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Certificate of Status of Beneficial Owner for United States Tax Withholding and Reporting (Entities)
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■@JUj■ Certified Deemed-Compliant Sponsored, Closely Held lnvestment Vehicle 20 5H/ V LK ćj L ćL}_ � V ~_~y T l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l 21 O C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
• Qć H BBC ćLQVQy ?V"Hu ćV _~ _ć H _ v Vć~/ V ~ V ~_~y ' Vć" }_?V' _ : V� u QH~_L ć ćV"~_L 1y1D t 1lpeVveDvs • Qć L~ H OCu 8 6u L} WT; • 8 _QQ ; Hv V HQQ LK _~ć ' u V ' _Q_� V "Vu w _~; ; LQ' _ � u H ' }Vj L}~_ � }Vćj L ć_?_Q_~_Vć e' V~V}/ _ V' Hć _K ~; V BBC w V}V H j H}~_"_j H~_ � BBCv Ku QK_QQV' ?y ~; V ćj L ćL}_ � V ~_~y _' V ~_~_V' L Q_ V 70s H '
• 70 L} ~Vw V} _ ' _v _' u HQć Lw HQ_ LK ~; V ' V?~ H ' V\ u _~y _ ~V}Vć~ć _ ~; V V ~_~y e' _ć}V� H}' _ � ' V?~ _ ~V}Vć~ć Lw V' ?y 9yUy K_ H "_HQ _ ć~_~u ~_L ću j H}~_"_j H~_ � BBQću }V� _ć~V}V' ' VV/ V' l "L/ j Q_H ~ BBQću H ' "V}~_K_V' ' VV/ V' l "L/ j Q_H ~ BBQć H ' V\ u _~y _ ~V}Vć~ć Lw V' ?y H V ~_~y _K ~; H~ V ~_~y Lw ć 100n LK ~; V V\ u _~y _ ~V}Vć~ć _ ~; V BBC H ' _ć _~ćVQ~ H ćj L ćL}V' BBCvy
1:ffilWli Certified Deemed-Compliant Limited Lite Debt lnvestment Entity 22 O C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_~_V' _ 6H}~ CT
• 8 Hć _ Vx _ć~V "V Hć LK GH u H}y 1t u 701) s • Qćću V' HQQ "QHććVć LK _~ć ' V?_ L} V\ u _~y _ ~V}Vć~ć ~L _ v Vć~L}ć L L} ?VKL}V GH u H}y 1t u 701) u j u }ću H ~ ~L H ~}u ć~ _ ' V ~u }V L} ć_/ _QH} H� }VV/ V ~s H ' • Qć "V}~_K_V' ' VV/ V' l "L/ j Q_H ~ ?V"Hu ćV _~ ćH~_ćK_Vć ~; V }V\ u _}V/ V ~ć ~L ?V ~}VH~V' Hć H Q_/ _~V' Q_~V ' V?~ _ v Vć~/ V ~ V ~_~y eću " ; Hć ~; V }Vć~}_"~_L ć w _~; }Vćj V"~ ~L _~ć HććV~ć H ' L~; V} }V\ u _}V/ V ~ć u ' V} : V� u QH~_L ć ćV"~_L 1y1D t 1lpeKve7ve_v vvy ■@1f3i Certain lnvestment Entities that Do Not Maintain Financial Accounts
23 O C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT • Qć H ~_ H " _HQ _ ć~_~u ~_L ćLQVQy ?V"Hu ćV _~ _ć H _ v Vć~/ V ~ V ~_~y ' Vć" }_?V' _ : V� u QH~_L ć ćV"~_L 1y1D t 1lpeVveDve_ve21vu H ' • WLVć L~ / H_ ~H_ K_ H "_HQ H""Lu ~ćy ■@Q Owner-Documented FFI
Note: z; _ć ć~H~u ć L Qy Hj j Q_Vć _K ~; V 9yUy K_ H "_HQ _ ć~_~u ~_L u j H}~_"_j H~_ � BBCu L} }Vj L}~_ � ML' VQ 1 BBC ~L w ; _" ; ~; _ć ~L}/ _ć � _v V ; Hć H� }VV' ~; H~ _~ w _QQ ~}VH~ ~; V BBC Hć H Lw V}l ' L" u / V ~V' BBC ećVV _ ć~}u "~_L ć ~L} VQ_� _?_Q_~y }V\ u _}V/ V ~ćvy Q H' ' _~_L u ~; V BBC / u ć~ / H$V ~; V "V}~_~_"H~_L ć ?VQLw y 24a O (AII Lw V}l ' L" u / V ~V' BBQć " ; V"$ ; V}Vv C "V}~_Ky ~; H~ ~; V BBC _' V ~_K_V' _ 6H}~ CT
