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FormW-8BEN(Rev.February2006)DepartmentoftheTreasuryInternalRevenueServiceCertificateofForeignStatusofBeneficialOwnerforUnitedStatesTaxWithholdingSeeseparateinstructions.Givethisformtothewithholdingagentorpayer.DonotsendtotheIRS.OMBNo.1545-1621Donotusethisformfor:Instead,useForm:●Aforeignpartnership,aforeignsimpletrust,oraforeigngrantortrust(seeinstructionsforexceptions)W-8ECIorW-8IMY●Aforeigngovernment,internationalorganization,foreigncentralbankofissue,foreigntax-exemptorganization,foreignprivatefoundation,orgovernmentofaU.S.possessionthatreceivedeffectivelyconnectedincomeorthatisclaimingtheapplicabilityofsection(s)115(2),501(c),892,895,or1443(b)(seeinstructions)W-8ECIorW-8EXP●ApersonactingasanintermediaryW-8IMY●ApersonclaimingthatincomeiseffectivelyconnectedwiththeconductofatradeorbusinessintheUnitedStatesW-8ECIPartIPartIIIdentificationofBeneficialOwner(Seeinstructions.)1324567NameofindividualororganizationthatisthebeneficialownerTypeofbeneficialowner:CountryofincorporationororganizationPermanentresidenceaddress(street,apt.orsuiteno.,orruralroute).DonotuseaP.O.boxorin-care-ofaddress.Cityortown,stateorprovince.Includepostalcodewhereappropriate.Country(donotabbreviate)U.S.taxpayeridentificationnumber,ifrequired(seeinstructions)Foreigntaxidentifyingnumber,ifany(optional)IndividualCorporationPartnershipSimpletrustMailingaddress(ifdifferentfromabove)Cityortown,stateorprovince.Includepostalcodewhereappropriate.Country(donotabbreviate)ClaimofTaxTreatyBenefits(ifapplicable)Icertifythat(checkallthatapply):ThebeneficialownerisaresidentofwithinthemeaningoftheincometaxtreatybetweentheUnitedStatesandthatcountry.Ifrequired,theU.S.taxpayeridentificationnumberisstatedonline6(seeinstructions).Thebeneficialownerisnotanindividual,derivestheitem(oritems)ofincomeforwhichthetreatybenefitsareclaimed,and,ifapplicable,meetstherequirementsofthetreatyprovisiondealingwithlimitationonbenefits(seeinstructions).Thebeneficialownerisnotanindividual,isclaimingtreatybenefitsfordividendsreceivedfromaforeigncorporationorinterestfromaU.S.tradeorbusinessofaforeigncorporation,andmeetsqualifiedresidentstatus(seeinstructions).Thebeneficialownerisrelatedtothepersonobligatedtopaytheincomewithinthemeaningofsection267(b)or707(b),andwillfileForm8833iftheamountsubjecttowithholdingreceivedduringacalendaryearexceeds,intheaggregate,$500,000.Underpenaltiesofperjury,IdeclarethatIhaveexaminedtheinformationonthisformandtothebestofmyknowledgeandbeliefitistrue,correct,andcomplete.Ifurthercertifyunderpenaltiesofperjurythat:1Iamthebeneficialowner(oramauthorizedtosignforthebeneficialowner)ofalltheincometowhichthisformrelates,2ThebeneficialownerisnotaU.S.person,3Theincometowhichthisformrelatesis(a)noteffectivelyconnectedwiththeconductofatradeorbusinessintheUnitedStates,(b)effectivelyconnectedbutisnotsubjecttotaxunderanincometaxtreaty,or(c)thepartner’sshareofapartnership’seffectivelyconnectedincome,and4Forbrokertransactionsorbarterexchanges,thebeneficialownerisanexemptforeignpersonasdefinedintheinstructions.SignHereSignatureofbeneficialowner(orindividualauthorizedtosignforbeneficialowner)Date(MM-DD-YYYY)ForPaperworkReductionActNotice,seeseparateinstructions.Cat.No.25047ZFormW-8BEN(Rev.2-2006)SectionreferencesaretotheInternalRevenueCode.abcdeSSNorITINEINCapacityinwhichactingDisregardedentityCertification9Specialratesandconditions(ifapplicable—seeinstructions):ThebeneficialownerisclaimingtheprovisionsofArticleofthetreatyidentifiedonline9aabovetoclaima%rateofwithholdingon(specifytypeofincome):.Explainthereasonsthebeneficialownermeetsthetermsofthetreatyarticle:10GovernmentInternationalorganizationCentralbankofissueTax-exemptorganizationPartIVPartIIINotionalPrincipalContracts11IhaveprovidedorwillprovideastatementthatidentifiesthosenotionalprincipalcontractsfromwhichtheincomeisnoteffectivelyconnectedwiththeconductofatradeorbusinessintheUnitedStates.Iagreetoupdatethisstatementasrequired.●AU.S.citizenorotherU.S.person,includingaresidentalienindividualW-9PrivatefoundationNote:TheseentitiesshoulduseFormW-8BENiftheyareclaimingtreatybenefitsorareprovidingtheformonlytoclaimtheyareaforeignpersonexemptfrombackupwithholding.Note:Seeinstructionsforadditionalexceptions.GrantortrustEstateComplextrustFurthermore,Iauthorizethisformtobeprovidedtoanywithholdingagentthathascontrol,receipt,orcustodyoftheincomeofwhichIamthebeneficialowneroranywithholdingagentthatcandisburseormakepaymentsoftheincomeofwhichIamthebeneficialowner.8Referencenumber(s)(seeinstructions)PrintedonRecycledPaper表格用途：本表格適用於非美國居民向美國國稅局申報美國所得稅減免時使用。如果您所居住的國家為美國的稅務減免互惠國，您便可能符合減稅或免稅的資格。請到美國國稅局網站做進一步了解。請將您的W8表格寄到史考特證券，不要送到美國國稅局。表格不適用於：應使用表格•非美國居民本年度在美國居住超過183天(含183天)，但持有F，J，M，Q簽證者不在此限。如您持有上述種類簽證，請在此註明簽證類別：•美國公民，永久居民或美國稅法所定義的外國居民………………………………………………………………W9•申報稅務減免的個人與美國有經貿往來………………………………………………………………………W-8ECI詳細資料請查閲美國國稅局W-8BEN英文版全文説明。表格填寫簡單説明：第一部分(PartI)：帐户持有人資料第1點：姓名。第2點：如果是公司，填入公司成立的國家，如果是其他實體，填入創建，組合或管轄的法律根據國家，如果是個人，填入N/A(不適用)。第3點：持有人種類：個人請勾選Individual;若為共同賬戶請分別填寫W-8BEN。第4點：永久居住地址（請勿使用郵政信箱POBox或轉寄地址，還有國家名稱請勿簡寫。）第