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Form W' 9 Request for Taxpayer Give Form to the DWart August2013) Identification Number and Certification requester. Do not Departrnant of the Treasury send to the IRS. lntem al, Revenue.Servlce-- - Name (as shown' on your income tax return) - - `-" ' -- - - - - Dulnlnck, . In-c. N - Business"name/disregarded entity name; if different from above' _- - m o Check appropriate box for federal tax classification Exemptions (see instructions): — c m ❑ Individual/sole proprietor ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trustlestate p Exempt payee code (if any)TOM , -_ ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) 1 - Exemption from FATCA reporting C 1 code (if any) d _ ❑ . CKher (see Instructions) ►- u - - — - - - Address (number, street, and apt. or suite no.) Repuester's name and address (optional) a PO Box 208 N$ City, state, and ZIP code N Prinsbur , MN_ 56281 - List account hu' mber(s).here (option — — — - • . Tax ager identification Number" (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line 'Soot security number to avoid backup withholding . For individuals, this is your social security number (SSN). However, for a resident alien , sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a m, - - —• TIN on page 3 . Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer tdentlflgation number _ number to enter. M41 - 1 5 5 2 6 5 4 MENNEN ,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. 1 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 Of 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 generdlly, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN . See the instructions on1page 3. Sign Signature of IT Ir Here U.S. person lob Date ► General Instructions 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 Section references are to the Internal Revenue Code unless otherwise noted, exempt from the FATCA reporting, is correct. Future developments. The IRS has created a page on IRS.gov for information Note. If you are a U .S. person and a requester gives you a form other than Form about Form W-9, at wwwJrs.gov/w9. Information about any future developments W-9 to request your TIN, you must use the requester's form if It is substantially affecting Form W-9 (such as legislation enacted after we release it) will be posted similar to this Form W-9. on that page. Definition of a U.S. person. For federal tax purposes, you are considered a US. Purpose of Form person if you are: A person who is required to file an information return with the IRS must obtain your • An Individual who is a U.S. citizen or U .S. resident alien, cored taxpayer identification number (TIN) to report, for example, income paid to • A partnership, corporation, company, or association created or organized in the you, payments made to you in settlement of payment card and third party network United States or under the laws of the United States, transactions, real estate transactions, mortgage interest you paid, acquisition or . An estate (other than a foreign estate), or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. . q domestic trust (as defined in Regulations section 301 .7701 -7). Use Form W-9 only if you are a U.S. person (including a resident alien), to Special rules for partnerships. Partnerships that conduct a trade or business In provide your correct TIN to the person requesting it (the requester) and , when the United States are generally required to pay a withholding tax under section applicable, to: 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, 1 . Certify that the TIN you are giving is correct (or you are waiting for a number the rules under section 1446 require a partnership to presume that a partner is a to be issued), foreign person, and pay the section 1446 withholding tax. Therefore, if you are a 2. Certify that you are not subject to backup withholding, or U .S. parson that is a partner in a partnership conducting a trade or business in the 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If United States, provide Form W-9 to the partnership to establish your U.S. status applicable, you are also certifying that as a U.S. person, your allocable share of and avoid section 1446 withholding on your share of partnership income, any partnership income from a U .S. trade_ or business is not subject to the -- - - -- - _ Cat. No, 10231X Form W-9 (Rev. 8W2013)