REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ________________________________________________________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED ________________________________________________________ ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Name (If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and apt. or suite no.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that: (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 (2) I 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 Service ("IRS") 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 no longer subject to backup withholding.
Appears in 2 contracts
Samples: Letter of Transmittal (Laralev Inc), Letter of Transmittal (Laralev Inc)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= Delivery Prepared by ________________________________________ Checked By _________________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED _____________________________________________Date ___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Name (If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and apt========================= ====================================================== Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. or suite no.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE Form FORM W-9 Department of FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Proper Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NOto Give the Payor. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer Identification Number Noteidentification numbers have nine digits separated by only one hyphen: If i.e. 00-0000000. The table below will help determine the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by give the Internal Revenue Service ("IRS") 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 no longer subject to backup withholdingpayor.
Appears in 2 contracts
Samples: Letter of Transmittal (Terex Corp), Letter of Transmittal (Terex Corp)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ------------------------------------- CERTIFICATE OLD NOTES OLD NOTES SURRENDERED TENDERED ACCEPTED ------------------------------------- ------------------------------------- ------------------------------------- Delivery Prepared By________________________ Checked By________________________ Date________________ ----------------------------------------------------------------------------------------------------------------------------------- PAYER'S NAME: ----------------------------------------------------------------------------------------------------------------------------------- SUBSTITUTE PART 1--PLEASE PROVIDE YOUR TIN IN THE BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW: ______________________________________ FORM W-9 Social Security Number OR ______________________________________ Employer Identification Number
(1) The number shown on this form is my current taxpayer identification number (or I am waiting for a number to be issued to me) and (2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, (b) I have not been notified by the Internal Revenue Service (the IRS) 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 no longer subject to backup withholding. ----------------------------------------------------------------------------------------------------------------------------------- PAYER'S REQUEST FOR TAXPAYER Certificate Instructions-- You must cross out Item (2) above if you have been notified by the IRS IDENTIFICATION NUMBER "TIN" that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return. However, if after being notified by the IRS that you were subject to backup withholding you received another notification from the IRS that you are no longer subject to backup withholding, do not cross out such Item (2). SIGNATURE:_________________________________________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED _________________________________________DATE:_______________ ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Name (If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and apt. or suite no.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I 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 Service ("IRS") 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 no longer subject to backup withholding.-----------------------------------------------------------------------------------------------------------------------------------
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ================================= ========================== ================================ Certificate Old Notes Old Notes Surrendered Tendered Accepted ================================= ========================== ================================ --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- Delivery Prepared by __________________________________________ Checked By _______________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED Date ____________________________________________ ================================================================================ PAYOR'S NAME: XXXX CORP. ================================================================================ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, State and Zip Code ----------------------------------------------------- List account number(s) here (optional) ----------------------------------------------------- Part 1 - PLEASE PROVIDE YOUR Social Security TAXPAYER IDENTIFICATION NUMBER number or TIN ("TIN") IN THE BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ---------------------------------------------------- Part 2 - Check the box if you are NOT subject to backup withholding under the provisions of section 3408(a)(1)(C) of the Internal Revenue Code because (1) you have not been notified that you are subject to backup withholding as a result of failure to report all interest or dividends or (2) the Internal Revenue Service has notified you that you are no longer subject to backup withholding. [ ] -------------------------- ---------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES Part 3 - Check OF PERJURY. I CERTIFY THAT THE if awaiting TIN INFORMATION ON THIS FORM IS TRUE, [ ] CORRECT AND COMPLETE. Signature _____________ ___________________________________________________Date _____ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Name (-------------------------- ---------------------------------------------------- Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. - 14 - GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Obtaining a Number If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (you don't have a taxpayer identification number or you don't know your number, streetobtain Form SS-5, and apt. Application for a Social Security Number Card, or suite no.) ____________________________________________________________________________________________________________________ CityForm SS-4, stateApplication for Employer Identification Number, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ SUBSTITUTE Form W-9 Department at the local office of the Treasury Social Security Administration or the Internal Revenue Service