Please read the accompanying Management Information Circular and the instructions attached hereto carefully before completing this letter of transmittal.
LETTER OF TRANSMITTAL
FOR COMMON SHARES
OF
VIZSLA SILVER CORP.
For Use in Connection with the Arrangement
Involving Vizsla Silver Corp. and Vizsla Royalties Corp.
This letter of transmittal (the "Letter of Transmittal") is for use by registered holders of common shares (the "Vizsla Silver Shares") of Vizsla Silver Corp. ("Vizsla Silver") in connection with a proposed arrangement (the "Arrangement") involving, among other things, (i) the redesignation of the Vizsla Silver Shares, (ii) the distribution of common shares of Vizsla Royalties Corp. ("Vizsla Royalties") to shareholders of Vizsla Silver on the basis of one- third of a Vizsla Royalties common shares (each, a "Vizsla Royalties Share") and one-third of a Vizsla Royalties common share purchase warrant (each, a "Vizsla Royalties Warrant") for each Vizsla Silver Share held, and (iii) the distribution of common shares of Vizsla Silver following the closing of the Arrangement (each, a "New Vizsla Silver Shares") to each holder of Vizsla Silver Shares on the basis of one New Vizsla Silver Share per each Vizsla Silver Share held, as described in the management information circular (the "Circular") of Vizsla Silver dated May 17, 2024, which is to be considered at a special meeting (the "Meeting") of holders of Vizsla Silver Shares scheduled to be held on June 17, 2024 (or any adjournment(s) or postponement(s) thereof). Holders of Vizsla Silver Shares (the "Shareholders") are referred to the Circular, including the schedules attached thereto that were mailed to Shareholders on May 21, 2024 and posted on Vizsla Silver's profile at www.sedarplus.ca. Capitalized terms used but not otherwise defined herein have the respective meanings ascribed thereto in the Glossary of Defined Terms in the Circular. Shareholders whose Vizsla Silver Shares are registered in the name of a broker, investment dealer, bank, trust company or other nominee should contact that nominee for assistance in depositing those Vizsla Silver Shares.
TO: | VIZSLA SILVER CORP. |
AND TO: | VIZSLA ROYALTIES CORP. |
AND TO: | COMPUTERSHARE INVESTOR SERVICES INC. at its offices set out herein. |
The undersigned Shareholder herby irrevocably deposits the Vizsla Silver Shares held by the undersigned. Each Shareholder will receive, for each one Vizsla Silver Share, one-third of one Vizsla Royalties Share, one-third of one Vizsla Silver Warrant and one New Vizsla Silver Share pursuant to the Arrangement.
No fractional Vizsla Royalties Shares or Vizsla Royalties Warrants will be issued to any Registered Shareholder in connection with the Arrangement. If a Registered Shareholder is entitled to receive a fractional Vizsla Royalties Share or Vizsla Royalties Warrants pursuant to the Arrangement, then the number of Vizsla Royalties Shares or Vizsla Royalties Warrants to which such Registered Shareholder is entitled will be rounded down to the next whole number and such Registered Shareholder will not receive any consideration in lieu of such fractional share.
Registered Shareholders who do not deliver their Vizsla Silver Share certificates or Direct Registration System advice statement ("DRS Advice") and all other documents required by this Letter of Transmittal to the Depositary on or before the date which is six years after the Effective Date will lose their right to receive New Vizsla Silver Shares, the Vizsla Royalties Shares and the Vizsla Royalties Warrants for their Vizsla Silver Shares and cease to have any claim or interest of any kind or nature against Vizsla Silver, Vizsla Royalties or the Depositary. The undersigned understands that whether or not the undersigned delivers the required documentation to the Depositary, as of the Effective Date, the undersigned will cease to hold Vizsla Silver Shares and, subject to the ultimate expiry identified above, will have the right to receive certificates or DRS Advice representing the New Vizsla Silver Shares, Vizsla Royalties Shares and Vizsla Royalties Warrants to which the undersigned is entitled under the Arrangement.
This Letter of Transmittal is for use by registered holders of Vizsla Silver Shares only and is not to be used by non-
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registered, beneficial holders of Vizsla Silver Shares. A non-registered holder does not have Vizsla Silver Shares registered in its name; rather, such Vizsla Silver Shares are registered in the name of the brokerage firm, bank or trust company through which it purchased the Vizsla Silver Shares or in the name of a clearing agency (such as CDS Clearing and Depository Services Inc.) of which the intermediary is a participant. Nonregistered holders of Vizsla Silver Shares should contact their nominee (i.e., broker, trust company, bank or other registered holder) which holds the certificates representing Vizsla Silver Shares on their behalf for instructions and assistance in delivering those Vizsla Silver Shares to the Depositary under the Arrangement.
