Carrier Certification Requirements Sheet Please DO NOT send this sheet back with your packet

KLLM Logistics Services welcomes your interest in becoming an approved carrier. We are confident that you will find KLLM Logistics Services a company that is dedicated to our contract carriers and we’ll make it easy to do business with us. The attached Packet includes information about our company along with various forms that you will need to fill out in order to become an approved contract carrier for KLLM Logistics Services. This packet should contain:

1. This Document-Certification Requirements 2. Carrier Profile Sheet-To Be Used as Your Coversheet when returning this packet to

KLLM Logistics Services 3. Broker Carrier Agreement 4. KLLM Logistics Services profile with credit references 5. KLLM Logistics Services Authority 6. KLLM Logistics Services Surety Bond 7. Request for Insurance Certificate Form to fax to your Insurance Company 8. Blank W-9

After you have filled out the Carrier Profile and signed the Broker Carrier Agreement, without exceptions, the following must be faxed to KLLM Logistics Services. We cannot dispatch a driver until this information is received and entered into our computer system:

1. The completed Carrier Profile Sheet used as your cover sheet when sending back to KLLM Logistics Services

2. The completed & signed Broker Carrier Agreement 3. A filled out W-9 4. A copy of your operating authority 5. A valid Insurance Certificate showing the current coverage with minimum amounts

of: a. $100,000 cargo coverage showing deductibles & reefer breakdown coverage

if you are hauling reefer loads and listing any exclusions b. $1,000,000 auto liability. c. $1,000,000 commercial general liability with a $2,000,000 aggregate

6. Receipt of a fax, sent from your Insurance Company showing KLLM Logistics Services as a Certificate Holder and Additional Insured on your Insurance Coverage.

If you should have any questions regarding these procedures, please call us at 504-210-0080. Please email or fax your complete packet to the office that you are doing business with: Jackson, MS ph. 866-682-3010 fax: 601-936-5449 email: kllmjn@kllm.com New Orleans, LA ph. 866-328-9189 fax: 504-210-0182 email: kllmnola@kllm.com Atlanta, GA ph. 678-894-1720 fax: 770-476-6133 email: kllmga@kllm.com Boston, MA ph. 508-762-0064 fax: 877-496-1491 email: bkicher@kllm.com Fernandina Beach, FL ph. 888-724-8789 fax: 601-510-2695 email: movercast@kllm.com Dallas, TX ph. 601-933-1434 fax: 877-496-1491 email: ghall@kllm.com Morrow, GA ph. 770-960-7026 fax: 877-496-1491 email: jjackson@kllm.com

Carrier Code Issued:_____________ Remit all invoices to: KLLM Logistics Services 135 Riverview Drive Jackson, MS 39218 Phone 866-682-3010

Please fax or email your carrier packet back to the office you are doing business with. See first page for fax numbers and email addresses.

CARRIER PROFILE SHEET Company Info Company Name (Include LLC or INC)________________________________________________________________________________ DBA_______________________________________________________________________________________________________ ADBA______________________________________________________________________________________________________ MC#_________________________________________ Street Address (physical address) _______________________ Remit to Address (This is where we will mail checks or 10-99’s for tax purposes) _______________________________________________ _________________________________________________________ _______________________________________________ _________________________________________________________ Name of Factoring company______________________________________________________________________________ Phone Info Watts_(________)___________________________________ Local # _(_________)_________________________________ Alternate (cell)_(_________)___________________________ Fax ___(_________)_________________________________ Email Address: _______________________________________________________________________________________________ Contact Name ____________________________________________Desired Lanes________________________________________

____________________________________________ _______________________________________

____________________________________________ _______________________________________ Type of Equipment Used (vans, reefers, flats) ______________________________________________________________________ Number of Trucks_________________________ Number of Trailers _________________________________ SCAC Code______________________________ Please notify us in writing if there are any changes to the information provided above. This will enable us to enter your company into our system accurately and rapidly.

