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TIN CERTIFICATION <br /> The COMPANY certifies that: <br /> 1. The number shown on this form is the COMPANY's correct taxpayer identification number(or <br /> the COMPANY is waiting for a number to be issued to them),and <br /> 2. The COMPANY is not subject to backup withholding because: (a)the COMPANY is exempt from <br /> backup withholding,or(b)the COMPANY has not been notified by the Internal Revenue Service (IRS) <br /> that the COMPANY is subject to backup withholding as a result of a failure to report all interest or <br /> dividends,or(c)the IRS has notified the COMPANY,that the COMPANY is no longer subject to back-up <br /> withholding, and , <br /> 3. The COMPANY's person with signatory authority for this AGREEMENT is a U.S. person (including '� <br /> a U.S. resident alien). <br /> Taxpayer ldentification Number: <br /> Legal Status: <br /> Individual Government <br /> _ Sole Proprietor _ Nonresident Alien <br /> _ Partnership/Legal Corporation _ Estate orTrust <br /> _ Tax-exempt _ Pharmacy(Non Corp.) <br /> _ Corporation providing or _ Pharmacy/Funeral home/Cemetery <br /> billing medical and/or <br /> health care services <br /> _ Corporation NOT providing _ Other <br /> or billing medical and/or <br /> health care services <br /> _ Limited Liability Company <br /> (Select applicable tax classification) <br /> o D= Disregarded entity <br /> o C=Corporation <br /> ❑ P= Partnership <br /> Page 5 of 6 <br />