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A;8 K C:070;8 AB0BCA Territory FI, ?@54AB02LB5 A>>B25BAB2CNICN D>@<C W-8. >A;5 2K1>@0 ;N1>3> 20@80=B0 ?5@5E>48B5 : ?.20..@848G5A:>5 ;8F> 8<55B AB0BCA D8=0=A>2>3> 8=AB8BCB0, =5 ?>4;560I53> @538AB@0F88 =0 ?>@B0;5 IRS  FORMCHECKBOX   FORMCHECKBOX "5 70?>;=O5BAO, 5A;8 2 ?.9 K >B25B8;8 ", 2 ?.11 K >B25B8;8 , 0 2 ?.12 K >B25B8;8     '!+%. A;8 K >B25B8;8 , 70?>;=8B5 @8;>65=85 ! 1 : 40==><C ?@>A=><C ;8ABC, ?@54>AB02LB5 A>>B25BAB2CNICN D>@<C W8 8 2A5 =5>1E>48<K5 4>:C<5=BK, C:070==K5 2 A>>B25BAB2CNI59 D>@<5 W8. 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FORMCHECKBOX  1O7C5<AO 2 A;CG05 87<5=5=8O ?@54AB02;5==>9 8=D>@<0F88 ?@54>AB028BL 2  !1"! >1=>2;5==CN 8=D>@<0F8N =5 ?>74=55 10 @01>G8E 4=59 A <><5=B0 55 87<5=5=8O.  FORMCHECKBOX  05< A>3;0A85 =0 ?5@540GC 8=D>@<0F88 2 A>>B25BAB288 A 70:>=>40B5;LAB2>< >AA89A:>9 $545@0F88 2 IRS 8;8 =0;>3>2><C 035=BC, C?>;=><>G5==><C IRS .  FORMCHECKBOX  5 405< A>3;0A85 =0 ?5@540GC 8=D>@<0F88 2 A>>B25BAB288 A 70:>=>40B5;LAB2>< >AA89A:>9 $545@0F88 2 IRS 8;8 =0;>3>2><C 035=BC, C?>;=><>G5==><C IRS.  FORMCHECKBOX  1O7C5<AO ?> 70?@>AC !1"! ?@54>AB028BL 2 !1"! 8=D>@<0F8N, =5>1E>48<CN 4;O 845=B8D8:0F88 2 :0G5AB25 =0;>3>?;0B5;LI8:0 !(. ____________________20___3. _________________________________________________ 0B0 ($, ?>4?8AL) 0?>;=O5BAO @01>B=8:><  !1"!:0B0 ?>;CG5=8O 4>:C<5=B>2 >B :;85=B0 _____ _____________20____3. ;85=B >B=>A8BAO : :0B53>@88 =0;>3>?;0B5;LI8:0 !(  FORMCHECKBOX   FORMCHECKBOX " ;85=B >B=>A8BAO : :0B53>@88 =0;>3>?;0B5;LI8:0 !(, 5A;8 =0 >A=>20=88 40==>3> ?@>A=>3> ;8AB0, ?@54AB02;5==KE D>@< W-9, W-8 CAB0=>2;5=>, GB> 53> AB0BCA 4;O F5;59 FATCA >48= 87 A;54CNI8E: Specified U.S. Person (>A=>2=0O G0ABL ?@>A=>3> ;8AB0 N@848G5A:>3> ;8F0); Owner-documented FFI with U.S .owners (?.4 @8;>65=8O ! 1 : 40==><C ?@>A=><C ;8ABC); Passive NFFE with substantial U.S. owners (?.2 @8;>65=8O ! 2 : 40==><C ?@>A=><C ;8ABC). 0B0 ?@8=OB8O @5H5=8O >1 >B=5A5=88 (=5>B=5A5=88) :;85=B0 : :0B53>@88 =0;>3>?;0B5;LI8:0 !( _____________20__3. 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