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I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and/div>

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The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

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You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding. You will need to print out your hard copy form at the end of the interview and cross out item 2 before signing and mailing to the address provided. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

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