• WLVć L~ H"~ Hć H _ ~V}/ V' _H}y s • WLVć L~ H""Vj ~ ' Vj Lć_~ć _ ~; V L}' _ H}y "Lu }ćV LK H ?H $_ � L} ć_/ _QH} ?u ć_ Vććs • WLVć L~ ; LQ' u Hć H ću ?ć~H ~_HQ j L}~_L LK _~ć ?u ć_ Vćću K_ H "_HQ HććV~ć KL} ~; V H""Lu ~ ot L~; V}ćs • Qć L~ H _ ću }H "V "L/ j H y eL} ~; V ; LQ' _ � "L/ j H y LK H _ ću }H "V "L/ j H y v ~; H~ _ćću Vć L}_ć L?Q_� H~V' ~L / H$V j Hy / V ~ć w _~; }Vćj V"~ ~L H K_ H "_HQ H""Lu ~s
• 1ć L~ Lw V' ?y L} _ H Vx j H ' V' HKK_Q_H~V' � }Lu j w _~; H V ~_~y ~; H~ H""Vj ~ć ' Vj Lć_~ć _ ~; V L}' _ H}y "Lu }ćV ot H ?H $_ � L} ć_/ _QH} ?u ć_ Vćću ; LQ' ću Hć H ću ?ć~H ~_HQ j L}~_L LK _~ć ?u ć_ Vćću ~_ H "_HQ HććV~ć ~L} ~; V H""Lu ~ LK L~; V}ću L} _ć H _ ću }H "V "L/ j H y eL} ~; V ; LQ' _ � "L/ j H y ot H _ ću }H "V "L/ j H y v ~; H~ _ćću Vć L} _ć L?Q_� H~V' ~L / H$V j Hy / V ~ć w _~; }Vćj V"~ ~L H ~_ H "_HQ H""Lu ~s
• WLVć L~ / H_ ~H_ H ~_ H "_HQ H""Lu ~ KL} H y L j H}~_"_j H~_ � BBCs and • WLVć L~ ; Hv V H y ćj V"_~_V' 9yUy j V}ćL ć ~; H~ Lw H V\ u _~y _ ~V}Vć• L} ' V?~ _ ~V}Vć_ eL~; V} ~; H H ' V?~ _ ~V}Vć_ ~; H~ _ć L~ H ~_ H " _HQ H""Lu ~ L} ~; H~ ; Hć H ?HQH "V L} v HQu V L~ Vx "VV' _ � r p0u000v _ ~; V BBC L~; V} ~; H ~; LćV _' V ~_~_V' L ~; V BBC Lw V} }Vj L}~_ � ć~H~V/ V ~y
BL}/ W-8BEN-E e: Vv y t l701t v
BL}/ 8 l d d - 5 l - e: Vv y t l 701t v ■@EI Owner-Documented FFI (continued) 6H� V 4
m; V" $ ?Lx 7D? L} 7D" u w ; _" ; Vv V} Hj j Q_Vćy
? O C " V}~_Ky ~; H~ ~; V BBC _' V ~_K_V' _ 6H}~ CT
• NHć j }Lv _' V' u L} w _QQ j }Lv _' Vu H BBC Lw V} }Vj L}~_ � ć~H~V/ V ~ ~; H~ " L ~H_ ćT
e_v z ; V H/ Vu H' ' }Vćću z C5 e_K H y vu " ; Hj ~V} D ć~H~u ću H ' ~y j V LK ' L" u / V ~H~_L j }Lv _' V' e_K }V\ u _}V' v LK Vv V}y _ ' _v _' u H• H ' ćj V" _K_V' 9 yUy j V}ćL ~; H~ Lw ć H ' _}V" ~ L} _ ' _}V" ~ V\ u _~y _ ~V}Vć_ _ ~; V Lw V}l ' L" u / V ~V' BBC eQLL$_ � ~; }Lu � ; HQ_ V ~_~_Vć L~; V} ~; H ćj V" _K_V' 9 yUy j V}ćL ćvs
e__v z ; V H/ Vu H' ' }Vćću z C5 e_K H y vu H ' " ; Hj ~V} D ć~H~u ć LK Vv V}y _ ' _v _' u H• H ' ćj V" _K_V' 9 yUy j V}ćL ~; H~ Lw ć H ' V?_ _ ~V}Vć• _ ~; V Lw V}l ' L" u / V ~V' BBC e_ " Qu ' _ � H y _ ' _}V" ~ ' V?_ _ ~V}Vć~u w ; _" ; _ "Qu ' Vć ' V?~ _ ~V}Vć~ć _ H y V ~_~y ~; H~ ' _}V" ~Qy L} _ ' _}V" ~Qy Lw ć ~; V j Hy VV L} H y ' _}V" ~ L} _ ' _}V" ~ V\ u _~y _ ~V}Vć~ _ H ' V?~ ; LQ' V} LK ~; V j Hy VVv ~; H~ " L ć~_~u ~Vć H K_ H " _HQ H" " Lu ~ _ Vx " Vćć LK r p0u000 e' _ć}V� H}' _ � HQQ ću " ; ' V?~ _ ~V}Vć~ć Lw V' ?y j H}~_" _j H~_ � BBQću }V� _ć~V}V' ' VV/ V' l " L/ j Q_H ~ BBQću " V}~_K_V' ' VV/ V' " L/ j Q_H ~ BBQću Vx " Vj ~V' 5 BB- ću Vx V/ j ~ ?V VK_" _HQ Lw V}ću L} 9 yUy j V}ćL ć L~; V} ~; H ćj V" _K_V' 9 yUy j V}ćL ćvs H '
