b'MISCELLANEOUS FORMSI-9 | W-9 | W-4 | 3921 | 3922I-9 W-9 W-4APEX I-9TFP 10251 APEX LW9TFP 5311 APEX W-422TFP 102022 Employment Eligibility VerificationUSCIS Form Request for TaxpayerGive Form to the Form Employees Withholding Certificate OMB No. 1545-0074Department of Homeland Security Form I-9W-9 Identication Number and Certication requester. Do notW-4 Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay.U.S. Citizenship and Immigration ServicesOMB No. 1615-0047(Rev. October 2018) Go to www.irs.gov/FormW9 for instructions and the latest information. send to the IRS. Department of the Treasury Give Form W-4 to your employer. 2022Expires 10/31/2022 Department of the TreasuryInternal Revenue ServiceInternal Revenue Service Your withholding is subject to review by the IRS.1Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Step 1:(a) First name and middle initial Last name (b) Social security numberuSriTnAgR cTo HmEpRleEti:o Rne oafd t hiniss tfrourcmti.o Enms pcaloryeefursla rbee lfioarbel ec foomr pelrertoirnsginth iths ef ocromm. Tplheeti oinns otrfu tchtiiso nfosr mm.u st be available, either in paper or electronicaly y,2Business name/disregarded entity name, if different from above EnterAddress Does your name match the dANTI-DISCRIMINATION NOTICE: Personalname on your social security It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an l because the3 following seven boxes.one of the 4Exemptions (codes apply only toInformation City or town, state, and ZIP code credit for your earnings, contact employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individuadocumentation presented has a future expiration date may also constitute illegal discrimination.certain entities, not individuals; seecard? If not, to ensure you geton page 3. See Specic Instructions SSA at 800-772-1213 or go toSection 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no laterIndividual/sole proprietor or C Corporation S Corporation Partnership Trust/estate instructions on page 3): (c)Single or Married filing separately www.ssa.gov.than the first day of employment, but not before accepting a job offer.) single-member LLC Exempt payee code (if any) Married filing jointly or Qualifying widow(er)Print or type. Last Name (Family Name) First Name (Given Name) Middle Initial Other Last Names Used (if any) P=Partnership)Head of household (Check only if youre unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)Note: Exemption from FATCA reportingAddress (Street Number and Name) Apt. Number City or Town State ZIP Code another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that code (if any) Complete Steps 24 ONLY if they apply to you; otherwise, skip to Step 5.(Applies to accounts maintained outside the U.S.) claim exemption from withholding, when to use the estimator at www.irs.gov/W4App See page 2 for more information on each step, who can , and privacy.Other (see instructions) Date of Birth (mm/dd/yyyy)U.S. Social Security NumberEmployee\'s E-mail Address Employee\'s Telephone Number 5Address (number, street, and apt. or suite no.) See instructions. Requesters name and address (optional) Step 2:Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse - - 6City, state, and ZIP code Multiple Jobsalso works. The correct amount of withholding depends on income earned from all of these jobs.I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in7List account number(s) here (optional) or SpouseDo only one of the following.www.irs.gov/W4App for most accurate withholding for this step (and Steps 34); or connection with the completion of this form. Works (a)Use the estimator at I attest, under penalty of perjury, that I am (check one of the following boxes): (b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate 1. A citizen of the United States Part I Taxpayer Identication Number (TIN) Social security number (c)withholding; or. Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoidIf there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This 2. A noncitizen national of the United States (See instructions) backup withholding. For individuals, this is generally your social security number (SSN). However, for aoption is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld 3. A lawful permanent resident (Alien Registration Number/USCIS Number): resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other How to get aor TIP: To be accurate, submit a 2022 Form W-4 for all other jobs. If you (or your spouse) have self-employment .income, including as an independent contractor, use the estimator.4. An alien authorized to workuntilTIN, later.If the account is in more than one name, see the instructions for line 1. Also see What Name andEmployer identication number Complete Steps 34(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will Some aliens may write "N/A" in the expiration date field.