Please read the Circular and the instructions set out below carefully before completing this Letter of Transmittal. Delivery of this Letter of Transmittal to an address other than as set forth herein will not constitute a valid delivery. If Vizsla Silver Shares are registered in different names, a separate Letter of Transmittal must be submitted for each different registered owner. See Instructions 2 and 5 on pages 11 and 12 of this Letter of Transmittal. Any questions and requests for assistance may be directed by Shareholders to the Depositary at the telephone number or email address set out at the end of this Letter of Transmittal.
Notice to U.S. Shareholders
The New Vizsla Silver Shares, Vizsla Royalties Shares and Vizsla Royalties Warrants to be issued and distributed pursuant to the Arrangement have not been and will not be registered under the United States Securities Act of 1933, as amended (the "U.S. Securities Act") or any applicable securities laws of any state of the United States, and are being issued in reliance on the Section 3(a)(10) Exemption on the basis of the approval of the Court, which will consider, among other things, the fairness of the Arrangement to securityholders of Vizsla Silver, and in reliance on similar exemptions from registration or qualification under any applicable securities laws of any state of the United States. The solicitation of proxies made pursuant to the Circular is not subject to the requirements of Section 14(a) of the United States Securities Exchange Act of 1934, as amended (the "U.S. Exchange Act"), by virtue of an exemption applicable to proxy solicitations by "foreign private issuers" (as defined in Rule 3b-4 under the U.S. Exchange Act). The U.S. Securities Act imposes restrictions on the resale of securities received pursuant to the Arrangement by persons who will be "affiliates" of Vizsla Silver and Vizsla Royalties after the Effective Date or who have been affiliates of Vizsla Silver or Vizsla Royalties within 90 days before the Effective Date. Section 3(a)(10) of the U.S. Securities Act does not exempt the issuance of underlying securities upon the exercise of securities that were previously issued pursuant to Section 3(a)(10) of the U.S. Securities Act.
In connection with the Arrangement being considered for approval at the Meeting, the undersigned delivers to you the enclosed certificate(s) for Vizsla Silver Shares. The following are the details of the enclosed certificate(s):
Certificate Number(s) or DRS Holder ID
Number(s)
Name and Address shin Which Registered
Number of Vizsla Silver Shares Deposited
It is understood that, upon receipt of this Letter of Transmittal duly completed and signed and of the certificate(s)/DRS Advice representing the Vizsla Silver Shares deposited herewith (the "Deposited Shares") and following the Effective Date, the Depositary will mail to the undersigned the certificate or DRS Advice representing the New Vizsla Silver Shares and the certificate or DRS Advice representing the Vizsla Royalties Shares and Vizsla Royalties Warrants that the undersigned is entitled to receive under the Arrangement, or hold such DRS Advice or certificate for pick-up in accordance with the instructions set out below. It is understood that all payments (including the delivery of New Vizsla Silver Shares, Vizsla Royalties Shares and Vizsla Royalties Warrants) will be net of any amounts required to be withheld by law including in respect of any applicable withholding taxes.
The undersigned holder of Vizsla Silver Shares represents and warrants in favor of Vizsla Silver and Vizsla Royalties that: (i) the undersigned is the registered holder of the Deposited Shares; (ii) such shares are owned by the undersigned free and clear of all mortgages, liens, charges, encumbrances, security interests and adverse claims; (iii) the undersigned has full power and authority to execute and deliver this Letter of Transmittal and to deposit, sell, assign,
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transfer and deliver the Deposited Shares and that, when the DRS Advices or certificates representing New Vizsla Silver Shares, Vizsla Royalties Shares and Vizsla Royalties Warrants are delivered, none of Vizsla Silver or Vizsla Royalties, or any successor thereto will be subject to any adverse claim in respect of such Deposited Shares; (iv) the Deposited Shares have not been sold, assigned or transferred, nor has any agreement been entered into to sell, assign or transfer any such Deposited Shares, to any other person; (v) the surrender of the Deposited Shares complies with all applicable laws; (vi) all information inserted by the undersigned into this Letter of Transmittal is complete, true and accurate, and (vii) unless the undersigned will have revoked this Letter of Transmittal by notice in writing given to the Depositary prior to the Effective Date, the undersigned will not, prior to such time, transfer or permit to be transferred any of such Deposited Shares. These representations and warranties set forth herein will survive the completion of the Arrangement.
