By submitting this form, you certify, under penalty of perjury that the Supplier or Subrecipient identified herein is the beneficial owner of any items of income paid to that Supplier or Subrecipient, and that no services will be performed in the United States by Supplier or Subrecipient for UW, nor will any property for which this Supplier or Subrecipient has granted UW a royalty will be used within the United States.
You further certify that the Supplier or Subrecipient is not a United States Person within the meaning of 26 U.S.C. 7701, will submit a new record within 30 days if any of the representations made herein change, and that no items of income to be paid hereunder are effectively connected with a US trade or business.
The Internal Revenue Service does not require Supplier or Subrecipient's consent to any provisions of this document other than the certifications required to establish Supplier or Subrecipient's status as a non-US person.
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