or retired any, or caused the restricted

fund to transfer the securities to a distributor that is a participating FFI or reporting Model 1 FFI securities which were sold to specified U.S.

persons, passive NFFEs with one or more substantial U.S. owners, or nonparticipating FFIs.

Form W-8BEN-E (Rev. 10-2021)

Page 5

Part XII Nonreporting IGA FFI

26 I certify that the entity identified in Part I:

• Meets the requirements to be considered a nonreporting financial institution pursuant to an applicable IGA between the United States and

. The applicable IGA is a Model 1 IGA or a Model 2 IGA; and

is treated as a under the provisions of the applicable IGA or Treasury regulations

(if applicable, see instructions);

•

If you are a trustee documented trust or a sponsored entity, provide the name of the trustee or sponsor

The trustee is:

U.S. Foreign

Part XIII Foreign Government, Government of a U.S. Possession, or Foreign Central Bank of Issue

I certify that the entity identified in Part I is the beneficial owner of the payment, and is not engaged in commercial financial activities of a

type engaged in by an insurance company, custodial institution, or depository institution with respect to the payments, accounts, or

obligations for which this form is submitted (except as permitted in Regulations section 1.1471-6(h)(2)).

Part XIV International Organization

Check box 28a or 28b, whichever applies.

28a

I certify that the entity identified in Part I is an international organization described in section 7701(a)(18).

I certify that the entity identified in Part I:

• Is comprised primarily of foreign governments;

• Is recognized as an intergovernmental or supranational organization under a foreign law similar to the International Organizations Immunities

Act or that has in effect a headquarters agreement with a foreign government;

• The benefit of the entity’s income does not inure to any private person; and

• Is the beneficial owner of the payment and is not engaged in commercial financial activities of a type engaged in by an insurance company,

custodial institution, or depository institution with respect to the payments, accounts, or obligations for which this form is submitted (except as

permitted in Regulations section 1.1471-6(h)(2)).

Part XV Exempt Retirement Plans

Check box 29a, b, c, d, e, or f, whichever applies.

29a

I certify that the entity identified in Part I:

• Is established in a country with which the United States has an income tax treaty in force (see Part III if claiming treaty benefits);

• Is operated principally to administer or provide pension or retirement benefits; and

• Is entitled to treaty benefits on income that the fund derives from U.S. sources (or would be entitled to benefits if it derived any such income)

as a resident of the other country which satisfies any applicable limitation on benefits requirement.

I certify that the entity identified in Part I:

• Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former

employees of one or more employers in consideration for services rendered;

• No single beneficiary has a right to more than 5% of the FFI’s assets;

• Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the

country in which the fund is established or operated; and

(i)

Is generally exempt from tax on investment income under the laws of the country in which it is established or operates due to its status

as a retirement or pension plan;

(ii)

Receives at least 50% of its total contributions from sponsoring employers (disregarding transfers of assets from other plans described

in this part, retirement and pension accounts described in an applicable Model 1 or Model 2 IGA, other retirement funds described in

an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A));

(iii)

Either does not permit or penalizes distributions or withdrawals made before the occurrence of specified events related to retirement,

disability, or death (except rollover distributions to accounts described in Regulations section 1.1471-5(b)(2)(i)(A) (referring to retirement

and pension accounts), to retirement and pension accounts described in an applicable Model 1 or Model 2 IGA, or to other retirement

funds described in this part or in an applicable Model 1 or Model 2 IGA); or

(iv)

Limits contributions by employees to the fund by reference to earned income of the employee or may not exceed $50,000 annually.

I certify that the entity identified in Part I:

• Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former

employees of one or more employers in consideration for services rendered;

• Has fewer than 50 participants;

• Is sponsored by one or more employers each of which is not an investment entity or passive NFFE;

• Employee and employer contributions to the fund (disregarding transfers of assets from other plans described in this part, retirement and

pension accounts described in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A)) are

limited by reference to earned income and compensation of the employee, respectively;

•

Participants that are not residents of the country in which the fund is established or operated are not entitled to more than 20% of the fund’s assets; and

• Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the

country in which the fund is established or operates.

Form W-8BEN-E (Rev. 10-2021)

Page 6

Part XV Exempt Retirement Plans (continued)

d I certify that the entity identified in Part I is formed pursuant to a pension plan that would meet the requirements of section 401(a), other

than the requirement that the plan be funded by a trust created or organized in the United States.

I certify that the entity identified in Part I is established exclusively to earn income for the benefit of one or more retirement funds

described in this part or in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A) (referring to

retirement and pension accounts), or retirement and pension accounts described in an applicable Model 1 or Model 2 IGA.

f I certify that the entity identified in Part I:

• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S. possession

(each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model 2 IGA to provide

retirement, disability, or death benefits to beneficiaries or participants that are current or former employees of the sponsor (or persons

designated by such employees); or

• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S. possession

(each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model 2 IGA to provide

retirement, disability, or death benefits to beneficiaries or participants that are not current or former employees of such sponsor, but are in

consideration of personal services performed for the sponsor.