Except for any proxy deposited with respect to the votes at the Meeting, the undersigned revokes any and all authority, other than as granted in this Letter of Transmittal, whether as agent, attorney-in-fact, proxy or otherwise, previously conferred or agreed to be conferred by the undersigned at any time with respect to the Deposited Shares and no subsequent authority, whether as agent, attorney-in-fact, proxy or otherwise, will be granted with respect to the Deposited Shares.
The undersigned will, upon request, execute any signature guarantees or additional documents deemed by the Depositary to be reasonably necessary or desirable to complete the transfer of the Deposited Shares.
The undersigned acknowledges that all authority conferred or agreed to be conferred by the undersigned in this Letter of Transmittal is, to the greatest extent permitted by applicable law, irrevocable and may be exercised during any subsequent legal incapacity of the undersigned and will, to the greatest extent permitted by applicable law, survive the death or incapacity of the undersigned and any obligation of the undersigned hereunder will be binding upon the heirs, personal representatives, successors and assigns of the undersigned.
The undersigned instructs Vizsla Silver, Vizsla Royalties and the Depositary to mail the certificates or DRS Advices representing New Vizsla Silver Shares, Vizsla Royalties Shares and Vizsla Royalties Warrants, that the undersigned is entitled to receive under the Arrangement representing payment for the Deposited Shares promptly after the Effective Date, by first-class insured mail, postage prepaid, to the undersigned, or to hold such DRS Advices or certificates for pick-up, in accordance with the instructions given below. If no such address is specified by the undersigned, the applicable DRS Advices or certificates will be sent to the address of the undersigned as shown on the register of Registered Shareholders maintained by the registrar and transfer agent of Vizsla Silver. The DRS Advices or certificates, mailed in accordance with this paragraph, will be deemed to be delivered at the time of mailing.
If the Arrangement is not completed or proceeded with, the enclosed certificate(s)/DRS Advice representing the Vizsla Silver Shares and all other ancillary documents will be returned forthwith to the undersigned at the address set out below in Box "A" or, failing such address being specified, to the undersigned at the last address of the undersigned as it appears on the securities register of Vizsla Silver.
The undersigned acknowledges that there will be no duty or obligation on Vizsla Silver, Vizsla Royalties, the Depositary or any other person to give notice of any defect or irregularity in any deposit and no liability will be incurred by any of them for failure to give such notice.
It is understood that under no circumstances will interest accrue or be paid on the New Vizsla Silver Shares, Vizsla Royalties Shares or Vizsla Royalties Warrants issuable in respect of the Deposited Shares in connection with the Arrangement.
By reason of the use by the undersigned of an English language Letter of Transmittal, the undersigned and each of you will be deemed to have required that any contract in connection with the delivery of the New Vizsla Silver Shares, Vizsla Royalties Shares and Vizsla Royalties Warrants pursuant to the Arrangement through this Letter of Transmittal, as well as all documents related thereto, be drawn exclusively in the English language. En raison de l'utilisation d'une lettre d'envoi en langue anglaise par le soussigné, le soussigné et les destinataires sont présumés avoir requis que tout contrat attesté par ceci et son acceptation au moyen de la présente lettre d'envoi, de même que tous les documents qui s'y rapportent, soient rédigés exclusivement en langue anglaise.
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BOX A
ENTITLEMENT DELIVERY
All share entitlement payments will be issued and mailed to your existing registration unless otherwise stated. If you would like your shares dispatched to a different address, please complete BOX B and refer to Instructions 2 and 3
- MAIL SHARES TO ADDRESS ON RECORD (DEFAULT)
- MAIL SHARES TO A DIFFERENT ADDRESS (MUST COMPLETE BOX B)
- HOLD SHARES FOR PICKUP AT COMPUTERSHARE TORONTO OFFICE:
Computershare Investor Services Inc.
100 University Ave, 8th Floor, Toronto ON
BOX B
MAIL PAYMENT TO 3rd PARTY ADDRESS*:
- CHECK BOX IF SAME AS EXISTING REGISTRATION (DEFAULT)
(ATTENTION NAME)
(STREET NUMBER & NAME)
(CITY AND PROVINCE/STATE)
(COUNTRY AND POSTAL/ZIP CODE)
(TELEPHONE NUMBER (BUSINESS HOURS)
(SOCIAL INSURANCE/SECURITY NUMBER)
- IF THIS NAME OR ADDRESS IS DIFFERENT FROM YOUR REGISTRATION, PLEASE PROVIDE SUPPORTING TRANSFER REQUIREMENTS (SEE INSTRUCTIONS 2&3)
BOX C
RESIDENCY DECLARATION
ALL VIZSLA SILVER SHAREHOLDERS ARE REQUIRED TO COMPLETE A RESIDENCY DECLARATION. FAILURE TO COMPLETE A RESIDENCY DECLARATION MAY RESULT IN A DELAY IN YOUR RECEIPT OF VIZSLA ROYALTIES SHARES, VIZSLA ROYALTIES WARRANTS AND NEW VIZSLA SILVER SHARES.
