HomeMy Public PortalAbout2016-12-14 packet NOTICE OF MEETING AND TENTATIVE AGENDA'
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City of Jefferson Cultural Arts Commission
Regular Meeting
Wednesday,December 14,2016—5:00 PM
City Hall,320 E.McCarty Street—Boone-Bancroft Conference Room
TENTATIVE AGENDA
1. Call to Order
2. Approval of Agenda
3. Approval of Minutes from October 4, 2016
4. New Business
a. By-law amendment allowing attendance by phone
b. Determine 2017 meeting dates
c. Mini-grant application review, Mostly Opera
d. Cooperative project with Cultural Arts Foundation
5. Old Business
a. Roll-over request of unexpended FY2016 funds
b. City Hall plaque update
6. Foundation Report
7. Adjourn
'Individuals should contact the ADA Coordinator at(573)634-6570 to request accommodations
or alternative formats as required under the Americans with Disabilities Act.
Please allow 3 business days to process the request.
Please call 573-634-6410 with questions regarding this agenda.
City of Jefferson Cultural Arts Commission Minutes
Tuesday, October 4, 2016
Boone/Bancroft Conference Room —John G. Christy Municipal Building
320 E. McCarty Street
COMMISSION MEMBERS PRESENT ATTENDANCE RECORD
Don Govang 11 of 11
Katy Lacy 2 of 2
Heidi Lucas 2 of 2
Sarah Nichols 5 of 11
Ashley Pringer 2 of 2
Zak Wilson 8 of 11
COMMISSION MEMBERS ABSENT
Erin Graham 1 of 2
Casey Osterkamp 6 of 11
Mitchell Woodrum 0 of 2
STAFF PRESENT
Amy Schroeder, Parks and Recreation
Call to Order:
Meeting was called to order at 5:06 PM by Chairman Zak Wilson.
Approval of Agenda:
Ashley moved and Katy seconded approval of the agenda, as published. Motion carried on a
voice vote, without dissention.
Approval of Minutes:
Ashley moved and Sarah seconded approval of the July 26 minutes as published. Motion
carried on a voice vote.
Member introductions were made as a reminder for all present.
New Business:
Commission members reviewed a mini-grant application by Thursday Night Live.
Ashley moved and Heidi seconded a motion to fund the request at $500.00. The motion carried
on a unanimous voice vote.
Old Business:
Zak led a discussion about the $4,000.00 left in the Cultural Arts Commission budget for
FY2016. After discussion, Don moved and Sarah seconded the Commission request that the
City allow unencumbered funds to be rolled over into FY2017 for the purpose of funding mini-
grant applications, and if that is not done the Commission requests that an even distribution be
made available to Jefferson City Public Schools elementary school art programs of the
remainder of all unencumbered funds. The motion carried on a unanimous voice vote.
Zak announced that there are currently two vacancies on the commission. With the thought that
Parks and Recreation will provide one member ultimately, the problem of the group making a
quorum was discussed. The following suggestions were agreed upon:
• Zak will email Mitchell Woodrum about a resolution with his seat;
• The Commission will consider the possibility of seeking a reduction of membership from
11 to 9; and
• The Commission will review the day and time of monthly meetings to find a solid time.
The Foundation Report:
As the Foundation did not meet the day before, Don had no report.
Adjourn:
The next meeting would be November, date and time to be determined. 2017 officers will be
considered at that time, so Zak encouraged Commission members to consider serving.
Heidi moved and Sarah seconded a move to adjourn. Motion carried on a voice vote without
dissention.
Zak adjourned the meeting at 6:00 PM.
CAC Amendment suggestion for Electronic Attendance. (Highlighted below is P&R Commission
terminology)
Section 10. Related Responsibilities
The Director shall perform any other related work that shall be required to
maintain a well-rounded Park and Recreation program for the people of
the Jefferson City area.
Section 11. Policy Implementation
The Director shall be under the general supervision of the President of the
Parks and Recreation Commission. He/she shall be responsible for
implementation of policy directives adopted by the Commission, but shall
not perform at the request of any individual Commission Member or
Committee any function which has not been formally discussed and
approved by the Commission as a whole.