Xxxxxand apply for a number. Payees Exempt from Backup Withholding Payees specifically exempted from backup withholding on ALL payments include the following: /bullet/ A corporation. /bullet/ An organization exempt from tax under section 501(a), or an individual retirement plan, or a custodial account under Section 403(b)(7). /bullet/ The United States or any agency or instrumentality thereof. /bullet/ A state, the District of Columbia, a possession of the United States, or any subdivision or instrumentality thereof, or a foreign government or any political subdivision, agency or instrumentality thereof. bullet/ An international organization or any agency or instrumentality thereof. /bullet/ A foreign central bank of issue. /bullet/ A registered dealer in securities or commodities registered in the U.S. or a possession of the U.S. /bullet/ A futures commission merchant registered with the Commodity Futures Trading Commission. /bullet/ A real estate investment. /bullet/ An entity registered at all times during the tax year under the Investment Company Act of 1940 or a common trust fund operated by a bank under section 584(a). /bullet/ A financial institution. /bullet/ A middleman known in the investment community as a nominee or listed in the most recent publication of the American Society of Corporate Secretaries, Inc., Nominee List. /bullet/ A trust exempt from tax under section 664 as described in section 4947. Payments of dividends and patronage dividends not generally subject to backup withholding include the following: /bullet/ Payments to nonresident aliens subject to withholding under section 1441. /bullet/ Payments to partnerships not engaged in a trade or business in the U.S. and which have at least one nonresident partner. /bullet/ Payments of patronage dividends where the amount received is not paid in money. /bullet/ Payments made by certain foreign organizations. Payments of interest not generally subject to backup withholding include the following: /bullet/ Payments of interest on obligations issued by individuals. Note: You may be subject to backup withholding if this interest is $600 or more and is paid in the course of the payor's Request for Taxpayer Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NO. Enter trade or business and you have not provided your correct taxpayer identification number to the payor. /bullet/ Payments of tax-exempt interest (including exempt-interest dividends under section 852). /bullet/ Payments described in the appropriate boxsection 6049(b)(5) to nonresident aliens. For most individuals/bullet/ Payments on tax-free covenant bonds under section 1451. /bullet/ Payments made by certain foreign organizations. /bullet/ Mortgage interest paid to you. Exempt payees described above should file Form W-9 to avoid possible erroneous backup withholding. FILE THIS FORM WITH THE PAYOR, this is your social security numberFURNISH YOUR TAXPAYER IDENTIFICATION NUMBER, WRITE "EXEMPT" ON THE FACE OF THE FORM, AND RETURN IT TO THE PAYOR. If you do ALSO SIGN AND DATE THE FORM. Certain payments other than interest, dividends, and patronage dividends that are not have a number, see How subject to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I am information reporting are also not subject to backup withholding because (a) I am exempt from backup withholding. For details, or (b) I have not been notified by see the Internal Revenue Service ("IRS") that I am subject to backup withholding as a result regulations under sections 6041, 6041A(a), 6042, 6044, 6045, 6049, 6050A and 6050N. Privacy Act Notice. -- Section 6109 requires most recipients of a failure to report all dividend interest or dividendsother payments to give taxpayer identification numbers to payors who must report the payments to the IRS. The IRS uses the numbers for identification purposes. Payors must be given the numbers whether or not recipients are required to file tax returns. Payors must generally withhold 20% of taxable interest, or (c) the IRS has notified me that I am no longer subject dividend, and certain other payments to backup withholding.a payee who does not furnish a taxpayer identification number to a payor. Certain penalties may also apply. Penalties
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or of this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ________________________________________________________ -------------------------------------------------------------------------------- CERTIFICATE SERIES A OLD NOTES SERIES A OLD NOTES SURRENDERED TENDERED ACCEPTED ________________________________________________________ ________________________________________________________ ________________________________________________________ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Delivery Prepared by__________________by _______________ Checked By_By _______________ Date__________________ ____________________________________________________________________________________________________________________ FORM W-9 (Rev. March 1994) REQUEST FOR TAXPAYER GIVE FORM TO THE Department of Treasury IDENTIFICATION NUMBER AND REQUESTER. DO NOT Internal Revenue Service) CERTIFICATION SEND TO THE IRS -------------------------------------------------------------------------------- Name (If joint names, see attached guidelineslist first and circle the name of the person or entity whose number you enter in Part I below. See instructions on page 2 if your name has changed.) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, proprietors see attached guidelinesinstructions on page 2.) ___________________________________________Please _________________________________________________________________________ print Please check appropriate box:[ ] : / / Individual/Sole Proprietor [ ] proprietor or / / Corporation [ ] / / Partnership [ ] Other ___________________________________________/ / Other. . . . . . . . . . . . type _________________________________________________________________________ Address (number, street, and apt. or suite no.) ___________________________________________Requester's name and address (optional) _________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service Xxxxx's Request for PART I Taxpayer Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NO. List account number(s) here (optional) -------------------------------------------------------------------------------- Enter your taxpayer identification number TIN in the Social Security appropriate box. For most Number individuals, this is your / / / / / -------------------------------- social security numbernumber (SSN). / / / / / PART II For Payees Exempt For sole proprietors, see the OR From Backup withholding instructions on page 3. For Employer (See Part II other entities, it is your Identification instructions on page 2) employer identification number Number -------------------------------- (EIN). If you do not have a / / / / / number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I 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 Service ("IRS") 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 no longer subject to backup withholdingHOW TO GET A TIN / / / / / below.
