six (6) cylinder ironman division 2016 rules

SIX (6) CYLINDER
IRONMAN
DIVISION
2016 RULES
2016 REVISIONS ARE IN RED
1
INTRODUCTION TO IRONMAN:
2016 SIX (6) Cylinder IRONMAN
DIVISION
NASCAR license will be required for any competition during a NASCAR weekly racing series
sanctioned race meet. The fee will be held from the payoff.
Scanners /radio communications from the race tower to the race car is mandatory. Radios
will be available for rent from the handicappers shack. Penalty - car will be placed last in
your heat or feature for not having the radio.
Transponders are required for ALL practices, heats and features. Rentals are available from
the handicappers shack.
1.
ELIGIBLE VEHICLES:
Eligible vehicle includes mid-sized front wheel drive V-6 Automatic models of US
Manufacturers Ford, GM, and Chrysler that are 10 years and older. The Ford Taurus, Chevrolet
Lumina, Monte Carlo, Pontiac Grand Prix, Olds Cutlass. Buick Regal and other similar cars will
comprise most of the field.
No convertibles, Pickup trucks or SUVs of any kind may compete. No special high
performance cars. Absolutely No Chevy Cavalier Z24 or Like- sized Mercury Cougars will be
permitted to compete. However some cars with a 104” wheelbase midsize cars like the Pontiac
Grand Am, Chevy Malibu, and Ford Contour, these may be penalized by adding weight.
Absolutely No vehicles of any foreign manufacturer can compete regardless of where
the car was built. No Toyotas, Hondas, Nissans VW's, Volvos and the like. No four wheel
drives. No car will be able to compete that will threaten the viability of less expensive and readily
available American made sedans. This Division will be all about driver performance and plenty
of luck and not about the superiority of any particular car. It’s all about having FUN and
entertaining the spectators.
Eligible cars should be constructed from running vehicles in relatively
good condition. Engines and all other drive train components MUST remain stock as
manufactured. NO interchanging of components allowed. No performance enhancements
of any kind will be allowed.
A.
ELIGIBLE PARTICIPANT:
Driver eligibility is limited to:
• Entry level participants (never driven in an organized racing
organization)
• Former drivers that have not participated in racing in the previous 5 years.
• Current drivers that have never won a feature at a level higher than the Hobby
Stock – Strictly Stock or equivalent competitive level in the past.
It is recommended that you contact the speedway office at 978-462-4252 and speak with the
general manager if you have driven a race car previously and desire to participant in this division.
2
2.
FINAL WORD ON RULES:
If it’s not in the rules and provisions listed herein, DON’T DO IT. In short, if it doesn’t say you
can do it than DON’T DO IT. If anyone is caught doing something to enhance the performance
of a car you will be disqualified from the race.
This IRONMAN series is being created for the people who want to give racing a try. For the
person that used to race and found it too costly to keep up with the big money teams and more important
the people that want to have fun without costing a fortune to do it.
This is going to be about 60% luck. About the same percentage you have making it heading
north on the southeast expressway at 5:00 PM on Friday. We want this to be the Daytona 500 at Lee
Speedway using Street Legal cars with some safety built in them.
3.
PAINT SCHEMES & CHARACTER CARS:
We want cars to be colorful and creatively designed. No factory paint jobs, cars should have a
scheme or a character look. Use bright colors; it does not need a professional spray job, just a couple
of cans of bright paint and a couple of brushes. The better the design the better the chance you have
at the prize for the best appearing car award.
Schemes and Characters, like The Destroyer, the Gravedigger, the Crusher, The Orange Crush,
Batman, Bulldog, Godzilla, Spiderman, etc. Use your own imagination but keep it family orientated.
Schemes and Characters must be registered along with your car number with Lee USA Speedway
Office, on first come first served basics.
A.
Car must have full width dash, may use a stock dash.
B.
Car must use a column mounted key switch. You must have a safety kill switch on
the left side of dashboard (Negative side of battery).
C.
Car must have factory column and steering wheel.
D.
All doors must be welded shut.
E.
All exterior trim must be removed; Door handle holes are to be covered with sheet
Metal.
F.
All glass must be removed – headlights, taillights, reflectors, side mirrors, including
all windows, regulators and door locks. Front Windshield can remain stock or it may
be replaced with Lexan.
G.
No mirrors allowed.
H.
All exterior holes must be patched, door handles, headlights, taillight openings etc.
I.
All air bag sensors and air bags must be disarmed for safety purpose.
J.
All cars must have a VIN number.
K.
All of the interior/trim panels must be removed; this doesn’t allow removal of metal
inner panels, the only exception would be removal for the cage door bars. Firewall
between passenger and trunk area must be covered with metal.
L.
No cutting of exterior sheet metal: fenders, bumpers, trunk, etc. Only the front
inner hood panel may be removed.
M.
Drivers side metal interior door panel may be removed for cage purposes only.
3
N.
Battery may remain in the stock location or relocated to the trunk area, must be in a
battery box acceptable to Lee Tech Staff. Battery must be free from any fluid leaks.
4.
WHEELBASE:
Cars must have a minimum of 104” wheelbase.
5.
6.
7.
8.
DRIVE TRAINS:
A.
Car must be front wheel drive, No all wheel drives. No rear wheel drives.
B.
No differential gear changes allowed. No locked differentials allowed.
