REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= Delivery Prepared by _____________ Checked By _________________ Date ___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------ Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------ Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature _________________ Date_______ ========================= ====================================================== Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Give the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payor.
Appears in 2 contracts
Sources: Letter of Transmittal (Terex Corp), Letter of Transmittal (Terex Corp)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= Delivery Prepared by _____________ Checked By ____________________________________________ Date CERTIFICATE SERIES A NOTES SERIES A NOTES SURRENDERED TENDERED ACCEPTED ________________________________________________________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature ________________________________________________________ ________________________________________________________ Delivery Prepared by_________________________________ Checked By________________ Date__________________ ========================= ====================================================== ____________________________________________________________________________________________________________________ Name (If joint names, see attached guidelines) ____________________________________________________________________________________________________________________ Business name (Sole proprietors, see attached guidelines) ____________________________________________________________________________________________________________________ Please check appropriate box:[ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ____________________________________________________________________________________________________________________ Address (number, street, and apt. or suite no.) ____________________________________________________________________________________________________________________ City, state, and ZIP code ____________________________________________________________________________________________________________________ _______________________________________________________________________________ SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service ▇▇▇▇▇'s Request for Taxpayer Identification Number (TIN) _______________________________________________________________________________ PART I -- TAXPAYER IDENTIFICATION NO. Enter your taxpayer identification number in the appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Obtain a "TIN" in the enclosed Guidelines. ______________________ Social Security Number _______________________ Employer Identification Number Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN If the account is more than one name, see the chart in enclosed Guidelines to determine what number to give. _______________________________________________________________________________ _______________________________________________________________________________ PART II -- FOR PAYEES EXEMPT FROM BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE (SEE ENCLOSED GUIDELINES FOR GUIDELINES) _______________________________________________________________________________ _______________________________________________________________________________ PART III -- CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper -- Under penalties of perjury, I certify that:
(1) The number shown on this form is my correct Taxpayer Identification Number to Give the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the (or I am waiting for a number to give 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 payorInternal 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.
Appears in 2 contracts
Sources: Letter of Transmittal (Laralev Inc), Letter of Transmittal (Laralev Inc)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= ------------------------------------- CERTIFICATE OLD NOTES OLD NOTES SURRENDERED TENDERED ACCEPTED ------------------------------------- ------------------------------------- ------------------------------------- Delivery Prepared by By_____________ Checked By _________________ Date Checked By___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature _________________ Date________________ ========================= ====================================================== Note----------------------------------------------------------------------------------------------------------------------------------- PAYER'S NAME: FAILURE TO COMPLETE ----------------------------------------------------------------------------------------------------------------------------------- SUBSTITUTE PART 1--PLEASE PROVIDE YOUR TIN IN THE BOX AT RIGHT AND RETURN THIS CERTIFY BY SIGNING AND DATING BELOW: ______________________________________ FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFERW-9 Social Security Number OR ______________________________________ Employer Identification Number
(1) The number shown on this form is my current 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, (b) I have not been notified by the Internal Revenue Service (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. PLEASE REVIEW THE ENCLOSED GUIDELINES ----------------------------------------------------------------------------------------------------------------------------------- PAYER'S REQUEST FOR CERTIFICATION OF TAXPAYER Certificate Instructions-- You must cross out Item (2) above if you have been notified by the IRS IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS"TIN" that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining However, if after being notified by the Proper Identification Number IRS that you were subject to Give backup withholding you received another notification from the PayorIRS that you are no longer subject to backup withholding, do not cross out such Item (2). Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payor.SIGNATURE:_________________________________________ DATE:_______________ -----------------------------------------------------------------------------------------------------------------------------------