The undersigned represents that:
- The beneficial owner of the Vizsla Silver Shares deposited herewith is a U.S. Shareholder.
- The beneficial owner of the Vizsla Silver Shares deposited herewith is not a U.S. Shareholder.
A "U.S. Shareholder" is any Shareholder who is either (i) has a registered account address that is located within the United States or any territory or possession thereof, or (ii) a "U.S. person" for the United States federal income tax purposes as defined in Instruction 7 below. If you are a U.S person or acting on behalf of a U.S. person, then in order to avoid backup withholding of U.S federal income tax you must provide a complete IRS Form W-9 (enclosed) below or otherwise provide certification that the U.S. person is exempt from backup withholding, as provided in the instructions (see Part VIII). If you are not a U.S. Shareholder as defined in (ii) above, but you provide an address that is located within the United States, you must complete an appropriate Form W-8.
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SHAREHOLDER SIGNATURE(S)
Signature guaranteed by
(if required under Instruction 3)
Authorized Signature
Name of Guarantor (please print or type)
Address of Guarantor (please print or type)
Dated:, 202__
Signature of Shareholder or authorized representative (see Instructions 2 and 4)
Address
Name of Shareholder (please print or type)
Telephone No
Name of authorized representative, if applicable (please print or type)
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Form W-9 | Request for Taxpayer | Give Form to the |
requester. Do not | ||
(Rev. October 2018) | Identification Number and Certification | send to the IRS. |
Department of the Treasury | ||
Internal Revenue Service |
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above | ||||
3 Check appropriate box for federal tax classification: | 4 Exemptions (codes apply only | |||
2. | to certain entities, not individuals; | |||
page | Individual/sole proprietor C Corporation S Corporation Partnership | Trust/estate | see instructions on page 3): | |
on | or single-member LLC | Exempt payee code (if | ||
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, | ||||
typeorPrint InstructionsSpecific | P=partnership) ▶ ____________ | any)_______ | ||
Note. For a single-member LLC that is disregarded, do not check LLC; check the | Exemption from FATCA | |||
appropriate box in the line above for the tax classification of the single-member owner. | ||||
reporting code (if any) | ||||
Other (see instructions) ▶_______________________________________________________ | ||||
__________ | ||||
(Applies to accounts maintained outside of | ||||
the U.S.) | ||||
See | 5 Address (number, street, and apt. or suite no.) | Requester's name and address (optional) | ||
6 City, state, and ZIP code | ||||
7 List account number(s) here (optional) |
Part I
Taxpayer Identification Number (TIN)
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 your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter.
Social security number
- | - | |||||||||
or
Employer identification number
-
Part II
Certification
Under penalties of perjury, I certify that:
- 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
- I 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
- I am a U.S. citizen or other U.S. person (defined below); and
- 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 dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3.