e___v b y H' ' _~_L HQ _ KL}/ H~_L ~; V w _~; ; LQ' _ � H� V ~ }V\ u Vć~ć _ L}' V} ~L Ku QK_QQ _~ć L?Q_� H~_L ć w _~; }Vćj V" ~ ~L ~; V V ~_~y y
• NHć j }Lv _' V' u L} w _QQ j }Lv _' Vu v HQ_' ' L" u / V ~H~_L / VV~_ � ~; V }V\ u _}V/ V ~ć LK : V� u QH~_L ć ćV" ~_L 1y1D t 1l ) e' veave___v KL} VH" ; j V}ćL _' V ~_K_V' _ ~; V BBC Lw V} }Vj L}~_ � ć~H~V/ V ~y
" O C " V}~_Ky ~; H~ ~; V BBC _' V ~_K_V' _ 6H}~ C ; Hć j }Lv _' V' u L} w _QQ j }Lv _' Vu H Hu ' _~L}Rć QV~~V}u ć_� V' w _~; _ D y VH}ć LK ~; V ' H~V LK j Hy / V ~u K}L/ H _ ' Vj V ' V ~ H" " Lu ~_ � K_}/ L} QV� HQ }Vj }VćV ~H~_v V w _~; H QL" H~_L _ ~; V 9 _~V' U~H~Vć ć~H~_ � ~; H~ ~; V K_}/ L} }Vj }VćV ~H~_v V ; Hć }Vv _Vw V' ~; V BBQRć ' L" u / V ~H~_L w _~; }Vćj V" ~ ~L HQQ LK _~ć Lw V}ć H ' ' V?~ ; LQ' V}ć _' V ~_K_V' _ : V� u QH~_L ć ćV" ~_L 1y1D t 1l ) e' veave_v veb ve7vu H ' ~; H~ ~; V BBC / VV~ć HQ_ ~; V }V\ u _}V/ V ~ć ~L ?V H Lw V}l ' L" u / V ~V' BBCy z ; V BBC _' V ~_K_V' _ 6H}~ C ; Hć HQćL j }Lv _' V' u L} w _QQ j }Lv _' Vu H BBC Lw V} }Vj L}~_ � ć~H~V/ V ~ LK _~ć Lw V}ć ~; H~ H}V ćj V" _K_V' 9 yUy j V}ćL ć H ' BL}/ ećv 8 lhu w _~; Hj j Q_" H?QV w H_v V}ćy
Check box 24d if applicable eLj ~_L HQu ćVV _ ć~}u " ~_L ćvy
' O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' L Q_ V 1 _ć H ~}u ć~ ~; H~ ' LVć L~ ; Hv V H y " L ~_ � V ~ ?V VK_" _H}_Vć L} ' Vć_� H~V' " QHććVć w _~; u _' V ~_K_V' ?V VK_" _H}_Vćy ■@E◄■ Restricted Distributor
7pH O eb CC }Vć~}_" ~V' ' _ć~}_?u ~L}ć " ; V" $ ; V}Vv C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
• 4 j V}H~Vć Hć H ' _ć~}_?u ~L} w _~; }Vćj V" ~ ~L ' V?_ L} V\ u _~y _ ~V}Vć~ć LK ~; V }Vć~}_" ~V' Ku ' w _~; }Vćj V" ~ ~L w ; _" ; ~; _ć KL}/ _ć Ku } _ć; V' s
• 6 }Lv _' Vć _ v Vć~/ V ~ ćV}v _" Vć ~L H~ QVHć~ ) 0 " u ć~L/ V}ć u }VQH~V' ~L VH" ; L~; V} H ' QVćć ~; H ; HQK LK _~ć " u ć~L/ V}ć H}V }VQH~V' ~L VH" ; L~; V}s
• Qć }V\ u _}V' ~L j V}KL}/ bMg ' u V ' _Q_� V " V j }L" V' u }Vć u ' V} ~; V H ~_l / L Vy QHu ' V}_ � QHw ć LK _~ć " Lu ~}y LK L}� H _z H~_L ew ; _" ; _ć H Bb z B " L/ j Q_H ~ %u }_ć' _" ~_L vs
• 4 j V}H~Vć ćLQVQy _ _~ć " Lu ~}y LK _ " L}j L}H~_L L} L}� H _z H~_L u ; Hć L K_x V' j QH" V LK ?u ć_ Vćć Lu ~ć_' V LK ~; H~ " Lu ~}y u H ' ; Hć ~; V ćH/ V " Lu ~}y LK _ " L}j L}H~_L L} L}� H _z H~_L Hć HQQ / V/ ?V}ć LK _~ć HKK_Q_H~V' � }Lu j u _K H y s
• WLVć L~ ćLQ_"_~ " u ć~L/ V}ć Lu ~ć_' V _~ć " Lu ~}y LK _ " L}j L}H~_L L} L}� H _z H~_L s
• NHć L / L}V ~; H r 1t p / _QQ_L _ ~L~HQ HććV~ć u ' V} / H H� V/ V ~ H ' L / L}V ~; H r t / _QQ_L _ � }Lćć }Vv V u V L _~ć _ " L/ V ć~H~V/ V ~ KL} ~; V / Lć~ }V" V ~ H" " Lu ~_ � y VH}s