Section 12. Executive Secretary Duties
The Director shall serve as Executive Secretary to the Commission and in
addition to other duties shall be responsible for those duties ordinarily
performed by the Secretary. He/she may select or appoint a member of
the staff to serve as recording secretary.
Section 13. Electronic Attendance and Voting
Commissioners may attend Commission Meetings by electronic means
including video conferencing, the Internet, and telephone. Commissioners
who electronically attend meetings may participate in discussion and votes
as if physically present.
ARTICLE X. COMMITTEES
Section 1. Committee Structure
There shall be no permanent standing committees of the Commission.
Section 2. Determination Of Need
Agreement shall be made at the June organizational meeting as to what
committees are required for the year ahead.
Section 3. Creation&Appointments
The President shall appoint any committee agreed upon by the
Commission at the July meeting or throughout the year, and designate a
chairperson for the committee with the approval of the Commission. Items
of business may be referred to committees by motion and approval of the
Commission.
Section 4. Dissolution
All committees shall be dissolved when the purpose for which they were
appointed has been fulfilled or when the appointing President's current
term of office expires, whichever is first.
Cultural Arts Commission meeting time options SurveyMonkey
Days of the week you are available to
meet:
Answered:5 Skipped:0
Monday MEMR
Tuesday
Wednesday
Thursday
Friday
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Answer Choices Responses
Monday 60.00% 3
Tuesday 100.00% 5
Wednesday 100.00% 5
Thursday 100.00% 5
Friday 60.00% 3
Total Respondents: 5
Comments Date
1 I can make evenings any day.Lunch time on Tues,Thur,and Friday only. 10/20/2016 3:36 PM
2 My travel is going to be ending in November and I should be available most days-Katy 10/20/2016 12:24 PM
1 / 2
Cultural Arts Commission meeting time options SurveyMonkey
Times of the day you are available to
begin meetings:
Answered:5 Skipped:0
early morning
(7-8 am) IMP
mid-day(11:30
am-1 pm)
late afternoon
(4-5 pm)
early evening
(5-5:30 pm)
evening(6 pm
or later)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Answer Choices Responses
early morning(7-8 am) 60.00% 3
mid-day(11:30 am-1 pm) 60.00% 3
late afternoon(4-5 pm) 60.00% 3
early evening(5-5:30 pm) 80.00% 4
evening(6 pm or later) 40.00% 2
Total Respondents: 5
Comments Date
1 I would prefer mid-day or late afternoon. 10/20/2016 8:35 PM
2 Evening is a bit better 10/20/2016 3:36 PM
3 My preference is morning or lunch.I could do 4-5 pm if that's the only time that works for others-Katy 10/20/2016 12:24 PM
2 / 2
Cultural Arts Commission
Fiscal Year End: 10/31
Project Check Date Check# RFF Amount Balance Notes
$ 8,000.00
Capitol City Cinema 12/14/2015 49582 $ 400.00 $ 7,600.00 MAC Grant Project
Capital City Council on Arts 1/12/2016 49988 $ 285.00 $ 7,315.00 Mini Grant Snap Chat
HALO 3/17/2016 51036 $ 300.00 $ 7,015.00 MAC Grant Project-Artist Residency
Capital City Council on Arts 7/28/2016 53577 $ 461.67 $ 6,553.33 Artist Studio Crawl
Daily Plan-It 9/26/2016 54677 $ 550.00 $ 6,003.33 MAC Grant Project- Friday Night Art Stroll
Capital City Council on Arts 9/29/2016 54736 $ 319.25 $ 5,684.08 MAC Grant Project-CelebARTY
Capitol City Cinema 10/17/2016 55065 $ 250.00 $ 5,434.08 Mini Grant Social Media presence
Downtown JC Inc. 10/24/2016 55237 $ 500.00 $ 4,934.08 Mini Grant-Zombie Night Live
Capital City Council on Arts 10/31/2016 55395 $ 49.00 $ 4,885.08 MAC Grant Project- CelebARTY
Etta Miller Performing Arts 11/10/2016 55663 $ 1,000.00 $ 3,885.08 MAC Grant Project- Gallery Upgrade