Part XVI Entity Wholly Owned by Exempt Beneficial Owners

30 I certify that the entity identified in Part I:

• Is an FFI solely because it is an investment entity;

• Each direct holder of an equity interest in the investment entity is an exempt beneficial owner described in Regulations section 1.1471-6 or in

an applicable Model 1 or Model 2 IGA;

• Each direct holder of a debt interest in the investment entity is either a depository institution (with respect to a loan made to such entity) or an

exempt beneficial owner described in Regulations section 1.1471-6 or an applicable Model 1 or Model 2 IGA.

• Has provided an owner reporting statement that contains the name, address, TIN (if any), chapter 4 status, and a description of the type of

documentation provided to the withholding agent for every person that owns a debt interest constituting a financial account or direct equity

interest in the entity; and

• Has provided documentation establishing that every owner of the entity is an entity described in Regulations section 1.1471-6(b), (c), (d), (e),

(f) and/or (g) without regard to whether such owners are beneficial owners.

Part XVII

Territory Financial Institution

31 I certify that the entity identified in Part I is a financial institution (other than an investment entity) that is incorporated or organized under

the laws of a possession of the United States.

Part XVIII

Excepted Nonfinancial Group Entity

32 I certify that the entity identified in Part I:

• Is a holding company, treasury center, or captive finance company and substantially all of the entity’s activities are functions described in

Regulations section 1.1471-5(e)(5)(i)(C) through (E);

• Is a member of a nonfinancial group described in Regulations section 1.1471-5(e)(5)(i)(B);

• Is not a depository or custodial institution (other than for members of the entity’s expanded affiliated group); and

• Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or any

investment vehicle with an investment strategy to acquire or fund companies and then hold interests in those companies as capital assets for

investment purposes.

Part XIX

Excepted Nonfinancial Start-Up Company

33 I certify that the entity identified in Part I:

• Was formed on (or, in the case of a new line of business, the date of board resolution approving the new line of business)

(date must be less than 24 months prior to date of payment);

• Is not yet operating a business and has no prior operating history or is investing capital in assets with the intent to operate a new line of

business other than that of a financial institution or passive NFFE;

• Is investing capital into assets with the intent to operate a business other than that of a financial institution; and

• Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or any

investment vehicle whose purpose is to acquire or fund companies and then hold interests in those companies as capital assets for investment purposes.

Part XX Excepted Nonfinancial Entity in Liquidation or Bankruptcy

34 I certify that the entity identified in Part I:

• Filed a plan of liquidation, filed a plan of reorganization, or filed for bankruptcy on

;

• During the past 5 years has not been engaged in business as a financial institution or acted as a passive NFFE;

• Is either liquidating or emerging from a reorganization or bankruptcy with the intent to continue or recommence operations as a nonfinancial

entity; and

• Has, or will provide, documentary evidence such as a bankruptcy filing or other public documentation that supports its claim if it remains in

bankruptcy or liquidation for more than 3 years.

Form W-8BEN-E (Rev. 10-2021)

Page 7

Part XXI 501(c) Organization

35 I certify that the entity identified in Part I is a 501(c) organization that:

• Has been issued a determination letter from the IRS that is currently in effect concluding that the payee is a section 501(c) organization that is

dated

; or

• Has provided a copy of an opinion from U.S. counsel certifying that the payee is a section 501(c) organization (without regard to whether the

payee is a foreign private foundation).

Part XXII Nonprofit Organization

36 I certify that the entity identified in Part I is a nonprofit organization that meets the following requirements.

• The entity is established and maintained in its country of residence exclusively for religious, charitable, scientific, artistic, cultural or educational purposes;

• The entity is exempt from income tax in its country of residence;

• The entity has no shareholders or members who have a proprietary or beneficial interest in its income or assets;

• Neither the applicable laws of the entity’s country of residence nor the entity’s formation documents permit any income or assets of the entity

to be distributed to, or applied for the benefit of, a private person or noncharitable entity other than pursuant to the conduct of the entity’s

charitable activities or as payment of reasonable compensation for services rendered or payment representing the fair market value of property

which the entity has purchased; and

• The applicable laws of the entity’s country of residence or the entity’s formation documents require that, upon the entity’s liquidation or

dissolution, all of its assets be distributed to an entity that is a foreign government, an integral part of a foreign government, a controlled entity

of a foreign government, or another organization that is described in this part or escheats to the government of the entity’s country of

residence or any political subdivision thereof.