• Qć L~ H / V/ ?V} LK H Vx j H ' V' HKK_Q_H~V' � }Lu j ~; H~ ; Hć / L}V ~;H r p00 / _QQ_L _ ~L~HQ HććV~ć u ' V} / H H� V/ V ~ L} / L}V ~; H r 70 / _QQ_L _ � }Lćć }Vv V u V KL} _~ć / Lć~ }V" V ~ H" " Lu ~_ � y VH} L H " L/ ?_ V' L} " L ćLQ_' H~V' _ " L/ V ć~H~V/ V ~s H '
• WLVć L~ ' _ć~}_?u ~V H y ' V?~ L} ćV" u }_~_Vć LK ~; V }Vć~}_" ~V' Ku ' ~L ćj V" _K_V' 9 yUy j V}ćL ću j Hćć_v V 5 BB- ć w _~; L V L} / L}V ću ?ć~H ~_HQ 9 yUy Lw V}ću L} L j H}~_" _j H~_ � BBQćy
Check box 25b or 25c, whichever applies. C Ku }~; V} " V}~_Ky ~; H~ w _~; }Vćj V" ~ ~L HQQ ćHQVć LK ' V?_ or V\ u _~y _ ~V}Vć~ć _ ~; V }Vć~}_" ~V' Ku ' w _~; }Vćj V" ~ ~L w ; _" ; ~; _ć KL}/ _ć Ku } _ć; V' ~; H~ H}V / H' V HK~V} WV" V/ ?V} ) 1u 7011u ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
b O NHć ?VV ?Lu ' ?y H ' _ć~}_?u ~_L H� }VV/ V ~ ~; H~ " L ~H_ V' H � V V}HQ j }L; _?_~_L L ~; V ćHQV LK ' V?_ L} ćV" u }_~_Vć ~L 9 yUy V ~_~_Vć H ' 9 yUy }Vć_' V ~ _ ' _v _' u HQć H ' _ć " u }}V ~Qy ?Lu ' ?y H ' _ć~}_?u ~_L H� }VV/ V ~ ~; H~ " L ~H_ ć H j }L; _?_~_L LK ~; V ćHQV LK ' V?~ L} ćV" u }_~_Vć ~L H y ćj V"_K_V' 9 yUy j V}ćL u j Hćć_v V 5 BB- w _~; L V L} / L}V ću ?ć~H ~_HQ 9 yUy Lw V}ću L} L j H}~_" _j H~_ � BBCy
c O Cć " u }}V ~Qy ?Lu ' ?y H ' _ć~}_?u ~_L H� }VV/ V ~ ~; H~ " L ~H_ ć H j }L; _?_~_L L ~; V ćHQV LK ' V?~ L} ćV" u }_~_Vć ~L H y ćj V" _K_V' 9 yUy j V}ćL u j Hćć_v V 5 BB- w _~; L V L} / L}V ću ?ć~H ~_HQ 9 yUy Lw V}ću L} L j H}~_" _j H~_ � BBC H ' u KL} HQQ ćHQVć / H' V j }_L} ~L ~; V ~_/ V ~; H~ ću " ; H }Vć~}_" ~_L w Hć _ " Qu ' V' _ _~ć ' _ć~}_?u ~_L H� }VV/ V ~u ; Hć }Vv _Vw V' HQQ H" " Lu ~ć }VQH~V' ~L ću " ; ćHQVć _ H" " L}' H " V w _~; ~; V j }L" V' u }Vć _' V ~_K_V' _ : V� u QH~_L ć ćV" ~_L 1y1Dt 1l De" v Hj j Q_" H?QV ~L j }VVx _ć~_ � H" " Lu ~ć H ' ; Hć }V' VV/ V' L} }V~_}V' H y u L} " Hu ćV' ~; V }Vć~}_" ~V' Ku ' ~L ~}H ćKV} ~; V ćV" u }_~_Vć ~L H ' _ć~}_?u ~L} ~; H~ _ćH j H}~_" _j H~_ � BBC L} }Vj L}~_ � ML' VQ 1 BBC ćV" u }_~_Vć w ; _" ; w V}V ćLQ' ~L ćj V" _K_V' 9 yUy j V}ćL ću j Hćć_v V 5 BB- ć w _~; L V L} / L}V ću ?ć~H ~_HQ 9 yUy Lw V}ću L} L j H}~_" _j H~_ � BBQćy
BL}/ W-8BEN-E e: Vv y t l701t v
BL}/ 8 l d d - 5 l - e: Vv y t l 701t v
■=tff l3jl Nonreporting IGA FFI 6 H� V 5
26 O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
• MVV~ć ~; V }V\ u _}V/ V ~ć ~L ?V " L ć_' V}V' H L} Vj L}~_ � K_ H " _HQ _ ć~_~u ~_L j u }ću H ~ ~L H Hj j Q_" H?QV CE b ?V~w VV ~; V 9 _~V' U~H~Vć H '