For Office Use Only

Documentation Agent Receved Date:_____________ Notification Date:__________ _____Carrier Profile Sheet _____Signed Contract Notes:____________________________________ _____ W-9 _____ Authority __________________________________________ _____ Cargo Ins _____ Liability Ins __________________________________________

KLLM Logistics Services Broker-Carrier Transportation Agreement

This agreement made this ___day of ________, 20__, by and between KLLM Transport Services, LLC dba KLLM Logistics Services, 135 Riverview Drive, Richland, MS 39218 (“Broker”) and _________________________, (“Carrier”) of _______________________, __________________________. Recitals WHEREAS, Carrier represents and warrants it is an authorized for-hire-motor carrier operating pursuant to authority granted by the FMCSA (MC-_______); Broker represents and warrants it operates under FMCSA authority (MC-649560), holds appropriate Surety Bond, and desires to utilize the services of the Carrier designed to meet Broker’s customer’s transportation related needs; NOW THEREFORE the parties hereto mutually covenant and agree as follows:

1. SHIPMENTS: This agreement contemplates a series of shipments and each and every shipment tendered to Carrier by Broker shall be governed by the terms of this agreement and includes all transportation services associated with the shipment. Carrier agrees that at any time a request for service may violate any rule, regulation or law then Carrier shall notify Broker of the potential violation and other arrangements will be made that will not compromise safe and legal operation by the Carrier.

2. TERMS: This agreement shall continue in effect for a period of one (1) year and thereafter on a month to month basis, subject to cancellation upon thirty (30) days written notice by either party.

3. CARRIER’S RESPONSIBILITIES: Carrier agrees to perform all the transportation services for Broker pursuant to

this Agreement at the rates, charges, minimums and exceptions, and under the conditions delineated in a separate written rate confirmation, which shall be made a part of this contract as if fully set forth herein upon issuance by Broker. Acceptance of the load by Carrier shall be deemed an acceptance of the rate confirmation and its terms and conditions as issued by broker. Carrier acknowledges that it is involved in a heavily regulated industry. As such, Carrier, its agents and employees shall abide by any and all applicable safety statutes, regulations (including the FMCSR), and other regulations set forth by the FMCSA or other governing bodies related to all aspects of Carrier’s operations (safety, compliance, equipment, hazardous cargo, etc…) and also regulations related to sanitation and temperature requirements for transporting food and other perishable products, including all regulations specific to the State of California. Carrier also agrees to comply with all safety rules of the receiving Consignee and requirements of Broker or its customer. Carrier will furnish equipment for transporting temperature controlled products which is sanitary and free of any contaminations, suitable for the particular commodity being transported and which will not cause in whole or in part adulteration of the commodity as defined in 21 USCA 342. Carrier shall be responsible to Broker for any and all penalties assessed or other liability imposed upon Broker or any other party on the bill of lading (including its customer) due to failure of Carrier to comply with any statute, rule, regulation or other provision of law.

4. RECEIPT AND BILLS OF LADING: Carrier shall issue and sign a receipt or Bill of Lading issued under 49 U.S.C. §

80101 et. seq., and 49 C.F.R. §373.101 (and any amendments thereto), for each shipment in the form required by Broker which may be a Bill of Lading issued by consignor. Insertion by consignor or shipper of Broker’s name as the carrier on a bill of lading shall not change Broker’s status as a property broker or Carrier’s status as a motor carrier. Broker hereby consents to the execution of the receipt or Bill of Lading by Carrier and further consents to the use by Carrier of Broker or consignor’s Bill of Lading or receipt pursuant to 49 U.S.C. 14706(2). Carrier may not issue its own Bill of Lading or receipt containing terms that reference or attempt to incorporate a tariff or rules circular or similar document and any attempt to incorporate such into the Bill of Lading or receipt shall be ineffective and void. It is the express intent of the parties that this agreement shall govern all shipments and to the extent this agreement conflicts with any previously published rates or tariffs or other published terms and conditions of service, this agreement shall control. Upon delivery of each shipment, Carrier shall obtain a receipt signed by the Consignee, in a form required by Broker, showing the goods delivered, the condition of the goods, confirmed count of the goods and the date and time of delivery.

5. EQUIPMENT and COSTS: Carrier agrees to furnish suitable equipment at its own expense. Carrier shall assume and pay

all costs and expenses, including but not limited to fuel, oil, tires, and other parts, supplies and equipment necessary or required for the safe operation and maintenance of the equipment required for shipments tendered under this contract. Rates or charges, including but not limited to stop-offs, detention, loading or unloading, fuel surcharges, or other accessorial charges shall only be valid when expressly agreed to in writing via the rate confirmation or other signed writing.

