Common use of Substitute Form W Clause in Contracts

Substitute Form W. 9: Taxpayer Identification Number certification and backup withholding statement. PRIVACY ACT STATEMENT: Section 6109 of the Internal Revenue Code requires you (Issuer) to provide us with your correct Taxpayer Identification Number (TIN). Name of Business: [●] Tax Identification Number: [●] Under penalty of perjury, by signing this Agreement below I certify that: 1) the number shown above is our correct business taxpayer identification number; 2) our business is not subject to backup withholding unless we have informed Prime in writing to the contrary; and 3) our Company is a U.S. domiciled business. Consent is Hereby Given: By signing this Agreement electronically, Issuer explicitly agrees to receive documents electronically including its copy of this signed Agreement and the Business Custodial Agreement as well as ongoing disclosures, communications, and notices. Agreed as of the date set forth above by and between: STREAMNET, INC. By: /s/ Xxxxxx Xxxxx Name: XXXXXX XXXXX Title: CEO PRIME TRUST, LLC By: Name: Title: Exhibit A Fees and Costs

Appears in 1 contract

Samples: Escrow Services Agreement (StreamNet, Inc.)

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Substitute Form W. 9: Taxpayer Identification Number certification and backup withholding statement. PRIVACY ACT STATEMENT: Section 6109 of the Internal Revenue Code requires you (Issuer) to provide us with your correct Taxpayer Identification Number (TIN). Name of Business: [●] Bitzumi, Inc. Tax Identification Number: [●] 82186815 Under penalty of perjury, by signing this Agreement below I certify that: 1) the number shown above is our correct business taxpayer identification number; 2) our business is not subject to backup withholding unless we have informed Prime Trust in writing to the contrary; and 3) our Company is a U.S. domiciled business. Consent is Hereby Given: By signing this Agreement electronically, Issuer explicitly agrees to receive documents electronically including its copy of this signed Agreement and the Business Custodial Agreement as well as ongoing disclosures, communications, and notices. Agreed as of the date set forth above by and between: STREAMNET, INC. [●] By: /s/ Xxxxxx Xxxxx :__________________ Name: XXXXXX XXXXX :__________________ Title: CEO PRIME TRUST:__________________ Prime Trust, LLC By: :__________________ Name: :__________________ Title: Exhibit A :__________________ Summary of Fiduciary and Administrative Fees and Costsfor Standard Offerings† ** CONFIDENTIAL | Exclusive for Bitzumi Inc.**

Appears in 1 contract

Samples: Escrow Services Agreement (Bitzumi, Inc.)

Substitute Form W. 9: Taxpayer Identification Number certification and backup withholding statement. PRIVACY ACT STATEMENT: Section 6109 of the Internal Revenue Code requires you (Issuer) to provide us with your correct Taxpayer Identification Number (TIN). Name of Business: [●] Tax Identification Number: [●] Under penalty of perjury, by signing this Agreement below I certify that: 1) the number shown above is our correct business taxpayer identification number; 2) our business is not subject to backup withholding unless we have informed Prime Trust in writing to the contrary; and 3) our Company is a U.S. domiciled business. Consent is Hereby Given: By signing this Agreement electronically, Issuer explicitly agrees to receive documents electronically including its copy of this signed Agreement and the Business Custodial Agreement as well as ongoing disclosures, communications, and notices. Agreed as of the date set forth above by and between: STREAMNET, INC. [●] By: /s/ Xxxxxx Xxxxx :__________________ Name: XXXXXX XXXXX :________________ Title: CEO PRIME TRUST:_________________ Prime Trust, LLC By: :__________________ Name: :________________ Title: Exhibit A Fees and Costs:_________________

Appears in 1 contract

Samples: Escrow Services Agreement (Thinking Green)

Substitute Form W. 9: Taxpayer Identification Number certification and backup withholding statement. PRIVACY ACT STATEMENT: Section 6109 of the Internal Revenue Code requires you (Issuer) to provide us with your correct Taxpayer Identification Number (TIN). Name of Business: [●] Tax Identification Number: [●] Under penalty of perjury, by signing this Agreement below I certify that: 1) the number shown above is our correct business taxpayer identification number; 2) our business is not subject to backup withholding unless we have informed Prime Trust in writing to the contrary; and 3) our Company is a U.S. domiciled business. Consent is Hereby Given: By signing this Agreement electronically, Issuer explicitly agrees to receive documents electronically including its copy of this signed Agreement and the Business Custodial Agreement as well as ongoing disclosures, communications, and notices. Agreed as of the date set forth above by and between: STREAMNET, INC. [●] By: /s/ Xxxxxx Xxxxx :_____________________ Name: XXXXXX XXXXX :___________________ Title: CEO PRIME TRUST:____________________ Prime Trust, LLC By: :_____________________ Name: :___________________ Title: Exhibit A Fees and Costs:____________________

Appears in 1 contract

Samples: Escrow Services Agreement (Gab Al Inc)

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Substitute Form W. 9: Taxpayer Identification Number certification and backup withholding statement. PRIVACY ACT STATEMENT: Section 6109 of the Internal Revenue Code requires you (Issuer) to provide us with your correct Taxpayer Identification Number (TIN). Name of Business: [●] Bitzumi Inc. Tax Identification Number: [●] 82186815 Under penalty of perjury, by signing this Agreement below I certify that: 1) the number shown above is our correct business taxpayer identification number; 2) our business is not subject to backup withholding unless we have informed Prime Trust in writing to the contrary; and 3) our Company is a U.S. domiciled business. Consent is Hereby Given: By signing this Agreement electronically, Issuer explicitly agrees to receive documents electronically including its copy of this signed Agreement and the Business Custodial Agreement as well as ongoing disclosures, communications, and notices. Agreed as of the date set forth above by and between: STREAMNETBitzumi, INC. Inc. By: /s/ Xxxxxx Xxxxx :__________________ Name: XXXXXX XXXXX :__________________ Title: CEO PRIME TRUST:__________________ Prime Trust, LLC By: :__________________ Name: :__________________ Title: Exhibit A Fees and Costs:__________________

Appears in 1 contract

Samples: Escrow Services Agreement (Bitzumi, Inc.)

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