z ; V Hj j Q_" H?QV CE b _ć H 4 ML' VQ 1 CE b L} H 4 ML' VQ 7 CE b s H ' _ć ~}VH~V' Hć H u ' V} ~; V j }Lv _ć_L ć LK ~; V Hj j Q_" H?QV CE b L} z }VHću }y }V� u QH~_L ć e_K Hj j Q_" H?QVu ćVV _ ć~}u " ~_L ćvs
• Q_ y Lu H}V H ~}u ć~VV ' L" u / V ~V' ~}u ć~ L} H ćj L ćL}V' V ~_~y u j }Lv _' V ~; V H/ V LK ~; V ~}u ć~VV L} ćj L ćL} P
z; V ~}u ć~VV _ćT 4 9 yUy 4 BL}V_�
i=tfff3jjl Foreign Government, Government of a U.S. Possession, or Foreign Central Bank of lssue 7t O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6 H}~ C _ć ~; V ?V VK_" _HQ Lw V} LK ~; V j Hy / V ~u H ' _ć L~ V � H� V' _ " L/ / V}" _HQ K_ H " _HQ H" ~_v _~_Vć LK H
~y j V V � H� V' _ ?y H _ ću }H " V " L/ j H y u " u ć~L' _HQ _ ć~_~u ~_L u L} ' Vj Lć_~L}y _ ć~_~u ~_L w _~; }Vćj V" ~ ~L ~; V j Hy / V ~ću H" " Lu ~ću L} L?Q_� H~_L ć tor w ; _" ; ~; _ć ~L}/ _ć ću ?/ _~~V' eVx " Vj ~ Hć j V}/ _~~V' _ : V� u QH~_L ć ćV" ~_L 1y1D t 1l ae; ve7vvy
i=Zfflf:U!) International Organization Check box 28a or 28b, whichever applies. 28a O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ C _ć H _ ~V} H~_L HQ L}� H _z H~_L ' Vć" }_?V' _ ćV" ~_L tt 01 eHve1f vy
b O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6 H}~ CT
• Qć " L/ j }_ćV' j }_/ H}_Qy LK ~L}V_� � Lv V} / " ~ćT • Qć }V" L� _z V' Hć H _ ~V}� Lv V} / V ~HQ L} ću j }H H~_L HQ L}� H _z H~_L u ' V} H KL}V_� QHw ć_/ _QH} ~L ~; V C ~V} H~_L HQ 4 }� H _z H~_L ć Q/ / u _~_Vć b " ~ L} ~; H~ ; Hć _ VKKV" ~ H ; VH' \ u H}~V}ć H� }VV/ V ~ w _~; H ~L}V_� � Lv V} / V ~s
• z ; V ?V VK_~ LK ~; V V ~_~y Rć _ " L/ V ' LVć L~ _ u }V ~L H y j }_v H~V j V}ćL s and • Qć ~; V ?V VK_" _HQ Lw V} LK ~; V j Hy / V ~ H ' _ć L~ V � H� V' _ " L/ / V}" _HQ K_ H " _HQ H" ~_v _~_Vć LK H ~y j V V � H� V' _ ?y H _ ću }H " " " L/ j H y u " u ć~L' _HQ _ ć~_~u ~_L u L} ' Vj Lć_~L}y _ ć~_~u ~_L w _~; }Vćj V"~ ~L ~; V j Hy / V ~ću H" " Lu ~ću L} L?Q_� H~_L ć tor w ; _" ; ~; _ć KL}/ _ć ću ?/ _~~V' eVx " Vj ~ Hć j V}/ _~~V' _ : V� u QH~_L ć ćV" ~_L 1y1Dt 1l ae; ve7vvy
I am Exempt Retirement Plans Check box 29a, b, c, d, e, or f, whichever applies.
7hH O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
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b O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6 H}~ CT
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(iv) g_/ _~ć " L ~}_?u ~_L ć ?y V/ j QLy VVć ~L ~; V Ku ' ?y }VKV}V " V ~L VH} V' _ " L/ V LK ~; V V/ j QLy VV L} / Hy L~ Vx " VV' r p0u000 H u HQQy y " O C " V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
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• NHć KVw V} ~; H p0 j H}~_" _j H ~ćs