Part XXIII

Publicly Traded NFFE or NFFE Affiliate of a Publicly Traded Corporation

Check box 37a or 37b, whichever applies.

37a

I certify that:

• The entity identified in Part I is a foreign corporation that is not a financial institution; and

• The stock of such corporation is regularly traded on one or more established securities markets, including

(name one securities exchange upon which the stock is regularly traded).

I certify that:

• The entity identified in Part I is a foreign corporation that is not a financial institution;

• The entity identified in Part I is a member of the same expanded affiliated group as an entity the stock of which is regularly traded on an

established securities market;

• The name of the entity, the stock of which is regularly traded on an established securities market, is

; and

• The name of the securities market on which the stock is regularly traded is

Part XXIV

Excepted Territory NFFE

38 I certify that:

• The entity identified in Part I is an entity that is organized in a possession of the United States;

• The entity identified in Part I:

(i) Does not accept deposits in the ordinary course of a banking or similar business;

(ii) Does not hold, as a substantial portion of its business, financial assets for the account of others; or

(iii)

Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with

respect to a financial account; and

• All of the owners of the entity identified in Part I are bona fide residents of the possession in which the NFFE is organized or incorporated.

Part XXV

Active NFFE

39 I certify that:

• The entity identified in Part I is a foreign entity that is not a financial institution;

• Less than 50% of such entity’s gross income for the preceding calendar year is passive income; and

• Less than 50% of the assets held by such entity are assets that produce or are held for the production of passive income (calculated as a

weighted average of the percentage of passive assets measured quarterly) (see instructions for the definition of passive income).

Part XXVI

Passive NFFE

40a I certify that the entity identified in Part I is a foreign entity that is not a financial institution (other than an investment entity organized in a

possession of the United States) and is not certifying its status as a publicly traded NFFE (or affiliate), excepted territory NFFE, active

NFFE, direct reporting NFFE, or sponsored direct reporting NFFE.

Check box 40b or 40c, whichever applies.

I further certify that the entity identified in Part I has no substantial U.S. owners (or, if applicable, no controlling U.S. persons); or

I further certify that the entity identified in Part I has provided the name, address, and TIN of each substantial U.S. owner (or, if applicable,

controlling U.S. person) of the NFFE in Part XXIX.

Form W-8BEN-E (Rev. 10-2021)

Page 8

Part XXVII

Excepted Inter-Affiliate FFI

41 I certify that the entity identified in Part I:

• Is a member of an expanded affiliated group;

• Does not maintain financial accounts (other than accounts maintained for members of its expanded affiliated group);

• Does not make withholdable payments to any person other than to members of its expanded affiliated group;

• Does not hold an account (other than depository accounts in the country in which the entity is operating to pay for expenses) with or receive

payments from any withholding agent other than a member of its expanded affiliated group; and

• Has not agreed to report under Regulations section 1.1471-4(d)(2)(ii)(C) or otherwise act as an agent for chapter 4 purposes on behalf of any financial

institution, including a member of its expanded affiliated group.

Part XXVIII

Sponsored Direct Reporting NFFE (see instructions for when this is permitted)

Name of sponsoring entity:

I certify that the entity identified in Part I is a direct reporting NFFE that is sponsored by the entity identified on line 42.

Part XXIX Substantial U.S. Owners of Passive NFFE

As required by Part XXVI, provide the name, address, and TIN of each substantial U.S. owner of the NFFE. Please see the instructions for a definition of

substantial U.S. owner. If providing the form to an FFI treated as a reporting Model 1 FFI or reporting Model 2 FFI, an NFFE may also use this part for

reporting its controlling U.S. persons under an applicable IGA.

Name Address TIN

Part XXX

Certification

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further

certify under penalties of perjury that:

• The entity identified on line 1 of this form is the beneficial owner of all the income or proceeds to which this form relates, is using this form to certify its status for

chapter 4 purposes, or is submitting this form for purposes of section 6050W or 6050Y;

• The entity identified on line 1 of this form is not a U.S. person;

• This form relates to: (a) income not effectively connected with the conduct of a trade or business in the United States, (b) income effectively connected with the

conduct of a trade or business in the United States but is not subject to tax under an income tax treaty, (c) the partner’s share of a partnership’s effectively

connected taxable income, or (d) the partner’s amount realized from the transfer of a partnership interest subject to withholding under section 1446(f); and

• For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which the entity on line 1 is the beneficial

owner or any withholding agent that can disburse or make payments of the income of which the entity on line 1 is the beneficial owner.

I agree that I will submit a new form within 30 days if any certification on this form becomes incorrect.

I certify that I ha

ve the capacity to sign for the entity identified on line 1 of this form.

Sign Here

▲

Signature of individual authorized to sign for beneficial owner

Print Name Date (MM-DD-YYYY)

Form W-8BEN-E (Rev. 10-2021)

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