6. FREIGHT PAYMENTS: Invoices should be submitted with a clear and concise copy of the proof of delivery. Carrier

hereby appoints Broker as its agent for receipt of all transportation charges incurred. Broker reserves the right to request an original proof of delivery from the Carrier if needed. If invoices are complete and correct and are accompanied by proofs of delivery, and other required documentation, Broker agrees to make payment thereof to Carrier within a reasonable time not to exceed thirty (30) days following receipt of such invoices. However, no interest, penalty or other charges shall be applied for any late payment. All freight payments due are subject to set-off by Broker for any and all unpaid claims for loss or damage to cargo, or other unpaid indemnity obligations, whether the freight payment is due for transportation of the damaged cargo or transportation of other unrelated

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cargo. Broker will forward payments for net amounts due Carrier after all discounts, deductions and set-offs permitted by this Agreement. Carrier hereby assigns to Broker all its rights to collect freight charges from Shipper or any other responsible third party immediately upon receipt of payment of its freight charges by Broker. Carrier may not seek payment from any party other than the Broker if the third party has made payment to the Broker. Carrier hereby waives recourse against all parties to the bill of lading once the responsible party has paid Broker.

7. FREIGHT LOSS OR DAMAGE: Carrier’s liability for cargo loss, damage, delay or theft from any cause shall be as

described in the provisions of 49 U.S.C. 14706 (Carmack Amendment). The parties do not agree to released value rates, or other limitations on cargo liability, and any provision on any Bill of Lading, tariff, rules circular, receipt or other shipping document purporting to set a released value rate or limitation shall be invalid. Carrier by accepting shipment, whether or not by signing an original Bill of Lading or accepting an electronic shipping document in lieu of an original Bill of Lading, acknowledges that the cargo is in good condition. Claims will be filed and resolved in accordance with federal regulations found at 49 C.F.R.370 et seq., which shall govern all claims process and salvage. Notwithstanding the terms of 49 C.F.R. 370 et. seq., as amended, Carrier agrees to provide written disposition; pay, decline or make settlement offer in writing on all cargo loss and damage claims within sixty (60) days of its receipt thereof. In the event of failure by the Carrier to pay, decline or offer settlement within this 60 day period Broker may deduct the full amount of such claim from the outstanding invoices of the Carrier after providing Carrier with written notice and giving Carrier ten (10) days to process the claim and cure the breach. Neither party shall be liable to the other for consequential damages without prior written notification of the risk of loss and its approximate financial amount, and agreement to assume such responsibility in writing. All claims for cargo loss or damages shall be submitted to Carrier in writing within 270 days after delivery or, if lost, the date of the scheduled delivery. Any civil action or arbitration for loss or damage to cargo must be brought within two (2) years. The period for bringing a civil action or arbitration is computed from the date the Carrier gives Broker written notice that the carrier has disallowed any part of the claim specified in the notice.

8. BACK SOLICTATION: Carrier agrees that it shall not, during the term hereof, and for a period of two (2) years from the

date of the termination of this agreement, directly or indirectly solicit or otherwise contact any person or customer of Broker with whom Carrier had substantial contact for the purpose of transporting shipments directly for or on behalf of such person or customer, as the violations by Carrier of the provisions of the paragraph would cause irreparable injury to Broker, and there is no adequate remedy at law or in equity, to enjoin Carrier in a court of equity from violating such provision.

9. INDEMNIFICATION: Carrier shall be liable to Broker and the parties identified on bills of lading for any and all loss,

damage, or delay to shipments. The value of the shipment shall be sales price at destination. Carrier shall indemnify, defend and save harmless Broker, Broker’s customer, and the parties identified on the bills of lading, and its subsidiaries and their respective officers, directors, and employees from and against all liabilities, obligations, losses, damages, penalties, claims, actions, suits, costs, charges, and expenses, including without limitation, fees and expenses of legal counsel and expert witnesses as they accrue, which are the result of or arising out of any or all or the work or services performed under this contract by Carrier or its contractors.

10. INSURANCE: Carrier will provide to Broker insurance certificates naming Broker as certificate holder, and to include

additional insured endorsement required herein and providing 30 day notice of material change or cancellation of policies. Carrier will procure and maintain in force continuously throughout the term of this agreement the following types of insurance: 1) Comprehensive Automobile and Truck Liability Insurance (must include hired or non-owned vehicles and MCS-90) with limits of liability of not less than $1,000,000.00 combined single limit per occurrence ($5,000,000.00 for Hazardous Cargo) for bodily injury and property damage, insuring all motor vehicles used by Carrier in the performance of its obligations hereunder, whether such vehicles are owned, non-owned, leased, or hired; 2) Commercial general liability, including contractual liability, with a policy limit of not less than $1,000,000 per occurrence and $2,000,000 aggregate; 3) Motor Truck Cargo Insurance with a minimum limit of $100,000.00 per occurrence, or in excess of $100,000.00 as required by Broker. The per occurrence Cargo limit shall at all times be equal to or greater than Carrier’s legal liability under the Bill of Lading, contract of carriage, shipping receipt or similar and Carrier shall not accept loads in excess of its current coverage unless Carrier has secured additional insurance and provided Broker with proof of such prior to accepting the load tender. Coverage is to provide physical loss and/or damage to the transported commodities while in the course of transit including loss and/or damage sustained during loading and unloading, at rest stops (regardless of whether the truck is unattended), and dishonesty (including theft and/or pilferage) by drivers of transported commodities in the care, custody and control of the Carrier ; 4) Statutory Worker’s compensation; 5) Employer’s liability insurance with a policy limit of not less than $500,000. Broker shall be named via an Additional Insured Endorsement on the Carriers’ General Liability and Auto and Truck Liability Insurances and as a Loss Payee on the Motor Truck Cargo Insurance. Regardless of the insurance required above, the Carrier will at all times comply with the above limits or the minimum required by law, whichever is greater.