• 1ć ćj L ćL}V' ?y L V L} / L}V V/ j QLy V}ć VH" ; LK w ; _" ; _ć L~ H _ v Vć~/ V ~ V ~_~y L} j Hćć_v V 5 BB- s
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• Qć ću ?%V" ~ ~L � Lv V} / V ~ }V� u QH~_L H ' j }Lv _' Vć H u HQ _ KL}/ H~_L }Vj L}~_ � H?Lu ~ _~ć ?V VK_" _H}_Vć ~L ~; V }VQVv H ~ ~Hx Hu ~; L}_~_" ć _ ~; V " Lu ~}y _ w ; _" ; ~; V Ku ' _ć Vć~H?Q_ć; V' L} Lj V}H~Vćy
BL}/ W-88EN-E e: Vv y t l 701t v
BL}/ 8 l f d - 5 l - e: Vv y t l 701t v 6 H� V 6 ■:tff EN Exempt Retirement Plans (continued)
d WC "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ C _ć KL}/ V' j u }ću H ~ ~L H j V ć_L j QH ~; H~ w Lu Q' / VV~ ~; V }V\ u _}V/ V ~ć LK ćV"~_L D01 eHvu L~; V} ~; H ~; V }V\ u _}V/ V ~ ~; H~ ~; V j QH ?V Ku ' V' ?y H ~}u ć~ "}VH~V' L} L}� H _z V' _ ~; V 9 _~V' U~H~Vćy
e W C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ C _ć Vć~H?Q_ć; V' Vx "Qu ć_v VQy ~L VH} _ "L/ V KL} ~; V ?V VK_~ LK L V L} / L}V }V~_}V/ V ~ Ku ' ć ' Vć" }_?V' _ ~; _ć j H}~ L} _ H Hj j Q_"H?QV ML' VQ 1 L} ML' VQ 7 •Ebu L} H" "Lu ~ć ' Vć" }_?V' _ : V� u QH~_L ć ćV"~_L 1y1D t 1lpe?ve7ve_vebv e}VKV}}_ � ~L }V~_}V/ V ~ H ' j V ć_L H" "Lu ~ćvu L} }V~_}V} V ~ H ' j V ć_L H" "Lu ~ć ' Vć" }_?V' _ H Hj j Q_"H?QV ML' VQ 1 L} ML' VQ 7 •Eby
WC "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
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• •ć Vć~H?Q_ć; V' H ' ćj L ćL}V' ?y H KL}V_� � Lv V} / V ~u _ ~V} H~_L HQ L}� H _z H~_L u "V ~}H• ?H $ LK _ćću Vu L} � Lv V} / V ~ LK H 9yUy j LććVćć_L eVH" ; Hć ' VK_ V' _ : V� u QH~_L ć ćV"~_L 1y1D t 1lav L} H Vx V/ j ~ ?V VK_"_HQ Lw V} ' Vć" }_?V' _ H Hj j Q_"H?QV ML' VQ 1 L} ML' VQ 7 CEb ~L j }Lv _' V }V~_}V/ V ~u ' _ćH?_Q_~y u L} ' VH~; ?V VK_~ć ~L ?V VK_" _H}_Vć L} j H}~_"_j H ~ć ~; H~ H}V H~ " u }}V ~ L} KH}/ V} V/ j QLy VVć LK ću " ; ćj L ćL}u ?u ~ H}V _ "L ć_' V}H~_L LK j V}ćL HQ ćV}v _"Vć j V}KL}/ V' KL} ~; V ćj L ćL}y
1:tff f:\!U Entity Wholly Owned by Exempt Beneficial Owners 30 W C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
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• NHć j }Lv _' V' ' L" u / V ~H~_L Vć~H?Q_ć; _ � ~; H~ Vv V}y Lw V} LK ~; V V ~_~y _ć H V ~_~y ' Vć" }_?V' _ : V� u QH~_L ć ćV"~_L 1y1D t 1lae?vu e" vy e' vu eVvu eKv H ' 2L} e� v w _~; Lu ~ }V� H}' ~L w ; V~; V} ću " ; Lw V}ć H}V ?V VK_"_HQ Lw V}ćy
1@f:\!)11 Territory Financial lnstitution ) 1 W C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ C _ć H K_ H "_HQ _ ć~_~u ~_L eL~; V} ~; H H _ v Vć~/ V ~ V ~_~y v ~; H~ _ć _ "L}j L}H~V' L} L}� H _z V' u ' V}
~; V QHw ć LK H LććVćć_L LK ~; V 9 _~V' U~H~Vćy Excepted Nonfinancial Group Entity
