COACHMEN INDUSTRIES INC
SC TO-T, EX-99.(A)(5)(III), 2000-09-20
MOTOR HOMES
Previous: COACHMEN INDUSTRIES INC, SC TO-T, EX-99.(A)(5)(II), 2000-09-20
Next: LEE SARA CORP, DEF 14A, 2000-09-20



<PAGE>   1

            GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION
                         NUMBER ON SUBSTITUTE FORM W-9

GUIDELINES FOR DETERMINING THE PROPER IDENTIFICATION NUMBER TO GIVE THE PAYER.
-- 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 payer.

<TABLE>
<S>                             <C>                          <C>                          <C>
                                                                                          GIVE THE
                                GIVE THE                                                  EMPLOYER
                                SOCIAL SECURITY                                           IDENTIFICATION
FOR THIS TYPE OF ACCOUNT:       NUMBER OF--                  FOR THIS TYPE OF ACCOUNT:    NUMBER OF--
</TABLE>

--------------------------------------------------------
------------------------------------------------------

<TABLE>
<S>                         <C>
1. An individual's account  The individual
2. Two or more individuals  The actual owner of the
   (joint account)          account or, if combined
                            funds, any one of the
                            individuals(1)
3. Husband and wife (joint  The actual owner of the
   account)                 account or, if joint
                            funds, either person(1)
4. Custodian account of a   The minor(2)
   minor (Uniform Gift to
   Minors Act)
5. Adult and minor (joint   The adult or, if the minor
   account)                 is the only contributor,
                            the minor(1)
6. Account in the name of   The ward, minor, or
   guardian or committee    incompetent person(3)
   for a designated ward,
   minor, or incompetent
   person
7. a. A revocable savings   The grantor- trustee(1)
      trust account (in
      which grantor is
      also trustee)
  b. Any "trust" account    The actual owner(1)
     that is not a legal
     or valid trust under
     State Law
8. Sole proprietorship      The owner(4)
   account
 9. A valid trust, estate,  The legal entity (Do not
    or pension              furnish the identifying
                            number of the personal
                            representative or trustee
                            unless the legal entity
                            itself is not designated
                            in the account title.)(5)
10. Corporate account       The corporation
11. Religious, charitable,  The organization
    or educational
    organization account
12. Partnership account     The partnership
    held in the name of
    the business
13. Association, club, or   The organization
    other tax-exempt
    organization
14. A broker or registered  The broker or nominee
    nominee
15. Account with the        The public entity
    Department of
    Agriculture in the
    name of a public
    entity (such as a
    State or local
    government, school
    district, or prison)
    that receives
    agricultural program
    payments
</TABLE>

--------------------------------------------------------------------------------
(1) List first and circle the name of the person whose number you furnish.
(2) Circle the minor's name and furnish the minor's social security number.
(3) Circle the ward's, minor's or incompetent person's name and furnish such
    person's social security number.
(4) Show the name of the owner.
(5) List first and circle the name of the legal trust, estate, or pension trust.

NOTE: If no name is circled when there is more than one name, the number will be
considered to be that of the first name listed.
<PAGE>   2

            GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION
                         NUMBER ON SUBSTITUTE FORM W-9

OBTAINING A NUMBER

If you do not have a taxpayer identification number or you do not know your
number, obtain Form SS-5, Application for a Social Security Number Card (for
resident individuals), Form SS-4, Application for Employer Identification Number
(for businesses and all other entities), or Form W-7 for International Taxpayer
Identification Number (for alien individuals required to file U.S. Tax returns),
at an office of the Social Security Administration or the Internal Revenue
Service.

To complete the Substitute Form W-9, if you do not have a taxpayer
identification number, write "Applied For" in the space for the taxpayer
identification number in Part 1, sign and date the Form, and give it to the
requester. Generally, you will then have 60 days to obtain a taxpayer
identification number and furnish it to the requester. If the requester does not
receive your taxpayer identification number within 60 days, backup withholding,
if applicable, will begin and will continue until you furnish your taxpayer
identification number to the requester.

