HomeMy WebLinkAboutRESOLUTION - 36-25 - 5/27/2025 - 925 TONNE ROAD, B&B PARTNERSHIP, LLC PERMANENT EASEMENTRESOLUTION NO.36-25
A RESOLUTION APPROVING THE ACQUISITION OF A PERMANENT EASEMENT
FOR THE PURPOSE OF ROADWAY IMPROVEMENTS ALONG TONNE ROAD
BETWEEN THE VILLAGE OF ELK GROVE VILLAGE AND THE PROPERTY
OWNER OF 925 TONNE ROAD, B&B PARTNERSHIP, LLC AND PAYMENT TO THE
PROPERTY OWNER IN THE AMOUNT OF $800 FROM THE BUSINESS LEADERS
FORUM
NOW, THEREFORE, BE IT RESOLVED by the Mayor and Board of Trustees of the
Village of Elk Grove Village, Counties of Cook and DuPage, State of Illinois, as follows:
Section 1: That the Mayor be and is hereby authorized to sign the attached documents
marked:
PERMANENT EASEMENT
(Limited Liability Company)
a copy of which is attached hereto and made a part hereof as if fully set forth and the Village
Clerk is authorized to attest said document upon the signature of the Mayor.
Section 2: That this Resolution shall be in full force and effect from and after its passage
and approval according to law.
VOTE: AYES: 6 NAYS: 0 ABSENT: 0
PASSED this 27th day of May 2025
APPROVED this 27t' day of May 2025
APPROVED:
Mayor Craig B. Johnson
Village of Elk Grove Village
ATTEST:
Loretta M. Murphy, Village Clerk
i
Elk Grove Village
Owner:
B&B Partnership, LLC, an Illinois limited liability company
Address:
925 Tonne Road
Elk Grove Village, IL 60007
Route:
Route 2652 (Tonne Road)
Section:
20-00073-00-PV
County:
Cook
Job No.:
R-55-001-97
Parcel No.:
0007
P.I.N. No.:
08-27-300-033
State of
Illinois )
ss.
County of
Cook )
I, Paul
Bartolomei as Manager
Affidavit of Title
of B&B Partnership, LLC, an Illinois limited liability company, being first duly sworn upon oath states as follows:
Affiant has personal knowledge of the facts averred herein.
2. X'^ There are no parties other than Grantor in possession of any portion of the premises described in attached
Exhibit "A" through easement, lease, oral or written, or otherwise, whether or not of record.
❑ There are no parties other than Grantor and the parties listed below in possession of any portion of the
premises described in attached Exhibit "A" through easement, lease, oral or written, or otherwise, whether or not
of record:
SEE ATTACHED EXHIBIT "A"
3. This affidavit is made to provide factual representation as a basis for Elk Grove Village to accept a document of
conveyance for the premises described in said conveyance, the premises being a portion of or all of the above described
premises, from the record owners thereof.
4. The affiant has no knowledge of any driveway agreements, encroachments, overlaps, or boundary line disputes
involving the premises to be conveyed.
5. The said premises described in Exhibit "A" are: (Check One)
❑ Vacant and unimproved ❑ Agricultural and unimproved
® Improved and
(A) There have been no improvements made or contracted for on the premises within six (6) months
immediately preceding the date of the affidavit, out of which a claim for a mechanic's lien could accrue or
has accrued; and
(B) To the best of my knowledge all improvements now on the premises comply with all local building and
zoning ordinances.
Page 1 of 4 LA 4111 A (Rev. 11 /07/11)
6. There are no chattel mortgages, conditional sales contracts or financing statements existing on or in connection
with the premises to be conveyed which are not shown by the public records.
7. There are no taxes or special assessments which are not shown as existing liens by the public records involving the
premises described in Exhibit A.
8. Per 50 ILCS 105/3.1, the identities of all owners and beneficiaries having an interest in the premises to be
conveyed are as follows (check applicable box(es) and complete information requested):
❑ Individual. Individual owner of the property is:
❑ Nonprofit Organization. There is no individual or other organization receiving distributable income from the
organization.