(expiration date, if applicable, mm/dd/yyyy):(See instructions) Note: be most accurate if you complete Steps 34(b) on the Form W-4 for the highest paying job.)Number To Give the Requester for guidelines on whose number to enter.QR Code - Section 1 Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: Do Not Write In This Space Part II Certication Step 3:If your total income will be $200,000 or less ($400,000 or less if married filing jointly):$An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number. Under penalties of perjury, I certify that: ClaimMultiply the number of qualifying children under age 17 by $2,0001. Alien Registration Number/USCIS Number:and DependentsMultiply the number of other dependents by $500. . . .$OR he Internal Revenue 2. Form I-94 Admission Number: Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) theAdd the amounts above and enter the total here . . . . . . . . . . . . . 3 $OR no longer subject to backup withholding; and Step 4(a) Other income (not from jobs). If you want tax withheld for other income you 3. Foreign Passport Number: 4.The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. (optional):expect this year that wont have withholding, enter the amount of other income here . . . . . . . 4(a)$Country of Issuance: Certication instructions.Other This may include interest, dividends, and retirement income 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, withholding becauseAdjustments (b) Deductions. Signature of Employee Today\'s Date (mm/dd/yyyy) acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirementprovide your correct TIN. See the instructions for Part II, later.arrangement (IRA), and generally, paymentswant to reduceIfyouyour expect withholding, to claim use deductions the Deductions other than Worksheet the standard on page deduction 3 and enter andSignSignature ofDate(c) the result here. . . . . . . . . . . . . . . . . . . . . . . . . 4(b)$Preparer and/or Translator Certification (check one): Here U.S. person Extra withholding. Enter any additional tax you want withheld each pay period4(c)$I did not use a preparer or translator.A preparer(s) and/or translator(s) assisted the employee in completing Section 1. Form 1099-DIV (dividends, including those from stocks or mutual(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.) General Instructions funds)I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of mySection references are to the Internal Revenue Code unless otherwiseForm 1099-MISC (various types of income, prizes, awards, or gross Step 5:Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.knowledge the information is true and correct. noted. proceeds)Signature of Preparer or Translator Today\'s Date (mm/dd/yyyy) Future developments. For the latest information about developmentsForm 1099-B (stock or mutual fund sales and certain other Sign related to Form W-9 and its instructions, such as legislation enactedtransactions by brokers) Hereafter they were published, go to www.irs.gov/FormW9. Form 1099-S (proceeds from real estate transactions) Employees signature (This form is not valid unless you sign it.) Date Last Name (Family Name) First Name (Given Name) State ZIP Code Purpose of FormForm 1099-K (merchant card and third party network transactions) Employers Employers name and address First date of Employer identification Form 1098 (home mortgage interest), 1098-E (student loan interest),Address (Street Number and Name) City or Town information return with the IRS must obtain your correct taxpayer1098-T (tuition) Only employment number (EIN)Form 1099-C (canceled debt)Form 1099-A (acquisition or abandonment of secured property)(EIN), to report on an information return the amount paid to you, or otherUse Form W-9 only if you are a U.S. person (including a resident For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 10220Q FormW-4(2022) amount reportable on an information return. Examples of informationalien), to provide your correct TIN.102022returns include, but are not limited to, the following.If you do not return Form W-9 to the requester with a TIN, you might What is backupwithholding, be subject to backup withholding. See Employer Completes Next Page Form 1099-INT (interest earned or paid) later.Cat. No. 10231X5311 FormW-9(Rev. 10-2018)F Form I-910/21/2019 Page 1 of 3orm I-9 10/21/20193921 3922TFP 3921A TFP 3922A VOID CORRECTED OMB No. 1545-2129 I-9 EMPLOYMENT ELIGIBILITY VERIFICATION DETACH BEFORE MAILINGDETACH BEFORE MAILINGTRANSFERORS name, street address, city or town, state or province,1 Date option grantedcountry, and ZIP or foreign postal code Exercise of an 2 Date option exercised Form 3921 Incentive Stock(Rev. September 2016) The Department of Homeland Security: Requires employers to use this form to document that Option Under (Rev. October 2017) Section 422(b)TRANSFERORS TIN EMPLOYEES TIN $ 3 Exercise price per share $ 4 Fair market value per shareCopy A each new employee (both citizens and noncitizens) hired after November 6, 1986, is authorized on exercise date For EMPLOYEES name 5 No. of shares transferred Internal Revenueto work in the United States. This form must be completed no later than the time of hire, which Service CenterFile