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1=tffl3f3 Excepted Nonfinancial Start-Up Company 33 W C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
• 8 Hć KL}/ V' L eL}u _ ~; V "HćV LK H Vw Q_ V LK ?u ć_ Vćću ~; V ' H~V LK ?LH}' }VćLQu ~_L Hj j }Lv _ � ~; V Vw Q_ V LK ?u ć_ Vććv P e' H~V / u ć~ ?V QVćć ~; H 7D / L ~; ć j }_L} ~L ' H~V LK j Hy / V ~vs • •ć H~ y V~ Lj V}H~_ � H ?u ć_ Vćć H ' ; Hć L j }_L} Lj V}H~_ � ; _ć~L}y L} _ć _ v Vć~_ � "Hj _~HQ _ HććV~ć w _~; ~; V _ ~V ~ ~L Lj V}H~V H Vw Q_ V LK ?u ć_ Vćć L~; V} ~; H ~; H~ LK H K_ H "_HQ _ ć~_~u ~_L L} j Hćć_v V 5BB- s • Qć _ v Vć~_ � "Hj _~HQ _ ~L HććV~ć w _~; ~; V _ ~V ~ ~L Lj V}H~V H ?u ć_ Vćć L~; V} ~; H ~; H~ LK H K_ H "_HQ _ ć~_~u ~_L s and • WLVć L~ Ku "~_L eL} ; LQ' _~ćVQK Lu ~v Hć H _ v Vć~/ V ~ Ku ' u ću " ; Hć H j }_v H~V V\ u _~y Ku ' u v V ~u }V "Hj _~HQ Ku ' u QVv V}H� V' ?u y Lu ~ Ku ' u L} H y _ v Vć~/ V ~ v V; _"QV w ; LćV j u }j LćV _ć~L H" \ u _}V L} Ku ' "L/ j H _Vć H ' ~; V ; LQ' _ ~V}Vć~ć _ ~; LćV "L/ j H _Vć Hć "Hj _~HQ HććV~ć ~L} _ v Vć~/ V ~ j u }j LćVćy
1=tff Ef3 Excepted Nonfinancial Entity in Liquidation or Bankruptcy 34 W C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ CT
• B_QV' H j QH LK Q_\ u _' H~_L u K_QV' H j QH LK }VL}� H _z H~_L u L} K_QV' KL} ?H $}u j ~" y L • Wu }_ � ~; V j Hć~ p y VH}ć ; Hć H~ ?VV V � H� V' _ ?u ć_ Vćć Hć H K_ H "_HQ _ ć~_~u ~_L L} H"~V' Hć H j Hćć_v V 5BB- s • Qć V_~; V} Q_\ u _' H~_ � L} V/ V}� _ � ~}L/ H }VL}� H _z H~_L L} ?H $}u j ~" y w _~; ~; V _ ~V ~ ~L "L ~_ u V L} }V"L/ / V "V Lj V}H~_L ć Hć H L K_ H "_HQ V ~_~y s and
• NHću L} w _QQ j }Lv _' Vu ' L" u / V ~H}y Vv _' V "V ću " ; Hć H ?H $}u j ~" y K_Q_ � L} L~; V} j u ?Q_" ' L" u / V ~H~_L ~; H~ ću j j L}~ć _~ć "QH_/ _K _~ }V/ H_ ć _ ?H $}u j ~" y L} Q_\ u _' H~_L KH} / L}V ~; H ) y VH}ćy
BL}/ W-8BEN-E e: Vv y t l701t v
BL}/ 8 l d d - 5 l - e: Vv y t l 701t v
i:tflEEii 501 (c) Organization 6H� V 7
35 O C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ C _ć H p01 e" v L}� H _z H~_L ~; H~T
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j:ftitf:◄11 Nonprofit Organization 36 O C "V}~_Ky ~; H~ ~; V V ~_~y _' V ~_K_V' _ 6H}~ C _ćH L j }LK_~ L}� H _z H~_L ~; H~ / VV~ć ~; V KLQQLw _ � }V\ u _}V/ V ~ćy
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j@f)3111 Publicly Traded NFFE or NFFE Affiliate of a Publicly Traded Corporation Check box 37a or 37b, whichever applies. 37a O C "V}~_Ky ~; H~T
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j@tj3'~ Excepted Territory NFFE
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BL}/ W-88EN-E e: Vv y t l701t v