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or Prospectus, this Letter of Transmittal and the Notice of Guaranteed Delivery may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOWDo Not Write in The Space Below) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- Delivery Prepared by by: _____________ ____________Checked By _________________ Date ___________ ================================================================================ PAYORDate -------------------------------------------------------------------------------- Page 12 ------------------------------------------------------------------------------- PAYER'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE GAMECO, INC. -------------------------------------------------------------------------------- Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature ________________________________________________________________________________ DateAddress_________________________________________________________________________ ========================= ====================================================== Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. City, State and ZIP Code________________________________________________________ List account number(s) here (optional)__________________________________________ --------------------------------------------------------------------------------
SUBSTITUTE PART 1-- PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF PROVIDE YOUR Form W-9 TAXPAYER IDENTIFICATION OR TIN NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS("TIN") IN THE BOX AT RIGHT _____________________________ AND CERTIFY BY SIGNING AND DATING ____ BELOW. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines Social security number or TIN Department of the Treasury Internal Revenue Service ▇▇▇▇▇'s Request for Determining the Proper Taxpayer Identification Number to Give the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payor.(TIN) -------------------------------------- -------------------------------------
Appears in 1 contract
Sources: Letter of Transmittal (Raceland Truck Plaza & Casino LLC)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or Prospectus, this Letter of Transmittal and the Notice of Guaranteed Delivery may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOWDo Not Write in The Space Below) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- Delivery Prepared by by: _____________ ____________Checked By _________________ Date ___________ ================================================================================ PAYORDate -------------------------------------------------------------------------------- Page 12 ------------------------------------------------------------------------------- PAYER'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE ▇▇▇▇▇▇ ENTERTAINMENT, INC. -------------------------------------------------------------------------------- Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature ________________________________________________________________________________ DateAddress_________________________________________________________________________ ========================= ====================================================== Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. City, State and ZIP Code________________________________________________________ List account number(s) here (optional)__________________________________________ --------------------------------------------------------------------------------
SUBSTITUTE PART 1-- PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF PROVIDE YOUR Form W-9 TAXPAYER IDENTIFICATION OR TIN NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS("TIN") IN THE BOX AT RIGHT _____________________________ AND CERTIFY BY SIGNING AND DATING ____ BELOW. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines Social security number or TIN Department of the Treasury Internal Revenue Service ▇▇▇▇▇'s Request for Determining the Proper Taxpayer Identification Number to Give the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payor.(TIN) -------------------------------------- -------------------------------------
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ========================== ======================== =========================== Certificate Old Notes Old Notes Surrendered Tendered Accepted ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ======================== =========================== ========================== ======================== =========================== ========================== ======================== =========================== Delivery Prepared by ______________ Checked By _________________ Date ___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature _________________ Date_______ ========================= ========================================================== SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part FORM W-9 I below. See instructions if your name has changed.) Department of the Treasury Internal Revenue Service ========================================================== Address ========================================================== City, state and ZIP code ========================================================== List account number (s) here (optional) ---------------------------------------------------------- Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ========================================================== Part 2 - Check the box if you are NOT subject to backup withholding under the provisions of section 3408(a)(1)(C) of the Internal Revenue Code because (1) you have not been notified that you are subject to backup withholding as a result of failure to report all interest or dividends or (2) the Internal Revenue Service has notified you that you are no longer subject to backup withholding. [ ]1 ===================== ========================================================== Payor's Request for CERTIFICATION - UNDER THE PENALTIES OF PERJURY. PART 3 - TIN I CERTIFY THAT THE INFORMATION PROVIDED ON THIS FORM IS TRUE, CORRECT AND COMPLETE. AWAITING TIN Signature _____________________ Date ________ [ ] ===================== ========================================================== Note: :FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Give the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payor.