Projects w/Obligated Funds Remaining Award Notes
Capital Arts $ 120.08 $ 950.00 MAC Grant Project- "Celebrity Art Show or Studio Crawl"
Capital Arts $ - $ 285.00 Mini Grant-Snap Chat
Capitol City Cinema $ 100.00 $ 500.00 MAC Grant Project- Kids Film Festival
Daily Plan-It $ - $ 550.00 MAC Grant Project- Friday Night Art Stroll
Etta Miller Performing Arts $ - $ 1,000.00 MAC Grant Project-Gallery Upgrade
HALO $ - $ 300.00 MAC Grant Project-Artist Residency
Capitol City Cinema $ - $ 250.00 Mini Grant-Social Media Presence
Downtown JC Inc. $ - $ 500.00 Mini Grant-Zombie Night Live
$ 220.08 $ 4,335.00
Current Budget Balance $ 3,885.08
Funds Obligated $ 220.08
Amount Available $ 3,665.00
updated: 11/15/2016
OF
General Ledger o`at c`tr ��,®f F��"3 CITY O FJEFFERSON
Detailed Trial Balance 412.1061131104 w
W
JOHN G. CHRISTY MUNICIPAL BUILDING
User: aschroeder r 320 E McCarty St
Printed: 11/14/2016- 4:32PM L. ',l,_J'J, Jefferson City, MO 65101-3193
Period: 01 to 13,2016
-..._-:.A._
Account Number Description Budget Beginning Balance Debit This Period Credit This Period Ending Balance
10 General Fund
EXPENSE
10-185 Non-Departmental
10-185-550040 Public Art 8,000.00
12/17/2015AP 2 528 18791- Capitol City Cinema Ck#49582 400.00 0.00
1/12/2016 AP 3 297 10640- Capital City Council on the A Ck#49988 285.00 0.00
2/8/2016 AP 4 172 Void 18730 Ck#0 0.00 350.00
2/8/2016 AP 4 204 18730- Music,Art and Dance Camp Ck#50432 350.00 0.00
3/16/2016 AP 5 550 18716- Halo Foundation Ck#51036 300.00 0.00
7/25/2016 AP 9 825 10640- Capital City Council on the A Ck#53577 461.67 0.00
9/20/2016 AP 11 753 16918- Daily Plan It Ck#54677 550.00 0.00
9/26/2016 AP 11 800 10640- Capital City Council on the A Ck#54736 319.25 0.00
10/14/2016AP 12 438 18791- Capitol City Cinema Ck#55065 250.00 0.00
10/20/2016AP 12 721 11167- Downtown Jefferson City Inc Ck#55237 500.00 0.00
10/31/2016AP 12 957 10640- Capital City Council on the A Ck#55395 49.00 0.00
10/31/2016AP 12 1,152 18499- Jefferson City Public Schools Ck#55663 1,000.00 0.00
10-185-550040 Totals: 8,000.00 0.00 4,464.92 350.00 4,114.92
10-185 EXPENSE Totals: 8,000.00 0.00 4,464.92 350.00 4,114.92
EXPENSE Totals: 8,000.00 0.00 4,464.92 350.00 4,114.92
10 Totals: -8,000.00 0.00 4,464.92 350.00 4,114.92
Report Totals: -8,000.00 0.00 4,464.92 350.00 4,114.92
GL-Detailed Trial Balance(11/14/2016- 4:32 PM) Page 1
General Ledger erSF !E
' ®
ti
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CITY O FJEFFERSONBudget Status „ g diOl� hwM
W .\,-':' ' _ JOHN G. CHRISTY MUNICIPAL BUILDING
User: aschroeder
320 E McCarty St
Printed: 11/14/2016- 4:33 PM `�' I Jefferson City, MO 65101-3193
Period: 1 to 13,2016 4I ', _
1825
Account Number Description Budget Amount Period Amount YTD Amount YTD Var Encumbered Amount Available %Available
Fund 10 General Fund
Dept 10-185 Non-Departmental
E30 Other Operating Expenses
10-185-550040 Public Art 8,000.00 4,114.92 4,114.92 3,885.08 0.00 3,885.08 48.56
E30 Sub Totals: 8,000.00 4,114.92 4,114.92 3,885.08 0.00 3,885.08 48.56
Expense Sub Totals: 8,000.00 4,114.92 4,114.92 3,885.08 0.00 3,885.08 48.56
Dept 185 Sub Totals: 8,000.00 4,114.92 4,114.92 3,885.08 0.00
Fund Revenue Sub Totals: 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Fund Expense Sub Totals: 8,000.00 4,114.92 4,114.92 3,885.08 0.00 3,885.08 48.56
Fund 10 Sub Totals: 8,000.00 4,114.92 4,114.92 3,885.08 0.00
Revenue Totals: 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Expense Totals: 8,000.00 4,114.92 4,114.92 3,885.08 0.00 3,885.08 48.56
Report Totals: 8,000.00 4,114.92 4,114.92 3,885.08 0.00
GL-Budget Status(11/14/2016- 4:33 PM) Page 1
A City of Jefferson
iftx r s Cultural Arts.Commission
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Mini Grant Application OULTui%4L-2,..,s.