Form W-8BEN-E (Rev. 7-2017)
j@f:+3'Jjj Excepted lnter-Affiliate FFI Page 8
41 O I certify that the entity identified in Pari I:• Is a member of an expanded affiliated group;• Does not maintain financial accounts (other than accounts maintained for members of its expanded attiliated group);• Does not make withholdable payments to any person other than to members of its expanded affiliated group;• Does not hold an account (other than depository accounts in the country in which the entity is operating to pay for expenses) with or receivepayments trom any withholding agent othcr than a member of its expanded attiliated group; and
• Has not agreed to report under Regulations section 1.1471-4(d)(2)(ii)(C) or otherwise act as an agent for chapter 4 purposes on behalf of any financialinstitution, including a member of its expanded affiliated group.
1:tff E+!Wllf Sponsored Direct Reporting NFFE (see instructions for when this is permitted)42 Name of sponsoring entity:
43 O I certify that the entity identified in Part I isa direct reporting NFFE that is sponsored by the entity identified on line 42.i:zjjf$o3 Substantial U.S. Owners of Passive NFFE As required by Part X.XVI, provide the name, address, and TIN of each substantial U.S. owner of the NFFE. Please see the instructions fora definition ofsubstantial U.S. owner. lf 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 forreporting its controlling U.S. persons under an applicable IGA.
Name Address TIN
i@f:+$j 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 furthercertify under penalties of perjury that:
• The entity identified on line 1 of this form is the beneficial owner of all the income to which this form relates, is using this forrn to certify its status for chapter 4purposes, or is a merchant submitting this forrn for purposes of section 6050W;
• The entity identified on line 1 of this form is not a U.S. person;
• The income to which this form relates is: (a) not effectively connected with the conduct of a trade or business in the United States, (b) effect,vely connected but isnot subject to tax under an income tax treaty, or (c) the partner's share of a partnership's effectively connected income; 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 beneficialowner 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.
Signature of individua! authorized to sign for beneficial ownerCEO A.Mahmutović; CFO M.Consalvi
Print NameO=t-1:>0-Wk:J
Date (MM-OD-YYYY)
~ 0 I certify that I have the capacity to sign tor the entity identified on line 1 of this form.• I /
Form W-8BEN-E (Rev. 7-2017)