❑ Public Organization, including units of local government. There is no individual or other organization
receiving distributable income from the organization
❑ Publicly -Traded Corporation. There is no readily known shareholder entitled to receive more than 7-1/2%
interest in the total distribution income of the corporation.
® Corporation, Partnership, Limited Liability Company. Those entitled to receive more than 7-1/2% of the
total distributable income of said entity are as follows:
Name
Rt o-r*jeeu% At, e L 4 G
2.
Address
V A.0 eC 1IIIIC—L fL V%Z!
Cn000-7
3.
4.
❑ Land Trust or Declaration of Trust. The identity of each beneficiary of Grantor Trust is as follows:
% of
Name Address Interest
*1.
2.
3.
4.
* IF THE INITIAL DISCLOSURES SHOW INTERESTS HELD BY ANOTHER CORPORATION,
PARTNERSHIP, LIMITED LIABILITY COMPANY, OR TRUST, THEN FURTHER DISCLOSURES SHOULD
BE PROVIDED UNTIL THE NAMES OF INDIVIDUALS OWNING THE INTEREST IN THE ENTITY ARE
DISCLOSED.
Page 2 of 4 LA 4111 A (Rev. 11 /07/11)
Dated this 2- Z day of k F(L I L- , 2025
B&B Partnership, LLC, an Illinois limited liability company
Z: --'A.00000�--
i
Paul Bartolomel, Manager
Print Name and Title if applicable
State of
ss
County of L >L )
This instrument was acknowledged before me on :ail I 2025, by
Paul Bartolomei as Manager of B&B Partnership, LLC.
(SEAL)-
:AMIELGUI7ERREZ Notary Public
YIN�otery
CIAL SEAL 1
lc-SWeofIllinoie onNo.M211 My Commission Expires: i �t30 2P28 `
NOTE: THIS AFFIDAVIT MAY BE EXECUTED AND ACKNOWLEDGED ON BEHALF OF THE RECORD
OWNER(S) BY ANY ONE OF THE RECORD OWNERS, OFFICERS, MANAGERS, PARTNERS,
OR TRUSTEES HAVING KNOWLEDGE OF THE FACTS IN THIS AFFIDAVIT.
Page 3 of 4 LA 4111A (Rev. 11/07/11)
LEGAL DESCRIPTION
LOT 359 IN CENTEX INDUSTRIAL PARK UNIT 217, BEING A SUBDIVISION IN
THE SOUTHWEST QUARTER OF SECTION 27, TOWNSHIP 41 NORTH,
RANGE 11 EAST OF THE THIRD PRINCIPAL MERIDIAN, IN COOK COUNTY,
ILLINOIS.
PERMANENT TAX NUMBER(S): 08-27-300-033
Page 4 of 4 LA 4111A (Rev. 11/07/11)
Owner:
B&B Partnership, LLC, an
Illinois limited liability company
Address:
925 Tonne Road
Elk Grove Village, IL 60007
Route:
Route 2652 (Tonne Road)
Section:
20-00073-00-PV
County:
Cook
Job No.:
R-55-001-97
Parcel No.:
0007
P.I.N. No.:
08-27-300-033
PERMANENT EASEMENT
(Limited Liability Company)
B&B Partnership, LLC, a limited liability company, organized and existing under and by
virtue of the laws of the State of Illinois and duly authorized to do business under the Statutes of
the State of Illinois, (Grantor), for and in consideration of Eight Hundred Dollars ($800), receipt of
which is hereby acknowledged, and pursuant to the authority given by the member(s) of said
company, hereby represents that Grantor owns the fee simple title to and grants and conveys to
Elk Grove Village, (Grantee), a permanent easement for the purpose of roadway improvements
and for other highway purposes, on, over and through the following described real estate:
See attached legal description.
situated in the County of Cook, State of Illinois and hereby releases and waives all right under
and by virtue of the Homestead Exemption Laws of the State of Illinois. The above -described
real estate and improvements located thereon are herein referred to as the "premises."