Appears in 1 contract
Sources: Letter of Transmittal (Terex Corp)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ================================= ========================== ================================ Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- ================================= ========================== ================================ --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- --------------------------------- -------------------------- -------------------------------- Delivery Prepared by _____________ Checked By _________________ Date ___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below▇▇▇▇ CORP. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature _________________ Date_______ ========================= ======================================================== SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, State and Zip Code ----------------------------------------------------- List account number(s) here (optional) ----------------------------------------------------- Part 1 - PLEASE PROVIDE YOUR Social Security TAXPAYER IDENTIFICATION NUMBER number or TIN ("TIN") IN THE BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ---------------------------------------------------- Part 2 - Check the box if you are NOT subject to backup withholding under the provisions of section 3408(a)(1)(C) of the Internal Revenue Code because (1) you have not been notified that you are subject to backup withholding as a result of failure to report all interest or dividends or (2) the Internal Revenue Service has notified you that you are no longer subject to backup withholding. [ ] -------------------------- ---------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES Part 3 - Check OF PERJURY. I CERTIFY THAT THE if awaiting TIN INFORMATION ON THIS FORM IS TRUE, [ ] CORRECT AND COMPLETE. Signature _____________ Date _____ -------------------------- ---------------------------------------------------- Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. - 14 - GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines Obtaining a Number If you don't have a taxpayer identification number or you don't know your number, obtain Form SS-5, Application for Determining the Proper Identification Number to Give the Payor. a Social Security numbers Number Card, or Form SS-4, Application for Employer Identification Number, at the local office of the Social Security Administration or the Internal Revenue Service and apply for a number. Payees Exempt from Backup Withholding Payees specifically exempted from backup withholding on ALL payments include the following: /bullet/ A corporation. /bullet/ An organization exempt from tax under section 501(a), or an individual retirement plan, or a custodial account under Section 403(b)(7). /bullet/ The United States or any agency or instrumentality thereof. /bullet/ A state, the District of Columbia, a possession of the United States, or any subdivision or instrumentality thereof, or a foreign government or any political subdivision, agency or instrumentality thereof. bullet/ An international organization or any agency or instrumentality thereof. /bullet/ A foreign central bank of issue. /bullet/ A registered dealer in securities or commodities registered in the U.S. or a possession of the U.S. /bullet/ A futures commission merchant registered with the Commodity Futures Trading Commission. /bullet/ A real estate investment. /bullet/ An entity registered at all times during the tax year under the Investment Company Act of 1940 or a common trust fund operated by a bank under section 584(a). /bullet/ A financial institution. /bullet/ A middleman known in the investment community as a nominee or listed in the most recent publication of the American Society of Corporate Secretaries, Inc., Nominee List. /bullet/ A trust exempt from tax under section 664 as described in section 4947. Payments of dividends and patronage dividends not generally subject to backup withholding include the following: /bullet/ Payments to nonresident aliens subject to withholding under section 1441. /bullet/ Payments to partnerships not engaged in a trade or business in the U.S. and which have nine digits separated at least one nonresident partner. /bullet/ Payments of patronage dividends where the amount received is not paid in money. /bullet/ Payments made by two hyphenscertain foreign organizations. Payments of interest not generally subject to backup withholding include the following: i.e. 000/bullet/ Payments of interest on obligations issued by individuals. Note: You may be subject to backup withholding if this interest is $600 or more and is paid in the course of the payor's trade or business and you have not provided your correct taxpayer identification number to the payor. /bullet/ Payments of tax-00exempt interest (including exempt-0000interest dividends under section 852). Employer /bullet/ Payments described in section 6049(b)(5) to nonresident aliens. /bullet/ Payments on tax-free covenant bonds under section 1451. /bullet/ Payments made by certain foreign organizations. /bullet/ Mortgage interest paid to you. Exempt payees described above should file Form W-9 to avoid possible erroneous backup withholding. FILE THIS FORM WITH THE PAYOR, FURNISH YOUR TAXPAYER IDENTIFICATION NUMBER, WRITE "EXEMPT" ON THE FACE OF THE FORM, AND RETURN IT TO THE PAYOR. ALSO