ZBA Application Package 92922

Request for Taxpayer Identification Number and Certification internal Revenue Serve > Go to www.irs.gov/FormW6 for instructions and the tatest information. T Rate is SHOWA GF your income tax returl, Nama is reaured on this ore. do not! 89 Ashland Avenue LLC F Elniness ravedinegarces evtty name tdarem ham above om WeQ Rev, Ootonee 2018) Deparment of the Troasuy Give Form to the requester. Do not send to the IRS, 3 Check appropraia box for taciessi tax classification of the par fellawing aoven Bows, 88 FAME S OM a on ine 1. Check only one of the certain entities, net inci inginuctions on page Bi Ti incwituavsote aropsetor or = C] C Carnaraven C1 8 cerporare G singis-marrber LEC rooraven, B=Pannershia: Note: Chace the appropiate box ih te ine above for the on af the singiaenamser aver, Do not check LLC # ihe LLC ws clnssifeed 2s 5 single-member LLC frat is d sregarced trom the owner apes the oymnar of toe LLC regardes tom the owner for U.S, feaeral tax cuvaoses, Cimenwise, a sngie-mamber LLC thay sp disregardeo from the ower shguld cnech she appropriate bak for the tha class\"cation of its owner. (CU) Oihar isee instructions: > & Acgrass inumber, streat, avd api. 6° ssa ng| See iASiuCHONN, 16 Hilltop Circte © Gity, state, and ZIP cogs Whippany, NJ 07984 F st account numbers) here wrnonal Parti Taxpayer Identification Number {TiN} Enter your TIN in the gopropriate box, The TIN provided must maten the name given on ine 1 to avo! backup withholding. Fer individuals, this is generally your sociel security number (SSN), However, for a resident alien, sole proprieter, or disregarded entity, see the instructions tor Part |, later. For other entitiss, 1t is your employer identification number EIN}, If you do not have a number, see How to gei a fia) Limted liabaty company, Enter the tax classification (SxC comaration $x$ cor si Exempta irom FATCA reporting cove amy Print os type. See Spacific Instructions on page 3. TRequesters name aod aderass [oovora ‘Soaial security number TIN, later, or Note: ff the account is is more than one nams, ses the insiructions ‘or ine 7, Also see What Name and Employer Number To Give the Requester for guidelines on whose numer io enter. 84) -)3;el7i2tolsy3 EAM Certification Under penalties of perjury, leerily that: 3, The number shown on this fore is my correct taxpayer (enutcation number (or | am wating for a

hose numer io enter. 84) -)3;el7i2tolsy3 EAM Certification Under penalties of perjury, leerily that: 3, The number shown on this fore is my correct taxpayer (enutcation number (or | am wating for a number to be issued to me}; and 2, 1ari not subject tc backup witsholding oecause: (2) 1 am exempt from backup wathholding. or fbi] have not been Aotified by the Internal Revenue Service (IRS) that | am subject to backup withholding as @ reguit of a failure te report all interest o° divicends, o: /¢} the IRS has notified me thet lam. ‘no longer subject to backup withneicing: anc 3.Jam e U.S, citizen or oiner U.S, person Wetined below), and 4. The FATCA code(s} entered on this form (if any) indicating that | am exempt trom FATCA report Certification instructions. You must cross out item 2 ahove if you have been netdisd by tne IAS that you are currently subject to Backup wuthhalding because you have falted to report ait interest arta dividencs on your tax raisin. For real esiate transections, tem 2 dcas not apply. For morgage interest paid, acquisition or abandonmisrt of secures property, cancellation ot debt, contributions to an individual retvement arrangement {IRA}, and generally, payments other than interest and dividends, you ae net required to sigh the Certification, out you must provids your correci TIN. S¢e the instructions for Part {i later. Sign Si a ignature of 4 0 ¢£ 4 F . Here | US. person® -... es ee a ee pater fp 2D. é + Form 1098-Di¥ idiwidends, including those from stocks or mutua! General Instructions funds) Section references are to the Internal Revenue Code unless otherwise + Form 3099-MISC (various types of income, prizes, awards, or gross noted. oreceeds} : Future developments. For the latest information about developments related te Form W-9 and its instructions, such as legislation enacted afier they were published, go to wew.irs. gouFormivg, Purpose of Form An individual or entity (Fora W-S requester who 's required to fife an information retura with the IRS must obtain your correct taxpayer identitcation number (TIN) woich may be your social security number {SSN}, individual taxpayer identification number (TIN), adoption taxpayer identification number (ATIN}, or employer identification number 4IN), te report on an information return the amount paid to you, or other amount reportable on ani information retum. Examples of

xpayer identification number (ATIN}, or employer identification number 4IN), te report on an information return the amount paid to you, or other amount reportable on ani information retum. Examples of information retums include, but are not limited to, the followring. * Form 7099-INT (interest eacned or paid) + Form 1099-8 (stock or mutual fund salas and certain other iransactons by brokers) * Form 1099-S (proceeds from real estate transactions} * Form 7099-K (merchant car and third pany network transactions} + For 1098 nome mortgage interest, 1098-E istuclent joan interest, 1086-T ttuition} + Form 1099-C (canceled debt} + Form 1099-A {acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resi¢ant en), to provide your correct TIN. If you go not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. a Cat. He. 16232 Ferm W-9 (Rev, 10-2018)