11. OVERCHARGES and UNDERCHARGES: Carrier specifically disclaims application of published or non-published

tariffs, and acknowledges that any rate of Carrier in excess of rate named herein an unreasonable and inapplicable rate. The processing, investigation, and disposition of overcharge, undercharge, duplicate payment, unidentified payment or over collection claims shall be governed by 49 C.F.R. 378.

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12. AMENDMENT/ASSIGNMENT/BROKERING: This Agreement may not be modified or amended except by an instrument in writing, signed by both parties hereto. Carrier shall not assign, lease, sub-lease, subcontract, delegate, interline or broker to any other Carrier or person, its responsibilities for the performance of transportation services pursuant to this Agreement. This prohibition does not apply to equipment under lease pursuant to 49 C.F.R. Part 376. Carrier accepts primary responsibility as the originating and delivering motor carrier for all loses if the terms of this paragraph are violated without regard to fault by Carrier or other third parties.

13. STATUS of CARRIER: In the performance of the transportation services hereunder, Carrier shall be an independent

for-hire motor carrier and shall not be or act as an agent or employee of Broker, shipper, consignor or consignee. As between the parties, Carrier shall have the sole and exclusive responsibility for the costs and over the manner in which its employees and/or independent contractors perform the transportation service, including the equipment provided. No employee, agent or other representative of either party shall at any time be deemed to be under the control or authority of the other party, or the joint control of both parties. Each party shall be fully liable for all worker's compensation premiums and liability, Federal, State and local withholding taxes or charges related to its respective employees, and each agrees to hold the other harmless from any claims brought against the other in relation thereto. No provision of this Agreement or any act of the parties pursuant to this Agreement shall be construed to express or imply a joint venture, partnership, principal-agent relationship, or employer-employee relationship exists. Neither party intends to give the other party exclusive rights or privileges under this Agreement or prohibit the provision of transportation services to other third parties.

14. ARBITRATION: Any and all disputes arising under this agreement shall be resolved in binding arbitration through

services of Transportation ADR Council, Inc. or the American Arbitration Association and shall be final and binding. The party filing arbitration shall select the arbitration rules under which to file and such selection shall be final. The “Arbitration Agreement and Jury Trial Waiver” are appended to this agreement and incorporated as set forth fully herein. Any award or judgment shall identify the losing party against whom all expenses of arbitration, including attorney fees, shall be cast.

15. APPLICABLE LAW: The terms of this contract shall be governed by the laws of the State of Mississippi, subject to

applicable federal law, rules and regulations and disregarding any choice-of-law principle under which Mississippi would look to the laws of another jurisdiction. IN WITNESS WHEREOF, the parties have executed this Transportation Agreement by their duly authorized representatives on the date first above written in duplicate. BROKER: KLLM Transport Services, LLC dba KLLM Logistics Services CARRIER: _____________________________ By:_____________________________ By: ____________________________________ Its: _____________________________ Its: ____________________________________