& COMMISSION
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Applicant Name l Q3 5`t"ly Oft f
Contact Person Qin 2 J ge qs
Telephone C� 7 3 / _ 6 7 7
E-Mail L et m
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Project Information: / I nI
Name of Project: H/_La 44,e1 GG re 14°,tme wl�h'S Amount of Request i S 00 . o2
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COVtc'e/i- uti nt-&-rc 37 f 2O r-sor\ 6 ty 5?eithp/i-cw'y o rd-es 'r —
Provide a detailed project description iddentifying how the project will enhance collaboration,
education� , )� and/or community involvemept.Attach addi ional pages if necessary.
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Dcumentation:Return this form with the following attachments:
Si Detailed Project Explanation
E/Budget Identifying All Sources of Funds(I.e. Cash Match, In-Kind,etc.)
U Project Renderings{Concept, Pictures, Drawings,etc.)
&Detailed Project Timeline
WW-9 W-9 Form
Certification By Applicant: f
The Applicant certifies that all information in this application, and all information furnished In support of
this application is given for the purpose of certifying the eligibility for the Cultural Arts Commission Mini f
Grant program and was completed to the best of the Applicant knowledge and belief.Verification of any
information contained in this application may be obtained from any source named herein. I understand
funding for this program is subject to annual appropriation by the City Council.
avvytc. G.w�� . s> c,/2%./2 0 /.‘
Signature of Applicant Date
Completed applications should be returned to:
Amy Schroeder,Park Planner
427 Monroe St.
Jefferson City, MO 65101
Individuals should contact the ADA Coordinator at (573) 634-6570 to request accommodations or
alternative formats as required under the Americans with Disabilities Act. Please allow three business
days to process the request
I
MOstly Opera ,l
801 PrimroseLane
Jefferson City, r
Mo. 65109
Here is a letter describing our fundraiser and our upcoming project. The Gala will be held on June 14th, 2017.
Come and bid on your favorite song and singer. I will be posting the list of Juke Box Gala songs. There will be
raffle tickets for a Margarita Basket complete with Sombrero,bed and breakfast and hotel package, ornament
art from a local artist, and other items. This will take place at the Side Bar next to Prison Brews from 6:30 to
9:30. You can order off the menu. Please come dressed in your 50s style clothing because of the Juke Box
theme and there will be table prizes for the best dressed tables.
I have been working many years to bring Opera performances and Opera Education to our area. Was fmally
able to get a 501 C3 this year. We now have an opportunity to do a debut performance of"Hansel and Gretel"
by Humperdinck with the Jefferson City Symphony Orchestra in this year"s children's conceit at Lincoln
University on February 7th, 2017. We are pleased to have two music students from the University of Missouri
in Columbia in our cast. We also have a children's choir of elementary school singers and we have dancers from
area studios involved. Very excited to partner with our community to keep Opera alive in our town.
I would also like to be interviewed on KBIA for this event and would be honored for you to be on our sponsor
list. I usually put an article in the News Tribune in Columbia and Jefferson City.
MOstly Opera of Jefferson City is a new 501 C3 organization providing opportunities for youth and adults in
our community to learn about Opera and participate in Opera performances. We give the gift of personal
experiences with Opera to keep the Opera genre relevant to our lives today.
Our future goal is to earn enough funding for a Summer camp where high school composers will write a new
Opera and perform the work here in Jefferson City. We hope to combine efforts with other organizations to
bring Opera to our community. Your support is much give us our start.
