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<br />ImemM Rev -11="y
<br />Request for Taxpayer
<br />Request) Identification Number and Certification
<br />to- Go to www.iris.gav/WmtVYR for irwtructtont; and the latest Information.
<br />Give Form to the
<br />requester. Do not
<br />send to the IRS.
<br />1 Name (as shown on your income tax retum} Name Is required on this line: do not leave this Me blank.
<br />MILESTONE CONTRACTORS NORTH, INC.
<br />2 Business nsmardhsregarded entity name, H different from above
<br />WALSH & KELLY, INC.
<br />c 3 Check appropriate box for federal tax clesalflosi on of the person whose name is entered on line 1. Chock only one of the
<br />4 EnempWna (codes apply only to
<br />following soven foxes,
<br />certain entities, not individuals; see
<br />r-�
<br />p ❑ IrndvAuallsote proprietor or U C Corporation S S Corporation 0 Partnership ❑ Truwastate
<br />Instructiorm on page 3):
<br />a single -somber LLC
<br />Exempt payee code Of any)
<br />© Umited liability tympany. Ester the tax classification (C -C corporation, S.S oorporation, P.Partnership) 00
<br />Note: Check the appropriate box In the line above for the tax classification of the single -member owner, 00 not check
<br />Exemption from FATCA reporting
<br />LLC 9 the LLC Is classified as a singia-morn1w Lt.0 that is disregarded from the owner unless the owner of the LLC Is
<br />LLC that b diare't, for
<br />Gf aryl
<br />canother not arded from the owner U.S. federal tax purposes. otherwise, a single -member LLC that
<br />g is disregarded from the owner should check the appropriate box for the tax classification of its owner.
<br />Other (sae Instructions) ►
<br />-6--Address
<br />charm toA=am n mrMwhed VA" ft U.S;
<br />(number, street, and apt. or suite nod See instructions. Requester's name end address (optionaq
<br />1700 EAST MAIN STREET
<br />E Cly. state, and ZIP code
<br />GRIFFITH, IN 46319
<br />7 List account number(s) hem {optional)
<br />ii= Taxpayer Identification Number (TIN)
<br />Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Socia( security number
<br />social baolap withholding. For individuals, this is generally your sal security number (SSN). However, for a - m .
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
<br />erdities, it Is your employer Identification number (EIN). If you do not have a number, am How to get a
<br />TIN, later. or
<br />Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and inpiotf+r IdwMeation number _ 1
<br />Number To Give the Requester for gu)detlnes on whose number to enter.
<br />1 3 5 - 1 1 2 0 6 018 @v1
<br />Certification
<br />Under penalties of perjury, I certify tftat:
<br />1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
<br />2.1 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
<br />Service QRS) that I am subject to backup withholding as a result of a faflure to report all interest or dividends, or (c) the IRS has notified me that 1 am
<br />no longer sub)ect to backup withholding; and
<br />3. 1 am a U.S. citizen or other U.S. person (defined below); and
<br />4. The FATCA code(s) entered on this form Of any) indicating that I am exempt from FATCA reporting is correct.
<br />Certification instructions. You must cross out itern 2 above If you have been notified by the IRS that you are currently subject to backup withholding because
<br />you have failed to report all interest and dividends on your tax return. For real estate transactions, keen 2 does not apply. For mortgage interest paid,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement ORA), and generally, payments
<br />other than interest and dividends, you are not required to sign the certification, but you rust provide your correct TIN. See the instructions for Part 11, later.
<br />Sign Here� person 1P
<br />► `
<br />General Instructions
<br />Section references aro to the Internal Revenue Code unless otherwise
<br />noted.
<br />Future developments. For the latest information about developments
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, go to www.irs.gov1FormW9.
<br />Purpose of Form
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />information return with the iRS must obtain your correct taxpayer
<br />identification number (TiNj which may be your social security number
<br />(SSM, individual taxpayer identification number QTiM. adoption
<br />taxpayer identification number (ATIN), or employer identification number
<br />(EIN), to report on an infomwtion return the amount paid to you, or other
<br />amount reportable on an Information retum. Examples of information
<br />returns include, but are not limited to, the following.
<br />• Form 1099 -INT (intermit earned or paid)
<br />Date ► 2-11 q I
<br />e Form 1099 -DN (dividends, including those from stocks or mutual
<br />funds)
<br />• Form 1099-OSC (various types of income, prizes, awards, or gross
<br />proceeds)
<br />• Form 1099-B (stock or mutual fund sales and certain other
<br />transactions by brokers)
<br />• Form 1099-S (proceeds from real estate transactions)
<br />• Form 1099-K (merchant card and third party network transactions)
<br />• Form 1098 (home mortgage interest), 1098-E (student loan intorest),
<br />1098-T(tuition)
<br />• Form 1099-C (canceled debt)
<br />• Form 1099-A (acquisition or abandonment of secured property)
<br />Use Form W-9 only if you are a U.S. person (including a resident
<br />alien), to provide your correct TIN.
<br />1(you do not return form W-9 to the requester with a 71N, you might
<br />be subject to backup withholding, See What Is backup withholding,
<br />tater.
<br />Cat. No_ 10231X Form W-9 (Rev. 10-2018)
<br />
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