Sign | Signature of | |
Here | U.S. person ▶ | Date ▶ |
General Instructions | • Form 1098 (home mortgage interest), 1098-E (student loan interest), | |
Section references are to the Internal Revenue Code unless otherwise | 1098-T (tuition) |
noted. | • Form 1099-C (canceled debt) |
• Form 1099-A (acquisition or abandonment of secured property) | |
Future developments. Information about developments affecting Form | |
Use Form W-9 only if you are a U.S. person (including a resident | |
W-9 (such as legislation enacted after we release it) is at | |
alien), to provide your correct TIN. | |
www.irs.gov/fw9. | |
If you do not return Form W-9 to the requester with a TIN, you might | |
Purpose of Form | |
be subject to backup withholding. See What is backup withholding? on | |
An individual or entity (Form W-9 requester) who is required to file an | |
page 2. | |
information return with the IRS must obtain your correct taxpayer | |
By signing the filled-out form, you: | |
identification number (TIN) which may be your social security number | |
1. Certify that the TIN you are giving is correct (or you are waiting for | |
(SSN), individual taxpayer identification number (ITIN), adoption | |
a number to be issued), | |
taxpayer identification number (ATIN), or employer identification | |
2. Certify that you are not subject to backup withholding, or | |
number (EIN), to report on an information return the amount paid to | |
3. Claim exemption from backup withholding if you are a U.S. exempt | |
you, or other amount reportable on an information return. Examples of | |
payee. If applicable, you are also certifying that as a U.S. person, your | |
information returns include, but are not limited to, the following: | |
allocable share of any partnership income from a U.S. trade or business | |
• Form 1099-INT (interest earned or paid) | |
is not subject to the withholding tax on foreign partners' share of | |
• Form 1099-DIV (dividends, including those from stocks or mutual | |
effectively connected income, and | |
funds) | |
4. Certify that FATCA code(s) entered on this form (if any) indicating | |
• Form 1099-MISC (various types of income, prizes, awards, or gross | |
that you are exempt from the FATCA reporting, is correct. See What is | |
proceeds) | |
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• Form 1099-B (stock or mutual fund sales and certain other | FATCA reporting? on page 2 for further information. |
transactions by brokers) | Note. If you are a U.S. person and a requester gives you a form other |
• Form 1099-S (proceeds from real estate transactions) | |
than Form W-9 to request your TIN, you must use the requester's form | |
• Form 1099-K (merchant card and third party network transactions) | |
if it is substantially similar to this Form W-9. | |
Definition of a U.S. person. For federal tax purposes, you are | interest, dividends, broker and barter exchange transactions, rents, |
considered a U.S. person if you are: | royalties, nonemployee pay, payments made in settlement of payment |
• An individual who is a U.S. citizen or U.S. resident alien; | card and third party network transactions, and certain payments from |
• A partnership, corporation, company, or association created or | fishing boat operators. Real estate transactions are not subject to |
organized in the United States or under the laws of the United States; | backup withholding. |
• An estate (other than a foreign estate); or | You will not be subject to backup withholding on payments you |
• A domestic trust (as defined in Regulations section 301.7701-7). | receive if you give the requester your correct TIN, make the proper |
Special rules for partnerships. Partnerships that conduct a trade or | certifications, and report all your taxable interest and dividends on |
your tax return. | |
business in the United States are generally required to pay a | |
Payments you receive will be subject to backup withholding if: | |
withholding tax under section 1446 on any foreign partners' share of | |
1. You do not furnish your TIN to the requester, | |
effectively connected taxable income from such business. Further, in | |
2. You do not certify your TIN when required (see the Part II | |
certain cases where a Form W-9 has not been received, the rules under | |
instructions on page 3 for details), | |
section 1446 require a partnership to presume that a partner is a foreign | |
3. The IRS tells the requester that you furnished an incorrect TIN, | |
person, and pay the section 1446 withholding tax. Therefore, if you are | |
4. The IRS tells you that you are subject to backup withholding | |
a U.S. person that is a partner in a partnership conducting a trade or | |
because you did not report all your interest and dividends on your tax | |
business in the United States, provide Form W-9 to the partnership to | |
return (for reportable interest and dividends only), or | |
establish your U.S. status and avoid section 1446 withholding on your | |
5. You do not certify to the requester that you are not subject to | |
share of partnership income. | |
backup withholding under 4 above (for reportable interest and dividend | |
In the cases below, the following person must give Form W-9 to the | |
accounts opened after 1983 only). | |
partnership for purposes of establishing its U.S. status and avoiding | |
Certain payees and payments are exempt from backup withholding. | |
withholding on its allocable share of net income from the partnership | |
See Exempt payee code on page 3 and the separate Instructions for the | |
conducting a trade or business in the United States: | |
Requester of Form W-9 for more information. | |
• In the case of a disregarded entity with a U.S. owner, the U.S. owner | |
Also see Special rules for partnerships above. | |
of the disregarded entity and not the entity, | |
What is FATCA reporting? | |
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, | |
The Foreign Account Tax Compliance Act (FATCA) requires a | |