It is our pleasure to invite you to attend and sponsor the event on Saturday January 14th, 2017 at the Side Bar
next to Prison Brews Restaurant in Jefferson City,MO.. This year's fundraiser will be our"Juke Box Gala".
Come and bid on your favorite aria and performer. Spending a lovely evening of food and song with MOstly
Opera will help to keep you warm on a cold night in January and keep Opera Alive in our city.
I humbly ask for help from the Cultural Arts Commission mini-grant. Thanks so much! My name is Anne
Riggs,Executive Director. My number is 573 301 6771. My email is anneriggs80@gmail.com.
II
Our EIN number is 475311222. If you need to contact me,I can be reached at anneri *s80(a)j=mail.corn or at F
(573) 301-6771.
Respectfully,
Anne Riggs
Executive Director of MOstly Opera
MOstly Opera of Jefferson City Presents. fl __
Jukebox Gala
When: Saturday January 14th-
6:30p.m- 9:30 p.m
Where: 305 Ash St. Jefferson City MO 65101
(Located at the side bar next to Prison Brews)
Come for dinner in your favorite
1950's style dress and bid on your
favorite songs. Enter raffle to win
prizes!
A. Additional Applicant Information
1.Popular Name,Department,Art Program or MOstly Opera
Doing Business As
2.Are you a new or returning MAC applicant? New Applicant
3.Grant Programs Express Project
4.Alternate telephone number 573-694-9609
5.What is the ending date of your organization's
12/31/2016
most recently completed fiscal year?
6a.Organization's Operating Income $1,338
6b.Organization's Operating Expenses $100
6c.Dept./Program Operating Income $1,238
6d.Dept./Program Operating Expenses $0
iJ
C. Project Description
1.Proposed Project Title Hansel & Gretel Feburary 2017
2.Project Discipline(s) Dance<>Music<>Theater
(Check all that apply)
3. Beginning Project Date 02/01/2017
4. Ending Project Date 02/14/2017
5. Project Location Richardson Auditorium ,Jefferson City, Missouri
6.Describe the project and how MAC funds will be used.
Mostly Opera will give a performance of Englebert Humperdinck's Hansel& Gretel on Feburary 7, 2017 at the
Richardson Auditorium on the Lincoln University Campus,Jefferson City MO. The performance will include a
full vocal cast,costuming and orchestra is a staged concert version with minimalist staging. The cast will
include include a community and children's chorus and dancers.
7.What is,the purpose of the project? How does the project fit into the scope of the organization's
mission and long range plans?
Thp purpose of the project is to bring opera to Jefferson City, MO. There are no other community opera
company's or performing groups in Jefferson City,an opera has not been staged here in many years. We will
be auditioning kids from the community to participate alongside experienced performers,teachers and
community members. This event will make us more visible and increase the community's awareness of opera
as a potential personaldexperience. Long range plans include the development of summer camps and other
youth outreach programs. We would also like to be a resource for area teachers looking for cultural and
historical interactive experiences.
8.List the project's artistic components.
Vocal and instrumental music,theater,dance.
9. How will the project be marketed?
Through the local newspaper,flyers and posters,spotlights through radio and television personalities,social
media and direct contact with area schools and community.
10.What is the project's estimated audience? 350
(such as 100-150)
11.What are the Project's Exhibition Hours? N/A
(Visual Arts-Exhibitions only)
D. Criteria
12.How does the project demonstrate artistic quality?
Describe the performer/artist's credentials and tell us why you chose to present/perform this work.
Many of the performers for Hansel and Gretel are area music professionals. Our volunteers include vocal
music performers and teacher with experience performing and directing music. Among our many student
volunteers we have a National Winner of the NewYouth Lyric Opera's 2016 Youth Competition The
consensus among our community is that there are not venues in our area for either performance or audience
members to experience opera as a high quality musical theatre experience. The decision was made to
collaborate with the Jefferson City Symphony Orchestra for a full-length production of Hansel and Gretel to be
performed with on the Community Concert Series spot the Jefferson City Symphony Orchestra is contracted to
priced in February. The Symphony has a performance slot in February and agreed to program Hansel &
Gretel in collaboration with Mostly Opera,making us this performance opportunity possible. The performance
will be given on the Lincoln University campus at Richardson Hall in the Mitchell Auditorium. The board of
Mostly Opera agreed to stage the opera in a traditional manner with tailored costumes and a built set. The JC
Symphony agreed to provide the orchestral accompaniment. We made these choices because we want
utilize our community professionals and support our talented youth through the creaation of an authentic opera
performance for the Mid-Missouri community.