Appendix A Compliance with Food Safety Modernization Act

All contracting carriers agree to the following terms and conditions when transporting refrigerated commodities, human and animal foods and other shipments which may be subject to adulteration in transit. Carrier warrants that it is in compliance with and will abide by the requirements and delegable duties set forth in the Food Safety Modernization Act including but not limited to: 1. The design and maintenance of transportation equipment necessary to ensure that food does not become unsafe. 2. Transportation operations – the maintenance of adequate temperature control, the separation of product to prevent contamination, etc. 3. The proper training of all carrier personnel in sanitary transportation practices and the documentation of such training. 4. The maintenance of written records and procedures and retention of records as required by the FSMA rules. Carrier agrees to comply with all delegable duties permitted under the Act as well as shipper or carrier requirements as set forth by the shipper or broker in writing as part of the load confirmation process or as set forth on the bill of lading at time of pickup. Carrier further agrees to ensure its trailer equipment is inspected and certified by the shipper as fit to load at point of origin, shall properly pulp shipments if required to do so, shall maintain seal integrity during transit, and evidence of temperature in transit. In the event of a rejected delivery, carrier shall immediately contact broker, shall note the extent of any damage, and shall thereafter maintain temperature awaiting broker’s direction for redelivery, inspection and salvage. Complete requirements can be found at https://www.federalregister.gov/documents/2016/04/06/2016-07330/sanitary-transportation-of-human-and-animal-food I Carrier Name ________________ hereby have read the FSMA laws and understand that I will comply to meet the standards set forth above and act responsibly in accordance with these laws. Broker: Carrier: Name: Cassie Icamina Name:_____________________________ KLLM Logistics Services Carrier Name:______________________ Signature ___________________ Signature _________________________ Title: Director of Logistics Title ______________________________

DBA KLLM Logistics Services Profile with Credit References

Physical Address

Remit all invoices to: KLLM Logistics Services

135 Riverview Drive Jackson, MS 39218

Phone 866-682-3010 Fax 601-936-5669

Federal ID# 26-3628823

MC# 649560 Duns # 045-321-841 SCAC Code KLLT

Carrier References:

Bopari Transport Inc.

Sunny Bopari PO Box 9367

Fresno, CA 93792-9367 559-275-1960

T.S. Expediting Services Inc

Kelly Scherer PO Box 307

Perrysburg, OH 43552 800-821-6395

Stewart Transportation

Jon Martin PO Box 16447

Hattiesburg, MS 39404 601-582-0246

Trade References:

Empire Trucks PO Box 54325; Jackson, MS 39208 601-939-5000 Utility Trailers 550 Hwy 49 South; Richland, MS 39218 601-939-9000 Travel Centers 24601 Centerridge; Westlake, OH 44145 440-808-9100

KLLM Logistics Services Preferred Document Delivery Method So Carriers GET PAID FASTER.

KLLM Logistics Services prefers that you submit your load paperwork and invoices using TRANSFLO $Velocity® or TRANSFLO® Mobile. This service allows you to get your trip information to us in a matter of minutes instead of days so you GET PAID FASTER. Benefits to You

Get paid faster – no more waiting for the mail to deliver the documents

Free to download and free to use!

Total control of your documents because you no longer hand your documents off to someone hoping they do not get lost.

Keep your original paperwork until payment has been received.

Ability to confirm that your invoices arrived for processing.

You get a confirmation number immediately after sending so you know your documents have been sent.

Eliminates the need to make copies before sending your documents. To Participate You need the following a smart phone or: A PC A local scanner or network scanner Go to your smart phone store or visit www.transflovelocity.com/download to download and install the program. Use the Broker ID of KLLTV. If you need additional assistance, please contact $Velocity Customer Support at 866-503-5707.

 

From: KLLM Logistics Services

Attention: ______________________________________________

Fax #: ______________________________________________

REQUEST FOR CERTIFICATE

Request for Certificate of Insurance for:

With Cargo, Auto Liability, and General Liability naming KLLM

Logistics Services as the certificate holder and as Additional Insured.

Please list the Deductible, Limits, Sub-Limits, and Exclusions. If you

are hauling a frozen or refrigerated load, please include reefer

breakdown.

Certificate Holder:

KLLM Logistics Services

135 Riverview Drive

Jackson, MS 39218

Please email to: cbryant@kllm.com

Please fax to: 601-936-5449

Attn: Logistics Department

Phone: 866-682-3010

****Payments are not released until all paperwork is on file.

Thank you.

Form W-9(Rev. December 2011)Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

Give Form to the requester. Do not send to the IRS.

Pri

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Sp

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2.

Name (as shown on your income tax return)

Business name/disregarded entity name, if different from above

Check appropriate box for federal tax classification:

Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶

Other (see instructions) ▶

Exempt payee

Address (number, street, and apt. or suite no.)

City, state, and ZIP code

Requester’s name and address (optional)

List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter.

Social security number

– –

Employer identification number

–

Part II CertificationUnder 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, and

3. I am a U.S. citizen or other U.S. person (defined below).

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 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, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4.

Sign Here

Signature of U.S. person ▶ Date ▶

General InstructionsSection references are to the Internal Revenue Code unless otherwise noted.

Purpose of FormA person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA.

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or

3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income.

Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien,

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States,

• An estate (other than a foreign estate), or

• A domestic trust (as defined in Regulations section 301.7701-7).

Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income.

Cat. No. 10231X Form W-9 (Rev. 12-2011)