with Form 1096.Street address (including apt. no.) 6 If other than TRANSFEROR, name, address, and TIN ofFor Privacy Act and City or town, state or province, country, and ZIP or foreign postal code corporation whose stock is being transferred Paperworkistheactualbeginningofemployment.BothemployerandemployeearerequiredtofillinReduction Act Notice, see thecurrent version ofAccount number (see instructions) the GeneralForm3921(Rev. October 2017) Certain InformationReturns. information to complete an I-9 form.Instructions for Department of the Treasury - Internal Revenue ServiceDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Pa (Rev. 9-2016)ge VOID CORRECTED OMB No. 1545-2129 Exercise of anW-9 PAYERS REQUEST FOR TAXPAYER IDENTIFICATION NUMBERTRANSFERORS name, street address, city or town, state or province,1 Date option grantedcountry, and ZIP or foreign postal codeForm 3921 Incentive Stock 2 Date option exercised Option Under (Rev. October 2017) Section 422(b)TRANSFERORS TIN EMPLOYEES TIN 3 Exercise price per share 4 Fair market value per shareCopy A (Rev. September 2016) FormW-9isusedbypayersrequiredtofileinformationreturns(forexampleincomepaid,on exercise date For EMPLOYEES name $ 5 No. of shares transferred $ Internal Revenuereal estate transactions, mortgage interest, acquisition or abandonment of secured property, Service CenterFile with Form 1096.Street address (including apt. no.) 6 If other than TRANSFEROR, name, address, and TIN ofFor Privacy Act andcancellation of debt, or contributions made to an IRA) with the IRS to get the payees correct Paperwork corporation whose stock is being transferred Reduction Act Notice, see the City or town, state or province, country, and ZIP or foreign postal code current version ofAccount number (see instructions) Certain InformationReturns. TaxpayerIdentificationNumber(TIN).PayeesuseFormW-9togivetheircorrectTINtothethe GeneralInstructions forForm3921(Rev. October 2017) Department of the Treasury - Internal Revenue Service person requesting it and, when applicable to: Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Pa(Rev. 9-2016)ge VOID CORRECTEDTRANSFERORS name, street address, city or town, state or province,1 Date option granted OMB No. 1545-2129 Exercise of an1. Certify the TIN given is correct, country, and ZIP or foreign postal codeForm 3921 Incentive Stock 2 Date option exercised Option Under (Rev. October 2017) Section 422(b)TRANSFERORS TIN EMPLOYEES TIN 3 Exercise price per share 4 Fair market value per shareCopy A (Rev. September 2016) 2. Certify payee is not subject to backup withholding, or on exercise date For EMPLOYEES name $ $ Internal Revenue 5 No. of shares transferred Service CenterStreet address (including apt. no.) 6 If other than TRANSFEROR, name, address, and TIN ofFile with Form 1096. 3. Claim exemption from backup withholding. For more information on backup withholding and For Privacy Act and Paperwork corporation whose stock is being transferred Reduction Act City or town, state or province, country, and ZIP or foreign postal code Notice, see the requirements, obtain IRS Pub. 1679 A Guide to Backup Withholding, or Pub. 1281 Backup current version ofthe General Account number (see instructions) Instructions forCertain InformationReturns.Form3921(Rev. October 2017) Department of the Treasury - Internal Revenue Service Withholding on Missing and Incorrect TINs.Required envelope Apex and TFP DW19W or DW19WS(Rev. 9-2016) Apex SW19 TFP 1111 W-4 EMPLOYEES WITHHOLDING ALLOWANCE CERTIFICATEMISCELLANEOUS FORMS EmployersarerequiredtofurnishW-4Certificatestoallnewemployees.ThisformincorporatesIRSinstructionstoemployeesforfilingexemptionallowances.APEXTFP 3921 EXERCISE OF STOCK FORMSDESCRIPTION Every corporation which in any calendar year transfers to any employee a share of stock I-910251I-91 Page Equals 1 Form (20 SHEETS PER FORM/50 PER PACK) pursuant to that employees exercise on an incentive stock option described in section 422(b) LW95311W-91 Page Equals 1 Form must,forthatcalendaryear,fileForm3921foreachtransfermadeduringtheyear.W-422102022W-4 20221 Page Equals 1 Form (2 SHEETS PER FORM/50 PER PACK)W-423102023W-4 20231 Page Equals 1 Form (2 SHEETS PER FORM/50 PER PACK) 3922 TRANSFER OF STOCK FORMS3921A503921A3921 Copy A1 Page Equals 3 Forms Every corporation which in any calendar year records, or has by its agent recorded, a 3921B503921B3921 Copy B1 Page Equals 3 Forms transfer of the legal title of a share of stock acquired by the employee pursuant to the employees exercise of an option granted under an employee stock purchase plan and 3921C503921C3921 Copy C1 Page Equals 3 Forms described in section 423(c) (where the exercise price is less than 100% of the value of 3921D503921D3921 Copy D1 Page Equals 3 Forms thestockonthedateofgrant,orisnotfixedordeterminableonthedateofgrant),must,3922A503922A3922 Copy A1 Page Equals 3 Forms forthatcalendaryear,fileForm3922foreachtransfermadeduringtheyear.3922B503922B3922 Copy B1 Page Equals 3 Forms3922C503922C3922 Copy C1 Page Equals 3 Forms54'