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Request for Taxpayer
Give form to the
(Rev. March 2024) Identification Number and Certification requester. Do not
Department of the Treasury Goto - /FormW5 for instructions and the latest inf tie send to the IRS.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
41) Name of entity/individual. An entry is required. (For 2 sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded
entity’s name on line 2.)
Flock Group, Inc.
2 Business name/disregarded entity name, if different from above.
_ | Flock Safety
© [3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered online 1. Check | 4 Exemptions (codes
Fy ‘only one of the following seven boxes. nme = pporisesicomperiassivicaas
| C1 individual's proprietor [7] Corporation [[] Scorporation [] Partnership [[] Trustestate ‘see instructions on page S)-
. o LLC. Enter the tax classification (C - C corporation, S - S corporation, P= Partnership) = _ Exempt payee code (if any)
ge Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax trom '
ra ‘aseification of the LLC, unless itis a disregarded entity. A disregarded entity should instead check the appropriate | Exemption ror Foreign Account fax
E (1 Other (eee instructions} code (ff any)
2
% Fon line 3a you checked “Trust/estate,” or checked “LLC” and entered “P” as its tax classification, _—
3 nd Yau we pong fa frm fos peters. bis cle wich You te cure ie, Sek epies fo accounts maintained
his ont youtevs say foragpnparinese omnont or bencticarien, See tainedore | outside the United States)
3 5S Address (number, street, and apt. or suite no.). See instructions. Requester's name and address (optional)
PO BOX 121923 (Remittance) 1170 Howell Mill Rd NW Ste 210
6 City, state, and ZIP code
Dallas TX 75312-1923 Atianta GA 30318
7 List account number(s) hare (optional)
Taxpayer Identification Number (TIN)
‘Social security number
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 generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part |, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
Ena) Certification
Under penalties of perjury, | certify that:
1. The number shown on this form is my correct taxpayer identification number (or | am waiting for a number to be issued to me); and
2. Lam not subject to backup withholding because (a) | am exempt from backup withholding, or (b) | have not been notified by the Internal Revenue
‘Service (IRS) that | am subject to backup withholding as a resuit of a failure to report all interest or dividends, or (c) the IRS has notified me that | am
no longer subject to backup withholding; and
3. lama U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that | 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 for Part Il, later.
Sign
Signature
Here
orsoen (22H ” Aewwby.
Date 4/10/2024
General Instructions
Section references are to the Intamal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www. irs.gov/FormW9.
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
appropriate box for the tax classification of its owner. Otherwise, it
should check the “LLC” box and enter its appropriate tax classification.
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
foreign partners, owners, or beneficiaries when it provides the Form W-9
to another flow-through entity in which it has an ownership interest. This
change is intended to provide a flow-through entity with information
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
requirements. For example, a partnership that has any indirect foreign
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 ev. 3-2024) Jump to an indexed page (163 of 163) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 Report a privacy or text-extraction issue through publication requests .