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or Prospectus, this Letter of Transmittal and the Notice of Guaranteed Delivery may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOWDo Not Write in The Space Below) Certificate Old Notes Old Notes Surrendered Tendered Accepted ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- Delivery Prepared by: ________________________Checked By ________________________________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED ________________________________________________________ ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Date -------------------------------------------------------------------------------- Page 12 ------------------------------------------------------------------------------- PAYER'S NAME: GAMECO, INC. -------------------------------------------------------------------------------- Name (If if joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business list first and circle the name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and aptof the person or entity whose number you enter in Part I below. or suite noSee instructions if your name has changed.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ___________________________________________Address_________________________________________________________________________ _______________________City, State and ZIP Code________________________________________________________ SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number List account number(s) here (TIN) _____________________________________optional)__________________________________________ --------------------------------------------------------------------------------
SUBSTITUTE PART I -- 1-- PLEASE PROVIDE YOUR Form W-9 TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a OR TIN NUMBER ("TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. __________________________________________________") IN THE BOX AT RIGHT _____________________________ ___________________________________________________________________________AND CERTIFY BY SIGNING AND DATING ____ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties BELOW. Social security number or TIN Department of perjury, I certify that:
(1) The number shown on this form is my correct the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number (or I am waiting for a number to be issued to me), and
(2TIN) I 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 Service ("IRS") 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 no longer subject to backup withholding.-------------------------------------- -------------------------------------
Appears in 1 contract
Samples: Letter of Transmittal (Raceland Truck Plaza & Casino LLC)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ========================== ======================== =========================== Certificate Old Notes Old Notes Surrendered Tendered Accepted ========================== ======================== =========================== ========================== ======================== =========================== ========================== ======================== =========================== ========================== ======================== =========================== Delivery Prepared by ______________ Checked By ________________ Date _____________________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ===================== ========================================================== SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part FORM W-9 I below. See instructions if your name has changed.) Department of the Treasury Internal Revenue Service ========================================================== Address ========================================================== City, state and ZIP code ========================================================== List account number (s) here (optional) ---------------------------------------------------------- Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ========================================================== Part 2 - Check the box if you are NOT subject to backup withholding under the provisions of section 3408(a)(1)(C) of the Internal Revenue Code because (1) you have not been notified that you are subject to backup withholding as a result of failure to report all interest or dividends or (2) the Internal Revenue Service has notified you that you are no longer subject to backup withholding. [ ]1 ===================== ========================================================== Payor's Request for CERTIFICATION - UNDER THE PENALTIES OF PERJURY. PART 3 - TIN I CERTIFY THAT THE INFORMATION PROVIDED ON THIS FORM IS TRUE, CORRECT AND COMPLETE. AWAITING TIN Signature _____________________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED ________________________________________________Date ________ ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Name (If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and apt===================== ========================================================== Note:FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. or suite no.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE Form FORM W-9 Department of FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Proper Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NOto Give the Payor. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer Identification Number Noteidentification numbers have nine digits separated by only one hyphen: If i.e. 00-0000000. The table below will help determine the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by give the Internal Revenue Service ("IRS") 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 no longer subject to backup withholdingpayor.
