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YourIRSFormW8hasbeenreceived
Yourinformationhasbeenreceived.Thereisnothingelseyouneedto
do.Wewillcontactyouifwerequireadditionalinformation.
CertificateofForeignStatusofBeneficial
OwnerforUnited
StatesTaxWithholdingandReporting SUBSTITUTE
Form W8BEN (Individuals) (February2014)
DoNOTusethisformif: Instead,useForm:
YouareNOTanindividual W8BENE
YouareaU.S.citizenorotherU.S.person,includingaresidentalienindividual W9
Youareabeneficialownerclaimingthatincomeiseffectivelyconnectedwiththeconductoftradeorbusiness W8ECI
withintheU.S.(otherthanpersonalservices)
YouareabeneficialownerwhoisreceivingcompensationforpersonalservicesperformedintheUnited 8233orW4
States
Apersonactingasanintermediary W8IMY
PartI IdentificationofBeneficialOwner
1 Nameofindividualwhoisthebeneficialowner
MehranMemon
2 Countryofcitizenship
Pakistan
3 Permanentresidenceaddress(street,apt.orsuiteno.,orruralroute).DonotuseaP.O.boxorincareofaddress.
19/A,KehkashanHousingSocietyOppositeNiBBank,Qasimabad
Cityortown,stateorprovince.Includepostalcodewhereappropriate.
HyderabadSindh71000
Country
Pakistan
4 Mailingaddress(ifdifferentfromabove)
Cityortown,stateorprovince.Includepostalcodewhereappropriate.
Country
PartIII Certification
https://www.mturk.com/taxinterview/landing 1/2
5/28/2017 TaxInformationInterview
Underpenaltiesofperjury,IdeclarethatIhaveexaminedtheinformationonthisformandtothebestofmyknowledgeandbeliefitistrue,correct,
andcomplete.Ifurthercertifyunderpenaltiesofperjurythat:
1.Iamtheindividualthatisthebeneficialowner(oramauthorizedtosignfortheindividualthatisthebeneficialowner)ofalltheincometowhich
thisformrelatesoramusingthisformtodocumentmyselfasanindividualthatisanowneroraccountholderofaforeignfinancialinstitution,
2.Thepersonnamedonline1ofthisformisnotaU.S.person,
3.Theincometowhichthisformrelatesis(a)noteffectivelyconnectedwiththeconductofatradeorbusinessintheUnitedStates,(b)
effectivelyconnectedbutisnotsubjecttotaxunderanincometaxtreaty,or(c)thepartner'sshareofapartnership'seffectivelyconnected
income,
4.Thepersonnamedonline1ofthisformisaresidentofthetreatycountrylistedonline9oftheform(ifany)withinthemeaningoftheincome
taxtreatybetweentheUnitedStatesandthatcountry,and
5.Forbrokertransactionsorbarterexchanges,thebeneficialownerisanexemptforeignpersonasdefinedintheinstructions.
Furthermore,Iauthorizethisformtobeprovidedtoanywithholdingagentthathascontrol,receipt,orcustodyoftheincomeofwhichIamthe
beneficialowneroranywithholdingagentthatcandisburseormakepaymentsoftheincomeofwhichIamthebeneficialowner.IagreethatI
willsubmitanewformwithin30daysifanycertificationmadeonthisformbecomesincorrect.
MehranMemon 05282017
SignHere
Signatureofbeneficialowner(orindividualauthorizedtosignforbeneficialowner) Date(MMDDYYYY)
Individual
Capacityinwhichacting
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