SIGN AND DATE THE FORM. Certain payments other than interest, dividends, and patronage dividends that are not subject to information reporting are also not subject to backup withholding. For details, see the regulations under sections 6041, 6041A(a), 6042, 6044, 6045, 6049, 6050A and 6050N. Privacy Act Notice. -- Section 6109 requires most recipients of dividend interest or other payments to give taxpayer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000to payors who must report the payments to the IRS. The table below will help determine IRS uses the numbers for identification purposes. Payors must be given the numbers whether or not recipients are required to file tax returns. Payors must generally withhold 20% of taxable interest, dividend, and certain other payments to a payee who does not furnish a taxpayer identification number to give the a payor.. Certain penalties may also apply. Penalties
Appears in 1 contract
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =========================== ========================== ========================= ------------------------ -------------------------- ------------------------ Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- ------------------------ -------------------------- ------------------------- --------------------------- ------------------------ ------------------------ -------------------------- ------------------------- --------------------------- ------------------------ ------------------------ -------------------------- ------------------------- =========================== ========================== ========================= ------------------------ Delivery Prepared by _____________ Checked By _________________ Date ___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature _________________ Date_______ ========================= ======================================================= SUBSTITUTE Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ---------------------------------------------------------------------- Address ---------------------------------------------------------------------- City, state and ZIP code ---------------------------------------------------------------------- List account number (s) here (optional) --------------------------------------------------------------------- Part 1 - PLEASE PROVIDE YOUR TAXPAYER IDENTIFICATION Social Security NUMBER ("TIN") IN THE BOX AT RIGHT AND CERTIFY BY Number or TIN SIGNING AND DATING BELOW ---------------------------------------------------------------------- Part 2 - Check the box if you are NOT subject to backup withholding under the provisions of section 3408(a)(1)(C) of the Internal Revenue Code because (1) you have not been notified that you are subject to backup withholding as a result of failure to report all interest or dividends or (2) the Internal Revenue Service has notified you that you are no longer subject to backup withholding. [ ]1 ---------------------------------------------------------------------- Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Give the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payor.
Appears in 1 contract
Sources: Letter of Transmittal (Terex Corp)
REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= ---------------------------------------------------------- CERTIFICATE SERIES A DEBENTURES SERIES A DEBENTURES SURRENDERED TENDERED ACCEPTED ---------------------------------------------------------- ---------------------------------------------------------- ---------------------------------------------------------- Delivery Prepared by by_______________________ Checked By _______By__________ Date ___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name (if If joint names, list first see attached guidelines) -------------------------------------------------------------------------------- Business name (Sole proprietors, see attached guidelines) -------------------------------------------------------------------------------- Please check appropriate box: [ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other -------------------------------------------------------------------------------- Address (number, street, and circle the name of the person apt. or entity whose number you enter in Part I below. See instructions if your name has changedsuite no.) FORM -------------------------------------------------------------------------------- City, state, and ZIP code -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- SUBSTITUTE Form W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- PayorPayer's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF Taxpayer Identification Number (TIN) -------------------------------------------------------------------------------- PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature _________________ Date_______ ========================= ====================================================== Note: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF -- TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILSNO. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining Enter your taxpayer identification number in the Proper Identification Number appropriate box. For most individuals, this is your social security number. If you do not have a number, see How to Give Obtain a "TIN" in the Payor. Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payorenclosed Guidelines.