Grantor shall have and retains all rights to use and occupy the premises and access to
Grantor's remaining property, except as herein expressly granted; provided, however, Grantor's
use and occupation of the premises may not interfere with Grantee's use of the premises for the
purposes herein described.
This permanent easement is made, executed and delivered pursuant to a resolution duly
adopted at a meeting of the members of the said limited liability company held on the
__�-- day of 2025.
Page 1 of 3 (Rev. 11/11)
Grantor, without limiting the interest above granted and conveyed, acknowledges that
upon payment of the agreed consideration, all claims arising out of the above acquisition have
been settled, including without limitation, any diminution in value to any remaining property of the
Grantor caused by opening, improving, and using the premises for highway purposes. This
acknowledgment does not waive any claim for trespass or negligence against the Grantee or
Grantee's agents which may cause damage to Grantor's remaining property.
This grant shall constitute a covenant, which runs with the land, and shall be binding upon
the legal representatives, successors and assigns of Grantor.
Dated this day of Pit It [_ 2025.
B&B Partnership, LLC, an Illinois
limited liability company.
By: (G� ignature
Paul Bartolomei, Manager
Print Name and Title
State of
ss
County of ���� )
This instrument was acknowledged before me on ) i , 2025, by
Paul Bartolomei
of B&B Partnership, LLC
(SEAL)
JAMIE L GLrnERREZ
„—TA—R OFFICIAL SEAL
rwuc Notary Public - State of Illinois
l7AOCF
r.,,,,� Commission No. 888211
M Commission A ust3mws
, as Manager
Notary-RdbIic
My Commission Expires
Page 2 of 3 (Rev. 11/11)
LEGAL DESCRIPTION
A permanent easement over the west 2.00 feet of Lot 359 in Centex Industrial Park Unit 217, being a
subdivision in the Southwest Quarter of Section 27, Township 41 North, Range 11 East of the Third
Principal Meridian, in Cook County, Illinois, per Document 24051587, as recorded on August 10, 1977,
bearings and distances are based on the Illinois State Plane Coordinate System, East Zone, NAD83 (2011
Adjustment), described as follows:
Beginning at the southwest corner of said Lot 359; thence along the west line of said Lot 359, North 00
degrees 21 minutes 25 seconds West, 75.01 feet to the northwest corner of said Lot 359; thence along
the north line of said Lot 359, North 88 degrees 37 minutes 35 seconds East, 2.00 feet to a line that is
2.00 feet east of and parallel with said west line; thence along said parallel line, South 00 degrees 21
minutes 25 seconds East, 75.01 feet to the south line of said Lot 359; thence along said south line, south
88 degrees 37 minutes 35 seconds west, 2.00 feet to the point of beginning.
Said easement containing 0.003 acres (150 square feet), more or less.
Page 3 of 3 (Rev. 11/11)
Owner:
B&B Partnership, LLC, an
Illinois limited liability company
Address:
925 Tonne Road
Elk Grove Village, IL 60007
Route:
Route 2652 (Tonne Road)
Section:
20-00073-00-PV
County:
Cook
Job No.:
R-55-001-97
Parcel No.:
0007
P.I.N. No.:
08-27-300-033
CERTIFIED RESOLUTION
(Limited Liability Company)
I, Paul Bartolomei, as Manager under the Operating Agreement of B&B Partnership, LLC,
an Illinois limited liability company, organized and existing under and by virtue of the laws of the
State of Illinois and duly authorized to do business in the State of Illinois, do hereby certify that:
1. The following is a true and correct copy of a resolution adopted by the members
of said limited liability company, at a meeting held on the 22, day of
_444a, 2025 and
2. The resolution has not been amended or revoked and is in full force and effect.
Resolved that Paul Bartolomei, as Manager of the above -referenced limited liability
company is hereby authorized and directed to convey the limited liability company's interest in
the following described real estate in Cook County, Illinois to Elk Grove Village for highway
purposes for the sum of $800:
See attached legal description.
Further resolved that he is authorized and directed to execute and deliver such
instruments as may be necessary or convenient to consummate such sale.
Page 1 of 3 (Rev. 10/12)
Dated this X2 - day of API. f C-- 2025.
