|
a
<br />VM -9
<br />Request for Taxpayer
<br />Identification Number and Certification
<br />► Go to www.irs.gov/ForinW9 for instructions and the latest information.
<br />1 rJlallit• Id's $III,IWi+ on y-ir nc,omv idz ie,wm Name is r;,(.l,r±ired wi t:ns lino: too not leave,!
<br />Joshua Harvey Ghiz SR
<br />? l:� : r ,. �r r.^ -, ka.Grd t -h; •,t lr f arty: ,.,t !mm f,q ,
<br />JSR EN -I ERPRISES EAST COAST LLC d/b/a/ ISR FUELING TECHNOLOGIES, LLC
<br />9 , • tu,, rt,uux;r at, b,<,a t�.dela, tai ia; r:+c _aa :,I the., person whose name ts enured on Ime L Check only one of the
<br />' _✓ � 1:idi•:It tj,il <;Ic: flydpri-tor (,, .—i r;n•porat;r_,n 'J S Corporatio �.'- Partners!', Ej 1'rdst!estalr;
<br />;jin Jig-'-m:wlixar I Li,
<br />1 ,.,rite; l iardit; ;;w,1p (nV. E !aa; the tat ctras;ificat:nn rC;=c) ::r;rperation. i�=3 f:orpar:ation. � =:Parinerstllf�.J ----
<br />Note: CrwCk the aperonriate hot u, -hr Ilne abovu f:y in- tax classification of the s:ngIe-meo:ber owner. Do not check
<br />LL.; .f the t.i_C rs citiss+lted as a s-nyle-mcn,i.er LI -C. that Is :ilsregarded fro•' Inc owner :,;mess the owner nt the LL.C, is
<br />norhw L.t. C that Is not disregarded from 1e n%,,ver for U.S. to;ieral tax purposes. Otherwise. a single -member i-I_C that
<br />i, r!�:;wtt,rrdoJ from the (owner should chuck tha at.,propriite box for the tax classr ;cation of is owner.
<br />�...' t )I IP:,I tJ,:,; it iJifilGlVrlbl r
<br />., rld,u,....; t., illi r _.trro.Gt. ,.nd at,.. ;tr ,.. .(.: iti.:.,r... ,n,t ',:r.ton,.
<br />350') TADLOCK AVE
<br />V t:,:.v .. ,. ;Ii,o 71E' co(d(:
<br />CRANI VAIKARIAFt 329SO
<br />7 i i:.+ ., �..,nn❑ r:l n In;rL,) I+: .. (_,,nb(aunl(
<br />Taxpayer Identification Number (TIN)_
<br />Give Form to the
<br />requester. Do not
<br />send to the IRS.
<br />4 Exempuons fcoor.�- arply only id
<br />amour e^titres, net aid:vir:oral;:. s. ;.
<br />2nstluctions or: paa+ 3).
<br />Exempt payee code if ; -
<br />Exemp,ion ron; r=Att;l, !sporting
<br />code tit any(
<br />I ReC;ui;3ter s narile .1 1.6 address t'.p': mw
<br />I
<br />r ,our 1 IN in it a, appropriate her. Thr; TIN provsdad must match tyre name give -„n on line, t to avoid
<br />v?i111INd n(I. Frit Ind:v du;.tl this r, gertr•r:idly your -%C171's:3.^:Irity nirn'ber (SSN). HowevAr, for a
<br />:ak;nt air(,• . t.oli; propnctor_ or r.flsr(,rgirded ent+ty, see the nstructtons for Part I later. f -or other
<br />rt:tlr:es: It it, y,.;ur einpioyt-i identification number (EIN). It you do riot have a number, see How to get a
<br />ON, lat-r,
<br />Note: 14 .the account is in more that, one name. see the instructions for line 1. Also see lNhat Name and
<br />Number Ti', Give the Requester for qufdelines cm whose number to enter.
<br />Certification _
<br />,jr-idet penait.;as of oerfurv. I certify that:
<br />or
<br />number
<br />4161-13101315 1 1!710
<br />I IIH number --how,, on this form Is my correct iaxpayei Identification number to• I am waiting for a number to be issued to me): and
<br />_.
<br />innot subject to backup wrthl �oldlnq oecause. sal 1 am exempt from backup withholding, or (b) i have not been notified by the Internal Revenue
<br />S•:-rvica (IR�;t that I am subject to backup withholding as a result of a failure to report all interest or divicenos. or (c) the IRS has notified me that I am
<br />no ioncjet sit lent to backup withholding. and
<br />'. 1 a^; a td.S. rit;,.rrt or other I.f.S. person (defined below): and
<br />4. 'h( [A I GA codes eritered on this forts, id any, ridicating that I ant exempt from.; FATCA reporting is correct.
<br />Certification instructions. You must c;ress out tela 2 above .f you have been notilied by the IRS that you are currently subject to backup withholding because
<br />,ou have tailed to fepor, all interest and dividends ort yoilm. For real estateTrATiSactions, item 2 does not apply. For mortgage Interest paid.
<br />:;Gaus;`1 on at abandonment of secured oroperty eaticellayah of deot.pettfF6utions to an individual ret dement arrangement (IRA), andgeneraliy, payments
<br />other than interest and dividends. you are nqi- euu red , sign -.r,9 r✓%tiLcatlon, but you must provide your correct TIN. See the Ins�rt`i;,tions for Part If, later.
<br />t9n 1 Smimture of r `lam ^ i
<br />Here
<br />= '� rti
<br />I U.S. person r ,., � m"`��..._--.. ,...��_�, Date►
<br />General Instructions
<br />Srct:on references areZ,61he Internal Rev(' Code unless otherwise
<br />Future developments. For the latest information ,about developments
<br />?last o to F ^nn W-9 anG ,ts instructions. such as Iyglslatic:m enacted
<br />if r f -ey wet. published, go to wVVw irs.gov/f-orrr'A9.
<br />Purpose of Form
<br />/fin v divwual :�( entity (!-orrn W-9 requester) *h(I is mqurred to file an
<br />Monlali nt reaurn with the IHS mutt obtain your currect taxpayer
<br />tt;fic:tion number (?IN) which may be gent soc.al security number
<br />!SSN), Indiv dual taxpayer identification number It IN). adoption
<br />:,;xp-rp.;r dentttication number'ATIN). or employer identi`cation number
<br />riN). to report on an intonratlon return the amount paid to you. or other
<br />:;mount rc4p,xtable on an information ret.un, Examples cf information
<br />include, but are not limited to. the foilow+ :q.
<br />• Form, :099 INT (interest earned or paid)
<br />• Form 1099 -DIV (dividends, including those from stocks or mutual
<br />funds)
<br />• f=orm 1099 -MIST (various types of income, prizes, awards. or gross
<br />proceeds)
<br />• 'Form 1099-R (stor.k or mutual fund sates and relain other
<br />transactions i -y brokersl
<br />• l orm 1099-5 (pro,; t,eds frorn real estate transachonsi
<br />• t ofnl 1099-K (merchant card :rnd third,' party network tran,,actiw s)
<br />• Form 1098 (home mortgage Interest). 1098-ir (stude(,t loan interesti,
<br />1098-T ;tuition)
<br />• Form 1099-C ('canceled debt)
<br />• Form 1099-A (acquisition or abandonment of secured property)
<br />Use Form W-9 only :f you are a U.S. person (Including a resident
<br />alien), to provide your correct TW.
<br />It you do riot return Form W-9 to the requester with a TIN. you might
<br />be subject to backup withholding. See What is backup withholding.
<br />later.
<br />Cat. No, IU231X Form W-9 fRev. 10-2018)
<br />
|