Common use of DUNS Number; XXX Registration; Nature of Entity Clause in Contracts

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is Grantee’s correct DUNS number, that is Grantee’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds). Grantee is doing business as a (check): Individual Nonresident Alien Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  D = disregarded entity Estate or Trust  C = corporation Pharmacy-Non Corporate  P = partnership

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is GranteeXxxxxxx’s correct DUNS number, that is GranteeXxxxxxx’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds). Grantee is doing business as a (check): Individual Nonresident Alien Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  □ D = disregarded entity Estate or Trust  □ C = corporation Pharmacy-Non Pharmacy‐Non Corporate  □ P = partnership

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is Grantee’s correct DUNS number, that is Grantee’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds). Grantee is doing business as a (check): Individual Nonresident Alien Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  □ D = disregarded entity Estate or Trust  □ C = corporation Pharmacy-Non Pharmacy‐Non Corporate  □ P = partnership

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is Grantee’s correct DUNS number, that is Grantee’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds). Grantee is doing business as a (check): Individual Nonresident Alien Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  D = disregarded entity Estate or Trust  C = corporation Pharmacy-Non Corporate  P = partnership

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is GranteeXxxxxxx’s correct DUNS number, that is GranteeXxxxxxx’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds). Grantee is doing business as a (check): Individual Nonresident Alien Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  D = disregarded entity Estate or Trust  C = corporation Pharmacy-Non Corporate  P = partnership

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is Grantee’s correct DUNS numberNumber, that XXX is Grantee’s correct UEI, if applicable, that is Grantee’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds)registration. Grantee is doing business as a (checkcheck one): Individual Nonresident Alien Pharmacy-Non Corporate Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  D □ P = disregarded entity partnership Estate or Trust  □ C = corporation Pharmacy-Non Corporate  P = partnershipcorporation

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is GranteeXxxxxxx’s correct DUNS number, that is GranteeXxxxxxx’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds). Grantee is doing business as a (check): Individual Nonresident Alien Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  D = disregarded entity Estate or Trust  C = corporation Pharmacy-Non Corporate  P = partnership

DUNS Number; XXX Registration; Nature of Entity. Under penalties of perjury, Grantee certifies that is GranteeXxxxxxx’s correct DUNS number, that is GranteeXxxxxxx’s correct FEIN or Social Security Number, and that Grantee has an active State registration and XXX registration (if federal funds). Grantee is doing business as a (check): Individual Nonresident Alien Sole Proprietorship Pharmacy/Funeral Home/Cemetery Corp. Partnership Tax Exempt Corporation (includes Not For Profit) Limited Liability Company (select Medical Corporation applicable tax classification) Governmental Unit  □ D = disregarded entity Estate or Trust  □ C = corporation Pharmacy-Non Corporate  □ P = partnership