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<br />C
<br />(Rev. October 2018)
<br />==De ="ent d."= the Treestny
<br />"Pet Sennce
<br />Request for Taxpayer
<br />Identification Number and Certification
<br />► Go to www.N&gov1FbnnHM for Instructions and the latest !information.
<br />1 Name (as shown on your Income tax return). Name is
<br />MILESTONE CONTRACTORS NORTH, IN(
<br />2 Business name/disregarded entity name, If dit—t fr
<br />required on
<br />lime blank.
<br />Give Form to the
<br />requester. Do not
<br />send to the IRS.
<br />4:48 Check appropriate box for federal tax classification of the person whose name Is entered on One 1. Check only one of the ! 4 Exemptions (codes apply only 10
<br />mrn following seven boxes. certain entities, not individuals; we
<br />o.Instructions on page 3):
<br />C ❑ IndivldualMole proprietor or El Corporation 918 Corporation 11Parbnerehip ElTrust/estate
<br />r0 single -member LLC Exempt Pie code (If any)
<br />❑ Limited liability, company. Enter the tex classification (C-tC corporation, S=S corporation, P --Partnership) ►
<br />from
<br />o LLNote: the LLC is Check the wed as a aingl In the line above for the tax classification of the singla-member owner. Do not check e -member t1C that is disregarded from the owner unless the owner of theLLC Is FATCA reporting
<br />another LLC that Is not disregarded from the owner for U.S, federal tax purposes. Otherwise, a single -member ILC that
<br />Is disregarded from the owner should chat k the appropriate box for the tax classification of its owner.
<br />❑ other (we Instructions) ► OW" a.Ceowu. 0&9" m. UW
<br />5 Address (number, street, and apt. w suite no.) See instructions. Requester's name and address (optional)
<br />1700 EAST MAIN STREET _
<br />8 City, state, and ZIP code
<br />GRIFFITH, IN 46319 _
<br />7 List account numbers) here (optional)
<br />• Taxfpa�+er Ident'dication Number (TI ~
<br />Enter your TIN in the appropriate box. The TIN provided must match the name given an Iine 1 to avoid i Sootal security "umber
<br />backup withholding. For individuals, this is generally your social security number (SSN). However, fora � - � -
<br />resident alien, sole proprietor, or disregarded entity, see the Instrmic{ions for Part I, later. For other
<br />entities, R Is your employer identification number (EIN). ff you do not have a number, see How to get a
<br />77N, Iatar. or
<br />Nota: tf the account is in more than one name, see the Instructions for Iine 1. Also see What Name and ' EmPloysr Iden number Ij
<br />NumberTo Ghre the Requester for guldeiInes on whose number to enter.
<br />737f, - 1 7 2 0 6 8 5
<br />L Certification
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this form Is my correct taxpayer identification number (or I am wafting for a number to be Issued to me); and
<br />2.1 am not subject to backup withholding because: (a)1 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 failure to report all interest or dividends, or (c) the IRS has notified me that I am
<br />no longer subject to backup withholding; and
<br />3.1 am a U.S. cf lzen 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 Rem 2 above R you have been notRied 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, item 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 must provide your correct TIN. See the Instructions for Part 11, later.
<br />sign signature of , pato ►
<br />Here U.S. person►
<br />General Instructions
<br />Section references are 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.lrs.gov1FormW9.
<br />Purpose of Form
<br />An ind'nridual or entity (Form W-9 requests* who is required to file an
<br />information return with the IRS must obtain your correct taxpayer
<br />identification number (TIN) which may be your social security number
<br />(SSN), Individual taxpayer Identification number QTIN), adoption
<br />taxpayer identification number (ATIN), or employer identification number
<br />(EIN), to report on an information return the amount paid to you, or other
<br />amount reportable on an Information return. Examples of information
<br />returns Include, but are not limited to, the following.
<br />• Form 1099 -INT Qrtterest earned or paid)
<br />Cat No. 10231X
<br />• Form 1099 -DN (dividends, Including those from stocks or mutual
<br />funds)
<br />• Form 1099-MISO (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 interest),
<br />1098-T (turdon)
<br />• Form 1099-C (canceled debt]
<br />• Form 1099-A (aaluisitlon or abandonment of secured property)
<br />Use Form W-9 only R you are a U.S. person Qncluding a resident.
<br />alien), to provide your correct TIN.
<br />ff you do not retum Form W-9 to the requester wJth a TIN, you might
<br />be subject to backup withholding. See What is backup withholding,
<br />later.
<br />_ u - Form W-9 (Rev. 10-2018)
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