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Form 11■I.9 Request for Taxpayer
<br /> (aefr•October 2018) I
<br /> identification Number and Certification Give Form to the
<br /> Department of the Treasury requester. Do not
<br /> Internal Revenue SenecS 10- v Go to Vw.lts.gov/FomrW9 for instructions and the latest information. send to the IRS.
<br /> 1 Name(as shawl on your income tax return),Name Is required on this line;do not leave this line blank.
<br /> DLX Enterprises LLC
<br /> 2 Business name disregarded entity name,if Different from above
<br /> Deployed Logix
<br /> m
<br /> y to
<br /> o
<br /> c 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes
<br /> apply following seven boxes.
<br /> certain entities,not individuals;isee
<br /> c0instructions on page 3):
<br /> o Individual/tele proprietor or 0 C Corporation 0 S Corporation Partnership
<br /> of re single-member LLC P 0 Trust/estate' ❑ Limited liabilityExempt payee code(d any)
<br /> company.Enter the toe dassrfCat on(C=C corporation,S S corporation,P.Partnership)► P
<br /> a Note:Check the appropnate box in the line above for the tax classification of the single-member owner. Do not check Exempuun from FATCA reporting
<br /> £
<br /> ` a LLC If the LL C is classified as a singe-member LLC that is disregarded horn the owner unless the owner of the LLC a
<br /> another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise.a single-member LLC that y)
<br /> 0. 0 is disregardr,d from the owner should check thea code(if an
<br /> appropriate box for the tax classification of its owner.
<br /> 0 ❑ Other(see rrstructions)IP.
<br /> tri 6 Address(number,street,and apt,or suite no.)See instructions. Aa "r"'". ""'^',10 +•• us,
<br /> S520 S Bertelsen Rd Requester's name and address(optional)
<br /> 8 City,state,and ZIP code
<br /> Eugene Or 97402
<br /> 7 List account number(s)here(optional)
<br /> KM 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
<br /> backup withholding.For individuals,this is generally your social security number(SSN).However,for a
<br /> resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other L. ... LJ
<br /> L ........entitles,It Is your employer identification number(EIN).If you do not have a number,see Now to get a -T/N,later. —
<br /> Note:If the account is n more than one name,see the instructions for line 1.Also see What Name and o Employer identification number
<br /> Number To Give the Requester for guidelines on whose number to enter.
<br /> 4 1 7 - 3 2 8 6 9 2 7
<br /> Part 11 Certification
<br /> Underpenalties of penury,I certify that
<br /> 1.The number shown on this form is my correct taxpayer identification number(or I am wailing for a number to be issued to me):and
<br /> 2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not
<br /> benService(iRS)that I am subject to backup withholding as a result of a failure to report tified all interest or dividends,orr(c)othe IRSby the Inernal Revenue
<br /> has notified me that I am
<br /> no longer subject to oackup withholding;and
<br /> 3.I am a U.S.citizen or other U.S.person(defined below);and
<br /> 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
<br /> Certification Instructions.You must cross out item 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,item 2 does not apply.For mortgage Interest paid,
<br /> acquisition or abandonrrent of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),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 II,later.
<br /> Sign I Signature of
<br /> Here us.person> 0 0
<br /> Date► t` 3 2_0 l 9
<br /> General Instructions
<br /> •ndrm 1099-DIV(dividends,including those from stocks or mutual
<br /> Section references are•;i3 the Internal Revenue Code unless otherwise funds)
<br /> noted. •Form 1099-MISC(various types of income,prizes,awards,or gross
<br /> Future developments.For the latest information about developments proceeds)
<br /> related t0 Form W-8 and its instructions,such as legislation enacted 'Form 1099b brokk or mutual fund sales and certain other
<br /> transactions•
<br /> b
<br /> after they were published,go to www.irs,gov/FormW9. y brokers)
<br /> Purpose of Form 'FOS 1099-S(proceeds from real estate transactions)
<br /> •Form 1099-K(merchant card and third party network transactions)
<br /> An Individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest),
<br /> information return with-he IRS must obtain your correct taxpayer 1098-T(tuition)
<br /> identification number(TIN)which may be your social security number
<br /> (SSN),individual taxpa�er identification number(MN),adoption •Form 1099-C(canceled debt)
<br /> taxpayer Identification number(ATIN),or employer identification numberForm
<br /> (EIN),to report on an In ormation return the amount paid to you,or other • Use 1099-Aorm (ac
<br /> oquisition or abandonment of secured property)
<br /> amount reportable on an information return.Examples of information alien),to provide your correct TiN.0 S person(including a resident
<br /> returns include,but are not limited to,the following.
<br /> •Form 1099-INT(interest earned or paid) if you do not return Form W-9 to the requester with a TIN.you mioht
<br /> be subject to backup withholding,See What is backup withholding,
<br /> tater.
<br /> Cat.No.10231X
<br /> Form W-9(Rev.10-20181
<br />
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