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REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or of this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= -------------------------------------------------------------------------------- CERTIFICATE OLD NOTES OLD NOTES SURRENDERED TENDERED ACCEPTED -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Delivery Prepared by _______________ Checked By _______________ Date___ Date ___________ ================================================================================ PAYOR'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE FORM W-9 (Rev. March 1994) REQUEST FOR TAXPAYER GIVE FORM TO THE Department of Treasury IDENTIFICATION NUMBER AND REQUESTER. DO NOT Internal Revenue Service) CERTIFICATION SEND TO THE IRS -------------------------------------------------------------------------------- Name (if If joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions on page 2 if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City, state and ZIP code ----------------------------------------------------- List account number (s) here (optional) ------------------------------------------------------
Part 1 - PLEASE PROVIDE YOUR TAXPAYER Social security IDENTIFICATION NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature _________________________________________________________________________ DateBusiness name (Sole proprietors see instructions on page 2.) Please _________________________________________________________________________ ========================= ====================================================== Noteprint Please check appropriate box: FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER/ / Individual/Sole proprietor or / / Corporation / / Partnership / / Other. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper . . . . . . . . . . type _________________________________________________________________________ Address (number, street, and apt. or suite no.) Requester's name and address (optional) _________________________________________________________________________ City, state, and ZIP code _________________________________________________________________________ PART I Taxpayer Identification Number to Give (TIN) List account number(s) here (optional) -------------------------------------------------------------------------------- Enter your TIN in the Payor. Social Security numbers appropriate box. For Number individuals, this is your / / / / / -------------------------------- social security number (SSN). / / / / / PART II For Payees Exempt For sole proprietors, see the OR From Backup withholding instructions on page 3. For Employer (See Part II other entities, it is your Identification instructions on page 2) employer identification number Number -------------------------------- (EIN). If you do not have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the number to give the payora / / / / / number, see HOW TO GET A TIN / / / / / below.
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REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or Prospectus, this Letter of Transmittal and the Notice of Guaranteed Delivery may be directed to the Exchange Agent at the address specified in the Prospectus. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN THE SPACE BELOW) =========================== ========================== ========================= Certificate Old Notes Old Notes Surrendered Tendered Accepted --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- --------------------------- -------------------------- ------------------------- =========================== ========================== ========================= Delivery Prepared by _____________ CERTIFICATE OLD NOTES OLD NOTES SURRENDERED TENDERED ACCEPTED ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- DELIVERY PREPARED BY: Checked By _________________ -------------------------------------------------- Date ___________ ================================================================================ PAYOR-------------------------------------------------- -------------------------------------------------------------------------------- PAYER'S NAME: TEREX CORPORATION ------------------------- ------------------------------------------------------ SUBSTITUTE Name GLASSTECH, INC. -------------------------------------------------------------------------------- NAME (if joint names, list first and circle the name of the person or entity whose number you enter in Part I below. See instructions if your name has changed.) FORM W-9 Department of the Treasury Internal Revenue Service ----------------------------------------------------- Address ----------------------------------------------------- City-------------------------------------------------------------------------------- ADDRESS ------------------------------------------------------------------------- CITY, state and STATE AND ZIP code ----------------------------------------------------- List account number CODE -------------------------------------------------------- LIST ACCOUNT NUMBER(S) HERE (sOPTIONAL) here (optional) ------------------------------------------------------------------------------------------------ --------------------------------------------------------------------------------
Part 1 SUBSTITUTE PART 1-- PLEASE PROVIDE YOUR FORM W-9 TAXPAYER Social security IDENTIFICATION OR TIN NUMBER ("TIN") IN THE number or TIN BOX AT RIGHT AND CERTIFY BY SIGNING AND DATING BELOW ------------------------------------------------------
Part 2 - ------------------------ ------------------------------------------------------- Payor's Request for TIN CERTIFICATION - UNDER THE PENALTIES OF PART 3 - PERJURY. I CERTIFY THAT THE INFORMATION AWAITING TIN PROVIDED ON THIS FORM IS TRUE, CORRECT [ ] AND COMPLETE. Signature ________________________________ Date_______ ========================= ====================================================== Note: FAILURE TO COMPLETE AT RIGHT AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING OF 31% OF ANY PAYMENTS MADE TO YOU PURSUANT TO THE EXCHANGE OFFER. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS. GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 Guidelines for Determining the Proper Identification Number to Give the Payor. CERTIFY BY Social Security numbers have nine digits separated by two hyphens: i.e. 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e. 00-0000000. The table below will help determine the security number to give the payoror TIN SIGNING AND DATING BELOW.
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