B&B Partnership, LLC, an Illinois limited liability company
ignature
Paul Bartolomei, Manager
Print Name and Title
State of ZL-- 1
County of -'v �L )
This instrument was acknowledged before me on
Paul Bartolomei
of B&B Partnership, LLC
, as
G , 2025, by
Manager
(SEAL) JnM[E L GUnERREZ
OFFlCIALSFJU otaPublic
�a Notary Public -State of Illlnals
404M Commisslon No. W211
M Commbsbn res u3tso.2028
My Commission Expires: Z
Page 2 of 3 (Rev. 10/12)
LEGAL DESCRIPTION
A permanent easement over the west 2.00 feet of Lot 359 in Centex Industrial Park Unit 217, being a
subdivision in the Southwest Quarter of Section 27, Township 41 North, Range 11 East of the Third
Principal Meridian, in Cook County, Illinois, per Document 24051587, as recorded on August 10,1977,
bearings and distances are based on the Illinois State Plane Coordinate System, East Zone, NAD83 (2011
Adjustment), described as follows:
Beginning at the southwest corner of said Lot 359; thence along the west line of said Lot 359, North 00
degrees 21 minutes 25 seconds West, 75.01 feet to the northwest corner of said Lot 359; thence along
the north line of said lot 359, North 88 degrees 37 minutes 35 seconds East, 2.00 feet to a line that is
2.00 feet east of and parallel with said west line; thence along said parallel line, South 00 degrees 21
minutes 25 seconds East, 75.01 feet to the south line of said Lot 359; thence along said south line, south
88 degrees 37 minutes 35 seconds west, 2.00 feet to the point of beginning.
Said easement containing 0.003 acres (150 square feet), more or less.
Page 3 of 3 (Rev. 10/12)
Owner:
B&B Partnership, LLC, an
Illinois limited liability company
Address:
925 Tonne Road
Elk Grove Village, IL 60007
Route:
Route 2652 (Tonne Road)
Section:
20-00073-00-PV
County:
Cook
Job No.:
R-55-001-97
Parcel No.:
0007
P.I.N. No.:
08-27-300-033
CERTIFICATION OF LIMITED LIABILITY COMPANY AGREEMENT
Paul Bartolomei, as Manager under the Operating Agreement of B&B Partnership, LLC,
an Illinois limited liability company certify as follows:
1. Attached hereto is a full, accurate and complete copy of the Operating Agreement
of B&B Partnership, LLC, an Illinois limited liability company dated June 15, 2015, and any
amendments thereto, which are in full force and effect and have not been revoked, modified or
amended in any way.
2. The Manager has the power under the Operating Agreement and applicable law
to sell, convey, encumber, lease, manage and otherwise deal with interests in real and personal
property held as an asset.
Dated this XIL- day of Au-1 t.- 2025.
B&B Partnership, LLC, an Illinois limited liability company
ignature
r
State of )
Paul Bartolomei, Manac
Print Name and Title
County ofLx
This instrument was acknowledged before me on �� � 2025 by
LA��
Paul Bartolomei, as Manager of B&B Partnership, LLC.
SEAL
JAMIELQLMERREZ \ Notary Bllbtic:
s,uY Notary Pub a SEAL
mmisslon State of INlnois J
M GOMM ton . N sqe2i I
My Commission Expires:
ali�
Page 1 of 1 (Rev. 0112017)
Elk Grove Village
I uz-�
Owner:
B&B Partnership, LLC, an Illinois
limited liability company
Address:
925 Tonne Road
Elk Grove Village, IL 60007
Route:
Route 2652 (Tonne Road)
Section:
20-00073-00-PV
County:
Cook
Job No:.
R-55-001-97
Parcel No.:
0007
P.I.N. No.:
08-27-300-033
State of Illinois
County of Cook
Paul Bartolomei
ss
Disclosure of Owner(s) and/or
Beneficial Interest(s) Affidavit
(Corporation, Partnership, Limited
Liability Company)
, Affiant, being first duly sworn on oath, states that the Affiant
is manager of B&B Partnership, LLC
which owns the property or is otherwise interested in the property described in the exhibit (copy of deed or legal description)
hereto attached, that Affiant has knowledge of the facts herein; and that the members entitled to receive more than 71/2%
of the total distributable income of said entity are as follows:
Name
Address
Percentage
1. fA LA l.. k�tC_o k4l
125 TaNPPE ,=L C 4 A9 o
70
2. YIJ
3.