generally, the U.S. grantor or other U.S. owner of the grantor trust and | |
participating foreign financial institution to report all United States | |
not the trust, and | |
account holders that are specified United States persons. Certain | |
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust | |
payees are exempt from FATCA reporting. See Exemption from | |
(other than a grantor trust) and not the beneficiaries of the trust. | |
FATCA reporting code on page 3 and the Instructions for the | |
Foreign person. If you are a foreign person or the U.S. branch of a | |
Requester of Form W-9 for more information. | |
foreign bank that has elected to be treated as a U.S. person, do not use | |
Updating Your Information | |
Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see | |
You must provide updated information to any person to whom you | |
Publication 515, Withholding of Tax on Nonresident Aliens and | |
claimed to be an exempt payee if you are no longer an exempt payee | |
Foreign Entities). | |
and anticipate receiving reportable payments in the future from this | |
Nonresident alien who becomes a resident alien. Generally, only a | |
person. For example, you may need to provide updated information if | |
nonresident alien individual may use the terms of a tax treaty to reduce | |
you are a C corporation that elects to be an S corporation, or if you no | |
or eliminate U.S. tax on certain types of income. However, most tax | |
longer are tax exempt. In addition, you must furnish a new Form W-9 | |
treaties contain a provision known as a "saving clause." Exceptions | |
if the name or TIN changes for the account, for example, if the grantor | |
specified in the saving clause may permit an exemption from tax to | |
of a grantor trust dies. | |
continue for certain types of income even after the payee has otherwise | |
Penalties | |
become a U.S. resident alien for tax purposes. | |
Failure to furnish TIN. If you fail to furnish your correct TIN to a | |
If you are a U.S. resident alien who is relying on an exception | |
requester, you are subject to a penalty of $50 for each such failure | |
contained in the saving clause of a tax treaty to claim an exemption | unless your failure is due to reasonable cause and not to willful |
from U.S. tax on certain types of income, you must attach a statement | neglect. |
to Form W-9 that specifies the following five items: | Civil penalty for false information with respect to withholding. If |
1. The treaty country. Generally, this must be the same treaty under | you make a false statement with no reasonable basis that results in no |
which you claimed exemption from tax as a nonresident alien. | backup withholding, you are subject to a $500 penalty. |
2. The treaty article addressing the income. | Criminal penalty for falsifying information. Willfully falsifying |
certifications or affirmations may subject you to criminal penalties | |
3. The article number (or location) in the tax treaty that contains the | |
including fines and/or imprisonment. | |
saving clause and its exceptions. | |
Misuse of TINs. If the requester discloses or uses TINs in violation of | |
4. The type and amount of income that qualifies for the exemption | |
federal law, the requester may be subject to civil and criminal | |
from tax. | penalties. |
5. Sufficient facts to justify the exemption from tax under the terms of | Specific Instructions |
the treaty article. | Line 1 |
Example. Article 20 of the U.S.-China income tax treaty allows an | You must enter one of the following on this line; do not leave this line |
blank. The name should match the name on your tax return. | |
exemption from tax for scholarship income received by a Chinese | |
If this Form W-9 is for a joint account, list first, and then circle, the | |
student temporarily present in the United States. Under U.S. law, this | |
name of the person or entity whose number you entered in Part I of | |
student will become a resident alien for tax purposes if his or her stay in | |
Form W-9. | |
the United States exceeds 5 calendar years. However, paragraph 2 of | |
a. Individual. Generally, enter the name shown on your tax return. If | |
the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows | |
you have changed your last name without informing the Social | |
the provisions of Article 20 to continue to apply even after the Chinese | |
Security Administration (SSA) of the name change, enter your first | |
student becomes a resident alien of the United States. A Chinese | |
name, the last name as shown on your social security card, and your | |
student who qualifies for this exception (under paragraph 2 of the first | |
new last name. | |
protocol) and is relying on this exception to claim an exemption from | |
Note. ITIN applicant: Enter your individual name as it was entered on | |
tax on his or her scholarship or fellowship income would attach to Form | |
your Form W-7 application, line 1a. This should also be the same as | |
W-9 a statement that includes the information described above to | |
the name you entered on the Form 1040/1040A/1040EZ you filed with | |
support that exemption. | |
your application. | |
If you are a nonresident alien or a foreign entity, give the requester the | |
b. Sole proprietor or single-member LLC. Enter your individual |
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appropriate completed Form W-8 or Form 8233. | name as shown on your 1040/1040A/1040EZ on line 1. You may enter | |
Backup Withholding | your business, trade, or "doing business as" (DBA) name on line 2. | |
c. Partnership, LLC that is not a single-member LLC, C | ||
What is backup withholding? Persons making certain payments to | ||
Corporation, or S Corporation. Enter the entity's name as shown on | ||
you must under certain conditions withhold and pay to the IRS 24% of | ||
the entity's tax return on line 1 and any business, trade, or DBA name | ||
such payments. This is called "backup withholding." Payments that | ||
on line 2. | ||
