Affiliate Registration 2018-02-27T10:51:49+00:00

Interesting Image
Referral Partner Registration
Request for Taxpayer Identification
Number & Certification
1. The number shown above 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 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 above); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.