13.How does the project demonstrate community support and/or community need?
Community volunteers are the people that make Mostly Opera work! Volunteers in collaboration with area
professionals are what make our productions possible both by provide direct funding and by giving service to
our organization. The community at large recently demonstrated its support by attendance at our first
fundraising event! Many area businesses donated goods and services for our fundraising auction which was
well received. Volunteers perform around town to raise awareness of our presence In the community and to
help raise funds for events sponsored by Mostly Opera such as our current project of Hansel &Gretel.The
consensus among our community is that there are not enough venues in our area for either performance or
audience members to experience opera as a high quality musical theatre experience. MOstly Opera strives to
change that by providing performance opportunities,and resources for community and educators in the
community.
14.How will the project be accessible for persons with disabilities?
The auditorium where the project will be performed is handicapped accessible and the stage is also
accessible to mobility chananged persons and performers. There is also a large screen projector on the side
wall where persons with visual impairments can better view the performance. The potential for deaf
interpretation of the performance is there also as we have a volunteer that is ASL certified.
15.If your operating figures for last fiscal year reflected a deficit,how did this deficit occur? How did
your organization handle this deficit? If not,type N/A.
N/A
16.*Minority Arts and Community Arts Basic Only*
How does the project benefit your community?
The project provides an opportunity for young and old audiences and performers alike to share in a unfamiliar
art form. Because it draws from the community at large,participation in this project will connect previously
unengaged community members to the arts community in Jefferson City.
They will see the relationship to art forms of today,and engage the arts as a form of dialouge. Participation in
this project will build relationships between mentors and youth in the community.
F. Summary Budget
CASH EXPENSES
1. Personnel -Administrative
$0
2. Personnel -Artistic $2,225
3. Personnel -Technical/Production $1,000
4.Outside Artistic Fees and Services $250
5.Outside Other Fees and Services $250
6. Space Rental $900
7.Travel $0
8. Marketing $165
9. Remaining Operating Expenses $805
See Help for what MAC CAN and CANNOT FUND.
10.Capital Expenditures-Acquisitions $0
MAC does NOT FUND Capital Expenditures.
11. Capital Expenditures-Other $0
MAC does NOT FUND Capital Expenditures.
Total Expenses $ 5,595
CASH INCOME
1.Admissions $0
2. Contracted Services Revenue $0
3.Corporate Support $0
4. Foundation Support $0
5.Other Private Support $1,459
6. Government Support-Federal ° $0
7. Government Support-State/Regional $0
8.Government Support-Local $0
9.Other Revenue $0
10.Applicant Cash (used for this request) $1,338
(Do NOT include MAC request in this line.)
11. Missouri Arts Council Request
(Request amount cannot exceed 50%of total project expenses.)
Maximum Request-Project$2,0001Minority$3,000/Community$3,000 $2,798
3
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General Instructions •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T
(tuition)
Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-C(canceled debt)
Future developments.Information about developments affecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release it)is at www.irs.gov/fw9.
Use Form W-9 only if you are a U.S.person(including a resident alien),to
Purpose of Form provide your correct TIN.
An Individual or entity(Form W-9 requester)who is required to file an information If you do not return Form W-9 to the requester with a TIN,you might be subject
return with the IRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2.
which may be your social security number(SSN),individual taxpayer identification By signing the filled-out form,you:
number(ITIN),adoption taxpayer identification number(ATIN),or employer 1.Certify that the TIN you are giving is correct(or you are waiting for a number
identification number(LIN),to report on an information retum the amount paid to to be issued),
you,or other amount reportable on an information return.Examples of information
returns include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or
•Form 1099-INT(Interest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If
•Form 7099-DIV(dividends,including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of
any partnership income from a U.S.trade or business is not subject to the
•Form 1099-MISC(various types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-B(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form Of any)indicating that you are
brokers) exempt from the FATCA reporting,is correct.See What is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further information.
•Form 1099-K(merchant card and third party network transactions)
Cat.No.10231X Form W-9(Rev.12-2014)