4.
5.
Paul Bartolomei, Manager
Print Name and Title
This instrument was acknowledged before me on (��'�(��! ,� 2025
by Paul Bartolomei as Manager of B&B Partnership, LLC.
(SEAL)
JAMIE L GUTIERREZ
HoW, OFFICIAL S
erI,"a. NotaryPublic- EAL
lanais Commisslon No" 2of 11 Is
M Comm6sion res A u9130, 2028
t
L L
Notar Public:
My Commission Expires:'
LA 4111 C (Rev. 11107111)
LEGAL DESCRIPTION
A permanent easement over the west 2.00 feet of Lot 359 in Centex Industrial Park Unit 217, being a
subdivision in the Southwest Quarter of Section 27, Township 41 North, Range 11 East of the Third
Principal Meridian, in Cook County, Illinois, per Document 24051587, as recorded on August 10, 1977,
bearings and distances are based on the Illinois State Plane Coordinate System, East Zone, NAD83 (2011
Adjustment), described as follows:
Beginning at the southwest corner of said Lot 359; thence along the west line of said Lot 359, North 00
degrees 21 minutes 25 seconds West, 75.01 feet to the northwest corner of said Lot 359; thence along
the north line of said Lot 359, North 88 degrees 37 minutes 35 seconds East, 2.00 feet to a line that is
2.00 feet east of and parallel with said west line; thence along said parallel line, South 00 degrees 21
minutes 25 seconds East, 75.01 feet to the south line of said Lot 359; thence along said south line, south
88 degrees 37 minutes 35 seconds west, 2.00 feet to the point of beginning.
Said easement containing 0.003 acres (150 square feet), more or less.
LA 4111 C (Rev. 11 /07/11)
Elk Grove Village
Receipt of Conveyance Documents and
Disbursement Statement
Owner:B&B Partnership, LLC, an Illinois limited liability company
Job No.: R-55-001-97
Parcel No.: 0007
Elk Grove Village (Grantee) acknowledges Receipt of the following:
(Check all that apply.)
❑ Warranty Deed covering acres
® Permanent Easement covering 0.003 acres
❑ Temporary Construction Easement covering acres
all located in Cook County, Illinois as right of way for Route: 2652 (Tonne Road), Section: 20-00073-00-PV
dated 4-X7--2-1 , executed by the undersigned Grantors.
Grantor and Grantee agree as follows:
The payment of the sum of Eight Hundred Dollars ($800) to Grantor as total consideration for the (PE)
by Grantee is subject to Grantee's approval of title and documentation and, if applicable, Grantee's final
approval in accordance with Section 9.02 of the Illinois State Finance Act.
2. All improvements located, wholly or partially, on the parcel shall become the property of Elk Grove
Village, unless provided as follows:
None
3. Possession and transfer of title to Elk Grove Village occur when Grantee delivers a state warrant to
Grantor, in person or to the address stated herein, in the amount of the above stated consideration,
unless provided herein. Grantor shall have the sole responsibility and obligation to protect, preserve
and maintain the parcel and improvements thereon until delivery of possession to Grantee.
4. Grantor directs Grantee to disburse the above stated consideration by warrant or by separate warrants
as follows:
Name*
B&B Partnership, LLC
TIN/FEIN/SSN** Address
qR
cvvtovc— It -
Ana 1
Amount
le
*If multiple names on the same warrant, list first and circle the name of the person or entity whose
TIN/FEIN/SSN is entered above. If lien holder is to be paid by warrant, use Grantor's TIN or SSN with
their name listed first and lien holder second. The first payee must match the TIN used.