may be subject to backup withholding include interest, tax-exempt | ||
d. Other entities. Enter your name as shown on required U.S. federal | above, 1 through 13. | |
tax documents on line 1. This name should match the name shown on | ||
IF the payment is for . . . | THEN the payment is exempt | |
the charter or other legal document creating the entity. You may enter | ||
for . . . | ||
any business, trade, or DBA name on line 2. | ||
e. Disregarded entity. For U.S. federal tax purposes, an entity that is | ||
Interest and dividend payments | All exempt payees except for 7 | |
disregarded as an entity separate from its owner is treated as a | ||
"disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). | ||
Enter the owner's name on line 1. The name of the entity entered on line | Broker transactions | Exempt payees 1 through 4 and 6 |
1 should never be a disregarded entity. The name on line 1 should be | through 11 and all C corporations. | |
the name shown on the income tax return on which the income should | S corporations must not enter an | |
be reported. For example, if a foreign LLC that is treated as a | exempt payee code because they | |
disregarded entity for U.S. federal tax purposes has a single owner that | are exempt only for sales of | |
is a U.S. person, the U.S. owner's name is required to be provided on | noncovered securities acquired | |
line 1. If the direct owner of the entity is also a disregarded entity, enter | prior to 2012. | |
the first owner that is not disregarded for federal tax purposes. Enter the | Barter exchange transactions and | Exempt payees 1 through 4 |
disregarded entity's name on line 2, "Business name/disregarded entity | patronage dividends | |
name." If the owner of the disregarded entity is a foreign person, the | ||
Payments over $600 required to | Generally, exempt payees 1 | |
owner must complete an appropriate Form W-8 instead of a Form W-9. | ||
be reported and direct sales over | through 52 | |
This is the case even if the foreign person has a U.S. TIN. | ||
$5,0001 | ||
Line 2 | ||
If you have a business name, trade name, DBA name, or disregarded | Payments made in settlement of | Exempt payees 1 through 4 |
entity name, you may enter it on line 2. | payment card or third party | |
Line 3 | network transactions | |
Check the appropriate box in line 3 for the U.S. federal tax | 1 See Form 1099-MISC, Miscellaneous Income, and its instructions. | |
classification of the person whose name is entered on line 1. Check | 2 However, the following payments made to a corporation and | |
only one box in line 3. | reportable on Form 1099-MISC are not exempt from backup | |
Limited Liability Company (LLC). If the name on line 1 is an LLC | withholding: medical and health care payments, attorneys' fees, gross | |
treated as a partnership for U.S. federal tax purposes, check the | proceeds paid to an attorney reportable under section 6045(f), and | |
"Limited Liability Company" box and enter "P" in the space provided. | payments for services paid by a federal executive agency. | |
If the LLC has filed Form 8832 or 2553 to be taxed as a corporation, | Exemption from FATCA reporting code. The following codes | |
check the "Limited Liability Company" box and in the space provided | identify payees that are exempt from reporting under FATCA. These | |
enter "C" for C corporation or "S" for S corporation. If it is a single- | codes apply to persons submitting this form for accounts maintained | |
member LLC that is a disregarded entity, do not check the "Limited | outside of the United States by certain foreign financial institutions. | |
Liability Company" box; instead check the first box in line 3 | Therefore, if you are only submitting this form for an account you hold | |
"Individual/sole proprietor or single-member LLC." | in the United States, you may leave this field blank. Consult with the | |
Line 4 | person requesting this form if you are uncertain if the financial | |
Exemptions | institution is subject to these requirements. A requester may indicate | |
If you are exempt from backup withholding and/or FATCA reporting, | that a code is not required by providing you with a Form W-9 with | |
enter in the appropriate space in line 4 any code(s) that may apply to | "Not Applicable" (or any similar indication) written or printed on the | |
you. | line for a FATCA exemption code. | |
Exempt payee code. Generally, individuals (including sole | A-An organization exempt from tax under section 501(a) or any | |
proprietors) are not exempt from backup withholding. | individual retirement plan as defined in section 7701(a)(37) | |
• Except as provided below, corporations are exempt from backup | B-The United States or any of its agencies or instrumentalities | |
withholding for certain payments, including interest and dividends. | C-A state, the District of Columbia, a U.S. commonwealth or | |
• Corporations are not exempt from backup withholding for payments | possession, or any of their political subdivisions or instrumentalities | |
made in settlement of payment card or third party network transactions. | D-A corporation the stock of which is regularly traded on one or | |
• Corporations are not exempt from backup withholding with respect to | more established securities markets, as described in Regulations | |
attorneys' fees or gross proceeds paid to attorneys, and corporations that | section 1.1472-1(c)(1)(i) | |
provide medical or health care services are not exempt with respect to | E-A corporation that is a member of the same expanded affiliated | |
payments reportable on Form 1099-MISC. | group as a corporation described in Regulations section 1.1472- | |
The following codes identify payees that are exempt from backup | 1(c)(1)(i) | |
withholding. Enter the appropriate code in the space in line 4. | F-A dealer in securities, commodities, or derivative financial | |
1-An organization exempt from tax under section 501(a), any IRA, or | instruments (including notional principal contracts, futures, forwards, | |
