com W=8BEN| Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting (Individuals) (Pex say 2007 > Foruse by individuals. Entities must use Form W-8BEN-E. COME No, 145-621 cepa ve ees > Go to wwwis.gov/FormWEBEN for instructions and the latest information ibe Sec. > Give this form othe withholding agent or payer. Do not send tothe IRS. De NOT use tis forme Instead, use For + You are NOT an invicta WeaBEN-e + You are aU. eizen or othr U.S, person including a resident aio navel we + You are a beneficial omer claiming that income is etfctvly connected wth he conduct f trade or business within the US. {other an personal verices) weseci + You are a beneficial onner whois receiving compensation for personal srlces performed inte United States 8253 or Wt + You ae aperson acting a8 an rteettary wan Note: I you ae resident ina FATCA partner jurisdiction (Le, a Medel 1 IGA jurisdiction with reciprocity, cetan tax account information may Be provided te your lursdiction of residence, Identification of Beneficial Owner [see instructions). SP NAT of ava wines the Bootie omer Coa oR ‘3 Porrnanent rescence adaess ave0t apt or Sle no, oF Tal Yous, Da not Use a P.O, bax or In-care-of adress, ‘ity ar town, sate or province, Include pewtal code where appropriate Coury 7 Maling adress (afferent rom above) ‘iy ar town, Hate or province, Include povlal code where appropriate County 5 TLS. taxpayer Weniineation number SSN or TIN, required feo ratuctons] Foreign tax idoring number G08 HSTAUCTOAS) 7 Reference numberfa (see instructions) @ Date of bith (MNCOO-VYYY) fee inatructons) [EER Gian of Tax Treaty Benefits (or chapter 3 purposes ony) lose netuctions] 1 caily tal he Benet ower isa resident of ‘atin the meaning ofthe come tax treat between the United States an tat county 10 Special rates and condone ( ppleable~see instructions The benef owner claiming the provisions a ticle and paragraph cf te vest dense on ne 9 above to clam rate of wielding on pect type o! Income) ‘Explain the adaivonal conditions in the Arle and paragraph the beneficial owner meets to be eligible fr the rate of winholding? Certification Tareel ard complete ther [musing ths frm to document ysl for chapter purposes ° (a rot etecwely connected wth the conduct of rade or business nthe United States, (eh etectnely connected buts not subject to tax under an applleaBle Income tx tty, or (ote partner’ share fa pavers’ etectvey connected income, +The person named on 1 of i fort a ede of he treaty county ate on ine 9a the form any win the meaning ofthe income tax nasty beeen + Forbrokertransactons or baer exchanges, he benefiin wra an exempt oeign parson as denen the stron, vedo ay wii st a ort ef usa ft care wich wn bel uno Fantname ogrer ‘Tape whch tng er rol signed by bara own For Paperwork Reduction Act Notice, se soparate instructions. ‘Ga Ne, 250872 Form W-BBEN hev.7-2017