**Attach a current W-9 form for each TIN/FEIN/SSN.
5. NON -FOREIGN CERTIFICATION — FIRPTA. Section 1445 of the Internal Revenue Code provides
that a transferee (buyer) of a U.S. real property interest must withhold tax if the transferor is a foreign
Page 1 of 2 LA 4112A Template (Rev. 02/9/16)
person. For purposes of this paragraph, "Transferee" shall mean "Grantee" and "Transferor" shall
mean "Grantor". To inform the Grantee that withholding of tax is not required upon the disposition of a
U.S. real property interest by Grantor, the Grantor hereby certifies the following:
a. Transferor is the owner of the real property being conveyed;
b. Transferor is not a foreign person, entity, or disregarded entity (as such terms are defined in the
Internal Revenue Code and Income Tax Regulations); and
c. Transferor's U.S. Taxpayer Identification Number and address set forth above are true and correct.
Transferor understands that this certification may be disclosed to the Internal Revenue Service by
Transferee and that any false statement contained herein could be punished by fine, imprisonment or_?—O
both. ky/
Indial
6. Illinois law (15 ILCS 405/10.05 to 405/10.05b) requires the State of Illinois Comptroller to deduct from
any State of Illinois warrants or payments the amount of any outstanding account or claim in favor of
the State of Illinois and any amount necessary to satisfy past due child support or delinquent student
loan and financial aid obligations on any loan guaranteed by the Illinois Student Assistance
Commission.
7. This Receipt of Conveyance Documents and Disbursement Statement is the entire and exclusive
agreement between the parties and supersede any written or oral understanding, promise or
agreement, directly or indirectly related to the conveyance of parcel and improvements. The parties
agree that any changes to this Receipt may only be made in writing and signed by the parties.
Date:?"
Grantor: B&B Partnership, LLC, an Illinois limited liability company
ature
Paul Bartolomei, Manager
Print Name (and Title, if applicable)
Page 2 of 2 LA 4112A Template (Rev. 02/9/16)
w_9
Request for Taxpayer
Give form to the
Form
(Rev. March2024)
Identification Number and Certification
requester. Do not
Department of the Treasury
Go to www.irs.gov/FormW9 for instructions and the latest information.
send to the IRS.
Internal Revenue Service
Before you begin. For guidance
related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the ousinessroLsregaraea
entity's name on line 2.)
3 A- t3 P
2 Business name/disregarded entity name, H different from above.
M
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
0
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
a
C
❑ Individualtsole proprietor ❑ C corporation ❑ S corporation ❑ Partnership ❑ Trust/estate
0
y
LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
Exempt payee code (if any)
a ,�o
u
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
`o
box for the tax classification of Its owner.
Compliance Act (FATCA) reporting
�i
ElOther (see instructions)
code (if any)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P° as its tax classification,
Il u
(Applies to accounts maintained
y
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check ❑
outside the United States.)
�a
this box if you have any foreign partners, owners, or beneficiaries. See instructions . . . . . . .
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
cn
`j 2 J to � 1�"� -
6 City, state, and ZIP code
rc Gam E V (00
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
C....i nl c rih, n„mhn
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid -- -
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or
TIN, later. I Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and m _ O 6
Number To Give the Requester for guidelines on whose number to enter. II`/'�71I
Under 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. 1 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
3.1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
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 div d� . not required to sign the certification but you must provide your correct TIN. Seethe instructions for Part II, later.
Sign I Sign
Here u.s.
Date
General Instructions
New line 3b has been added to this form. Aflow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
to another flow -through entity in which it has an ownership interest. This
noted.
Future developments. For the latest information about developments
change is intended to provide a flow -through entity with information
regarding the status of its indirect foreign partners, owners, or
related to Form and its instructions, such as legislation enacted
beneficiaries, so that it can satisfy any applicable reporting
after they were published, go to www.irs.gov/FormW9.
requirements. For example, a partnership that has any indirect foreign
partners may be required to complete Schedules K-2 and K-3. See the
What's New
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
An individual or entity (Form W-9 requester) who is required to file an
should check the "LLC" box and enter its appropriate tax classification.
information return with the IRS is giving you this form because they
Cat. No. 10231 X ' "" " —