a custodial account under section 403(b)(7) if the account satisfies the | and options) that is registered as such under the laws of the United | |
requirements of section 401(f)(2) | States or any state | |
2-The United States or any of its agencies or instrumentalities | G-A real estate investment trust | |
3-A state, the District of Columbia, a U.S. commonwealth or | H-A regulated investment company as defined in section 851 or an | |
possession, or any of their political subdivisions or instrumentalities | entity registered at all times during the tax year under the Investment | |
4-A foreign government or any of its political subdivisions, agencies, | Company Act of 1940 | |
or instrumentalities | I-A common trust fund as defined in section 584(a) | |
5-A corporation | J-A bank as defined in section 581 | |
6-A dealer in securities or commodities required to register in the | K-A broker | |
United States, the District of Columbia, or a U.S. commonwealth or | L-A trust exempt from tax under section 664 or described in section | |
possession | 4947(a)(1) | |
7-A futures commission merchant registered with the Commodity | M-A tax exempt trust under a section 403(b) plan or section 457(g) | |
Futures Trading Commission | plan | |
8-A real estate investment trust | Note. You may wish to consult with the financial institution requesting | |
9-An entity registered at all times during the tax year under the | this form to determine whether the FATCA code and/or exempt payee | |
Investment Company Act of 1940 | code should be completed. |
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10-A common trust fund operated by a bank under section 584(a)
11-A financial institution
12-A middleman known in the investment community as a nominee or custodian
13-A trust exempt from tax under section 664 or described in section 4947
The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed
Line 5
Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns.
Line 6
Enter your city, state, and ZIP code.
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN.
If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on this page), enter the owner's SSN (or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN.
Note. See the chart on page 4 for further clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772- 1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX- FORM (1-800-829-3676).
If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester.
Note. Entering "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.
Part II. Certification
To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, or 5 below indicate otherwise.
For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code earlier.
Signature requirements. Complete the certification as indicated in
What Name and Number To Give the Requester
For this type of account: | Give name and SSN of: |
1. Individual | The individual |
2. Two or more individuals (joint | The actual owner of the account |
account) | or, if combined funds, the first |
individual on the account 1 | |
3. Custodian account of a minor | The minor 2 |
(Uniform Gift to Minors Act) | |
4. a. The usual revocable savings | The grantor-trustee1 |
trust (grantor is also trustee) | The actual owner 1 |
b. So-called trust account that | |
is not a legal or valid trust | |
under state law | The owner 3 |
5. Sole proprietorship or | |
disregarded entity owned by | |
an individual | |
6. Grantor trust filing under | The grantor* |
Optional Form 1099 Filing | |
Method 1 (see Regulation | |
section 1.671-4(b)(2)(i)(A)) | |
For this type of account: | Give name and EIN of: |
7. Disregarded entity not owned | The owner |
by an individual | |
8. A valid trust, estate, or pension | Legal entity 4 |
trust | |
9. Corporation or LLC electing | The corporation |
corporate status on Form 8832 | |
or Form 2553 | |
10. Association, club, religious, | The organization |
charitable, educational, or | |
other tax-exempt | |
organization | |
11. Partnership or multi-member | The partnership |
LLC | |
12. A broker or registered | The broker or nominee |
nominee | |
13. Account with the Department | The public entity |
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 | |
14. Grantor trust filing under the | The trust |
Form 1041 Filing Method or | |
the Optional Form 1099 | |
Filing Method 2 (see | |
Regulation section 1.671- | |
4(b)(2)(i)(B)) |
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items 1 through 5 below.
- Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification.
- Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form.
- Real estate transactions. You must sign the certification. You may cross out item 2 of the certification.
- Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification.
- List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished.
- Circle the minor's name and furnish the minor's SSN.
- You must show your individual name and you may also enter your business or "DBA" name on the "Business name/disregarded entity" name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN.
-
List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 1.
*Note. Grantor also must provide a Form W-9 to trustee of trust. Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.
Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your personal information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer.
If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone
number printed on the IRS notice or letter.
If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039.
For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance.
Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at: spam@uce.gov or contact them at www.ftc.gov/idtheft or 1-877-IDTHEFT(1-877-438- 4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.
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Vizsla Silver Corp. published this content on 23 May 2024 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 23 May 2024 16:11:06 UTC.