PAYEES EXEMPT FROM BACKUP
WITHHOLDING

Payees specifically exempted from backup withholding on ALL payments include the
following:

- A corporation.

- A financial institution.

- An organization exempt from tax under section 501(a), or an individual
  retirement plan, or a custodial account under section 403(b)(7).

- The United States or any agency or instrumentality thereof.

- A State, the District of Columbia, a possession of the United States, or any
  subdivision or instrumentality thereof.

- A foreign government, or a political subdivision, agency or instrumentality
  thereof.

- An international organization or any agency or instrumentality thereof.

- A registered dealer in securities or commodities registered in the U.S. or a
  possession of the U.S.

- A real estate investment trust.

- A common trust fund operated by a bank under section 584(a).

- An exempt charitable remainder trust, or a nonexempt trust described in
  section 4947(a)(1).

- An entity registered at all times under the Investment Company Act of 1940.

- A foreign central bank of issue.

Payments of dividends and patronage dividends not generally subject to backup
withholding include the following:

- Payments to nonresident aliens subject to withholding under section 1441.

- Payments to partnerships not engaged in a trade or business in the U.S. and
  which have at least one nonresident partner.

- Payments of patronage dividends where the amount received is not paid in
  money.

- Payments made by certain foreign organizations.

- Payments made to a nominee.

Payments of interest not generally subject to backup withholding include the
following:

- 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 payer's trade or business and you have
      not provided your correct taxpayer identification number to the payer.

- Payments of tax-exempt interest (including exempt-interest dividends under
  section 852).

- Payments described in section 6049(b)(5) to non-resident aliens.

- Payments on tax-free covenant bonds under section 1451.

- Payments made by certain foreign organizations.

- Payments made to a nominee.

Exempt payees described above should file a Substitute Form W-9 to avoid
possible erroneous backup withholding.

FILE THIS FORM WITH THE PAYER, FURNISH YOUR TAXPAYER IDENTIFICATION NUMBER,
WRITE "EXEMPT" ON THE FACE OF THE FORM, AND RETURN IT TO THE PAYER. IF THE
PAYMENTS ARE INTER-

                                        2
<PAGE>   3

EST, DIVIDENDS, OR PATRONAGE DIVIDENDS, 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),
6045, and 6050A.

PRIVACY ACT NOTICE. -- Section 6109 requires most recipients of dividend,
interest, or other payments to give taxpayer identification numbers to payers
who must report the payments to the IRS. The IRS uses the numbers for
identification purposes. Payers must be given the numbers whether or not
recipients are required to file tax returns. Payers must generally withhold 31%
of taxable interest, dividends, and certain other payments to a payee who does
not furnish a taxpayer identification number to a payer. Certain penalties may
also apply.

PENALTIES

(1) PENALTY FOR FAILURE TO FURNISH TAXPAYER IDENTIFICATION NUMBER. -- If you
fail to furnish your taxpayer identification number to a payer, you are subject
to a penalty of $50 for each such failure unless your failure is due to
reasonable cause and not to willful neglect.

(2) FAILURE TO REPORT CERTAIN DIVIDEND AND INTEREST PAYMENTS. -- If you fail to
include any portion of an includible payment for interest, dividends, or
patronage dividends in gross income, such failure will be treated as being due
to negligence and will be subject to a penalty of 5% on any portion of an
under-payment attributable to that failure unless there is clear and convincing
evidence to the contrary.

(3) CIVIL PENALTY FOR FALSE INFORMATION WITH RESPECT TO WITHHOLDING. -- If you
make a false statement with no reasonable basis which results in no imposition
of backup withholding, you are subject to a penalty of $500.

(4) CRIMINAL PENALTY FOR FALSIFYING INFORMATION. -- Falsifying certifications or
affirmations may subject you to criminal penalties including fines and/or
imprisonment.

FOR ADDITIONAL INFORMATION CONTACT YOUR TAX CONSULTANT OR THE INTERNAL REVENUE
SERVICE

                                        3


© 2022 IncJournal is not affiliated with or endorsed by the U.S. Securities and Exchange Commission