Application for Employer Identification Number [Ts estates, churches, agencies. certain others. instructions) Ba Type of entity (Check only one box) fee instructions} Caution: # appicant és a Smitedt fabity company. see the instructions for fine Ba. C2 Sole proprietor (SSN) i C1) Estate (SSN of decedent) —_—H © Partnership C2 Persone service corp. () Pash aciministrator (SSN) ~ Cl remic © Natonat Gara (Other corporation (specify) > Qesigaaad Desinbing Svcs 2 Statefocai government (C1 Farmers’ conperative 0) teust DD Church or church-controtied organization 1 Federal governmentimaitary C) Other nonprofit organization fspecify) ® fetes GEN If applicable} eb corporation. came the state or foreign country) State Foreign country ff sppicabte) where incorporsted New YoK. s tor spplying (Check only one box.) (see instructions) C] Banking purpose (specify purpose) » Started mew business (specily ype » Sas Leyinn Cement pe ot pepe Spey SO ane aud bacenting Geme ———— Purchased going business 3 Mires empioyses the box and see tne 12) ©) Crested a » 0 Crete 0 trust (specify type) 2 ut be pend & nocvesiiore ston Pants dap. Jen) nn nn nn eee ee aga aw tus hou wa ast 68 paid to nonresictent allen. (month, day, yaad . > bh regres vom of evsoyens wei shen 12 ari oN Fh aPC et ecco Awe on meee Lend ent mnt ch nn . Ow # “Yes.~ oduct and raw material usec > w Tf mare most of the products o¢ services sold? Plesse check one box. © Business fwholesate} Public fretai (2 other (specity) © wa 17a Has the applicant ever applied for an employer identification number for this or any other business? 2 . . . [[] ves Cw Note: # “Yes,” pleate complete lines 17b and 1c. tenn Vib # you checked “Yes" on line 17a. give applicant's legei name and trade name shown on prior application, if different from fine 1 or 2 above. Lege! name > Trace name > We erodnuae dete vison Gad bens top panil Chpend adn eee ee Oa roan empty: teueaaton memter Fine Approaimate date when Med fro. day, year] City and stute where filed Under penaties of pecury, ! declare Gat | have examined ts application. and to the Dest af my tenawince and Setet, % 5 trun comect and complete | Sysiness ee | Fa ielegnone tumber Fnchade are4 rode) Name anc ttle (Please type or print clearly} BP, Prag 4 this tne. For OOfcial use © _ Please leave Munaon tee epehying blank » AwO2 For Privacy Act and Paperwark Reduction Act Notice, see page ¢. Cat. No, 1808SH Form SS-4 Rev. 420005 $/8/00 Published by Tax Management inc., a Subsidiary of The Gureau of National Affairs, inc, SS-4. CONFIDENTIAL UBSTERRAMARO0000040 EFTA00235829