Fill and Sign the Bbir Formb 1901 Etis 1 Only

Form SS-4 Application for Employer Identification Numbe r (For use by employers, corporations, partnerships, trusts, estates, churches, 'Rev. February 2006) government agencies, Indian tribal entities, certain individuals, and others .) Department of the Treasury ► See separate instructions for each line . ► Keep a copy for your records . internal Revenue Service 1 Legal nam e of entity (or individual) for whom the EIN is being requeste d OMB No . 1545-000 3 EI N THE BANKRUPTC Y ESTATE O F Trade name of business (if different from name on line 1) 3 Executor, administrator, trustee, 'care of" nam e ~' L 2 V 4a Mailing address (room, apt., suite no . and street, or P .O . box) 5a Street address (if different) (Do not enter a P .O . box . ) Q 4b City, state, and ZIP code [DEBTOR'S NAME], DEBTOR-IN-POSSESSIO N [DEBTOR'S MAILING ADDRESS] 5b City, state, and ZIP cod e O Q 6 County and state where principal business is locate d 7a Name of principal officer, general partner, grantor, owner, or truste r 8a Type of entity (check only one box) q Sole proprietor (SSN) q Partnershi p E-] Corporation (enter form number to be filed) 11 s E] Personal service corporatio n El Church or church-controlled organizatio n q Other nonprofit organization (specify) ► ® Other (specify) Or CHAPTER 11 BANKRUPTCY ESTAT E 8b If a corporation, name the state or foreign country Stat e (if applicable) where incorporated 9 Reason for applying (check only one box ) El Started new business (specify type) ► q Hired employees (Check the box and see line 12 . ) q Compliance with IRS withholding regulations Other (specify)0-CHAPTER 11 BANKRUPTCY Date business started or acquired (month, day, year) . See 10 7b SSN, ITIN, or EIN [DEBTOR'S SSN ] [DEBTOR'S NAME], DEBTOR-IN-POSSESSION Estate (SSN of decedent) q ' Plan administrator (SSN ) q Trust (SSN of grantor) E] State/local governmen t q National Guard Farmers' cooperative q Federal government/military REMIC El Indian tribal governments/enterprise s Group Exemption Number (GEN) Or Foreign country Banking purpose (specify purpose) ► Changed type of organization (specify new type) ► q Purchased going business Created a trust (specify type) ► Created a pension plan (specify type) ► 11 Closing month of accounting year [PETITION DATE ] 12 First date wages or annuities were paid (month, day, year) . Note . If applicant is a withholding agent, enter date income will first be paid t o ► nonresident alien. (month, day, year) . , . Agricultural Househol d Othe r Highest number of employees expected in the next 12 months (enter -0- if none) . Do you expect to have $1,000 or less in employment tax liability for the calenda r year? E]YesEl]No . (Ifyouexpect to pay $4 .000 or less in wages, you can mark yes . Check one box that best describes the principal activity of your business . q Health care & social assistanc e q Wholesale-agent/broke r E.] Construction E] Rental & leasing E] Transportation & warehousing q Accommodation & food service El Wholesale-other q Retai l q Real estate E] Manufacturing [] Finance & insurance E] Other (specify) 13 14 15 Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided . 16a Has the applicant ever applied for an employer identification number for this or any other business? Note . If "Yes, " please complete lines 16b and 16c . 16b If you checked "Yes" on line 16a, give applicant's legal name and trade name shown on prior application if different from line 1 or 2 above . Legal name Or Trade name 0• Approximate date when, and city and state where, the application was filed . Enter previous employer identification number if known . Approximate date when filed (mo ., day, year) City and state where filed Previous EIN 16c Third Part y Designee . . q Yes q No Complete this section only if you want to authorize the named individual to receive the entit y's EIN and answer questions about the completion of this form . Designee's name Designee's telephone number (include area code ) ( ) Designee's fax number (include area code) Address and ZIP code ( ) Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete . Applicant's telephone number (include area code ) Name and title (type or print clearly) ► ( ) Applicant's fax number (include area code ) Signature ► ( ) Date le For Privacy Act and Paperwork Reduction Act Notice, see separate instructions . Cat . No . 16055N Form SS — 4 (Rev . 2-2006)