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4 The FATCA code s entered on this form if any indicating that I am exempt from FATCA reporting is correct. MEMBER APPLICATION AND OWNERSHIP INFORMATION Member/Owner SSN/TIN Street Driver s Lic. No. City/State/Zip Date of Birth Home Phone Employment E-mail Work Phone Eligibility for Membership TIN CERTIFICATION AND BACKUP WITHHOLDING INFORMATION Under penalties of perjury I certify that 1 The number shown on this form is my correct taxpayer identification number. X Signature Date ACCOUNT...
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07 - account card is a financial document used to report income and expenses.
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