Appears in 1 contract
Samples: Letter of Transmittal (Terex Corp)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or Prospectus, this Letter of Transmittal and the Notice of Guaranteed Delivery may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOWDo Not Write in The Space Below) Certificate Old Notes Old Notes Surrendered Tendered Accepted ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- Delivery Prepared by: ________________________Checked By ________________________________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED ________________________________________________________ ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Date -------------------------------------------------------------------------------- Page 12 ------------------------------------------------------------------------------- PAYER'S NAME: XXXXXX ENTERTAINMENT, INC. -------------------------------------------------------------------------------- Name (If if joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business list first and circle the name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and aptof the person or entity whose number you enter in Part I below. or suite noSee instructions if your name has changed.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ___________________________________________Address_________________________________________________________________________ _______________________City, State and ZIP Code________________________________________________________ SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number List account number(s) here (TIN) _____________________________________optional)__________________________________________ --------------------------------------------------------------------------------
SUBSTITUTE PART I -- 1-- PLEASE PROVIDE YOUR Form W-9 TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a OR TIN NUMBER ("TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. __________________________________________________") IN THE BOX AT RIGHT _____________________________ ___________________________________________________________________________AND CERTIFY BY SIGNING AND DATING ____ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties BELOW. Social security number or TIN Department of perjury, I certify that:
(1) The number shown on this form is my correct the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number (or I am waiting for a number to be issued to me), and
(2TIN) I 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 Service ("IRS") 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 no longer subject to backup withholding.-------------------------------------- -------------------------------------
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or Prospectus, this Letter of Transmittal and the Notice of Guaranteed Delivery may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN THE SPACE BELOW) ________________________CERTIFICATE OLD NOTES OLD NOTES SURRENDERED TENDERED ACCEPTED ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- DELIVERY PREPARED BY: Checked By -------------------------------------------------- Date -------------------------------------------------- -------------------------------------------------------------------------------- PAYER'S NAME: GLASSTECH, INC. -------------------------------------------------------------------------------- NAME (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) -------------------------------------------------------------------------------- ADDRESS ------------------------------------------------------------------------- CITY, STATE AND ZIP CODE -------------------------------------------------------- LIST ACCOUNT NUMBER(S) HERE (OPTIONAL) ------------------------------------------ --------------------------------------------------------------------------------
SUBSTITUTE PART 1-- PLEASE PROVIDE YOUR FORM W-9 TAXPAYER IDENTIFICATION OR TIN NUMBER ("TIN") IN THE BOX ________________________________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED ________________________________________________________ ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ Name (If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and apt. AT RIGHT AND CERTIFY BY Social security number or suite noTIN SIGNING AND DATING BELOW.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I 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 Service ("IRS") 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 no longer subject to backup withholding.
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ________________________________________________________ ---------------------------------------------------------- CERTIFICATE SERIES A NOTES DEBENTURES SERIES A NOTES DEBENTURES SURRENDERED TENDERED ACCEPTED ________________________________________________________ ________________________________________________________ ________________________________________________________ ---------------------------------------------------------- ---------------------------------------------------------- ---------------------------------------------------------- Delivery Prepared by_________________________________ Checked By________________ Date__________________ ___________________________________________________________________________________________________________Date _________ Name (If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ -------------------------------------------------------------------------------- Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ -------------------------------------------------------------------------------- Please check appropriate box:: [ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ -------------------------------------------------------------------------------- Address (number, street, and apt. or suite no.) ____________________________________________________________________________________________________________________ -------------------------------------------------------------------------------- City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service XxxxxPayer's Request for Taxpayer Identification Number (TIN) _______________________________________________________________________________ -------------------------------------------------------------------------------- PART I -- TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I 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 Service ("IRS") 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 no longer subject to backup withholding.
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ------------------------ -------------------------- ------------------------ Certificate Old Notes Old Notes Surrendered Tendered Accepted ------------------------ -------------------------- ------------------------ ------------------------ -------------------------- ------------------------ ------------------------ -------------------------- ------------------------ Delivery Prepared by __________________________________________ Checked By _______________ CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED _____________________________________________Date ___________ ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ____________________________________________________________________________________________________________________ =============================================================================== PAYOR'S NAME: TEREX CORPORATION =============================================================================== SUBSTITUTE Name (If if joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business list first and circle the name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and aptof the person or entity whose number you enter in Part I below. or suite noSee instructions if your name has changed.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ SUBSTITUTE Form FORM W-9 Department of the Treasury Internal Revenue Service Xxxxx's Request for Taxpayer Identification Number ---------------------------------------------------------------------- Address ---------------------------------------------------------------------- City, state and ZIP code ---------------------------------------------------------------------- List account number (TINs) _______________________________________________________________________________ PART I -- here (optional) --------------------------------------------------------------------- Part 1 - PLEASE PROVIDE YOUR TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a Social Security NUMBER ("TIN" in ") IN THE BOX AT RIGHT AND CERTIFY BY Number or TIN SIGNING AND DATING BELOW ---------------------------------------------------------------------- Part 2 - Check the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING (SEE ENCLOSED GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION -- Under penalties of perjury, I certify that:
(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
(2) I am not box if you are NOT subject to backup withholding under the provisions of section 3408(a)(1)(C) of the Internal Revenue Code because (a1) I am exempt from backup withholding, or (b) I you have not been notified by the Internal Revenue Service ("IRS") that I am you are subject to backup withholding as a result of a failure to report all interest or dividends, dividends or (c2) the IRS Internal Revenue Service has notified me you that I am you are no longer subject to backup withholding. [ ]1 ---------------------------------------------------------------------- Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Give the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payor.
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Samples: Letter of Transmittal (Terex Corp)