Form Bfm-0001 - Substitute W-9 Taxpayer Identification Number (Tin) Verification - 2013 Page 3
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4Substitute W-9 Form, page 3
BFM-0001 (09/2013)
Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the Exemptions box, any code(s) that
may apply to you. See Exempt payee code and Exemption from FATCA reporting code below.
Exempt payee code. Generally, individuals (including sole proprietors) are not exempt from backup withholding.
Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Corporations
are not exempt from backup withholding for payments made in settlement of payment card or third
party
network
transactions.
Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous
backup withholding.
The following codes identify payees that are exempt from backup withholding:
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 possession of the United States, 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 possession of the United States
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
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. 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 possession of the United States, 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 Reg. 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 Reg.
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
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