C.
No computer performance chips allowed.
ENGINE:
A.
Must be a V 6-cylinder, fuel-injected motor models, stock for year and make and
model of car being used in (Completely Stock). Engine size and Transmission
must be car for car (will be checked by VIN code)
B.
Engine will only have water in radiator. Engine will be free of oil leaks and
fluid leaks.
EXHAUST SYSTEM:
A.
No headers or high performance exhaust manifold of any kind allowed. Stock
exhaust pipe should extend from the manifold to the flange for the catalytic
converter.
B.
The catalytic converter should be removed. Car may have any stock muffler.
C.
No glass packed mufflers allowed. No cherry bombs, No side exhausts.
Exhaust must dump under car at 90 degrees toward the track surface.
Muffler and pipes must be firmly attached to the bottom of the car.
TRANSMISSION:
A. Must be an automatic only.
B. NO traction control devices stock or aftermarket.
9.
WEIGHT:
A. 50lbs of right side weight mounted under the passenger outside area will be required
after 2 feature wins. Each additional feature wins after your 2 nd win will require you to add
an additional 25lbs of weight under the passenger outside area.
B. All cars will be weighed at beginning of racing season. Car weights may be adjusted
at any time to equal competition.
4
10.
11.
ROLL CAGE:
A.
All cars must have a four point roll cage constructed of 1¾” outside diameter X
.095 wall steel tubing. The roll cage shall consist of 4 vertical upright bars connected
at the top on all sides and shall be adequately cross braced. The base of the upright
members shall be solidly welded to the frame of the car. Four curved door bars on the
left side and three curved or straight door bars on the right side are mandatory. The roll
cage members must closely conform to window/door/roof contour and not be readily
apparent when car is viewed from side. Offset cages are not allowed.
B.
Forward bars attached to the main cage are not allowed, but minor front bracing for
protection of the radiator is allowed, must pass Lee Tech Staff inspection.
C.
Rear roll cage bars are allowed for added protection (only one bar per side). Rear bars
should mount from back of cage to rear trunk area only. Bars cannot connect/support rear
suspension or upper/top part of strut/shock tower or connect directly to the strut itself.
RACING SEAT:
A. Padded racing type driver’s seat is required. Seat must be bolted to brackets firmly,
and welded to the roll bar assembly. All bars within the driver’s reach must be padded
with approved roll bar padding. Approved five (5) point harness must be used and attached
to the roll cage. Harness must be in good condition. Five Point Harness must meet
requirements as defined in the General Rules.
12.
13.
BRAKES:
A.
Car must have brakes on all four (4) wheels and be operational.
B.
All ABS systems must be disarmed.
C.
All brakes must remain stock for year and make.
SUSPENSION:
A.
B.
All suspension components must remain stock as manufactured with the exception
of adding camber adjustments on the left front and right front suspension only. This is
to help prevent outside/inside tire edge wear and for aiding in car handing. A maximum
of 2 inches of negative camber is allowed on the right front wheel, left front wheel is
allowed 1/2 inch maximum positive camber. Right front and left front upper strut mounts
may be slotted for camber adjustments only. No top strut crossover supports allowed.
No adding rear camber to rear suspension.
All springs must be stock as manufactured, No changing, cutting or lowing of springs
allowed must be stock (OEM). Spring must be the same diameter on the left and right
side (same spring gauge). Shocks and struts must be stock or stock replacement type
and mounted in stock location. If you replace any part you must have the sales slip with
you if asked by track official. No altered or high performance components allowed. No
weight jacking devices to increase or decrease spring rate, but will allow the use of
rubber spring spacers only, maximum 1 spring rubber spacer per wheel. Spacer
length cannot exceed more the one coil wound (circumference).
No steel or wood spring spacers etc. allowed.
5
14.
FUEL TANK:
A.
Racing fuel cell is permitted and highly recommended, but is not mandatory. Fuel cells
may not be more than 15 gallons in capacity. Fuel cell must be securely fastened with minimum
of two 2” x 1/8 metal straps inside in the trunk. No cutting of trunk floorboard when installing a
fuel cell. A sheet metal firewall must separate the trunk from the driver’s compartment.
15.
FUEL INCENTIVE PROGRAM:
A.
16.
The speedway welcomes New England Racing Fuels & Sunoco. We endorse New England
Racing Fuels as part of our sponsorship program, where you, the racer can reap the benefits.
You must be a customer and purchase fuel at the speedway; you then will become part of their
“Fuel Incentive Program” and have a chance to be rewarded at the season year end banquet.
We want to welcome John Holland and New England Racing Fuels to our family of sponsors
to where you can be the beneficiary.
FUEL:
A. It is not mandatory to purchase all Sunoco Fuel from New England Racing
Fuels at the Speedway. Petroleum based automotive gasoline is the only fuel allowed.
No alcohol, No methanol, No nitrous oxide or any other fuel additive may be used.
See Fuel Incentive Program above 15 (A).
17.
18.
TIRES AND WHEELS:
A.
Car must run four (4) matching tires and wheels.
B.
Car may run Factory Steel wheels, No aftermarket wheels.
C.
Wheels and rims must be car for car, No universal rims.
D.
Must have all the same size tires with no less than a 60 series,
no less than 3 1/2 inches side wall height, no directional or snow tires and
no less than 300 compound tread wear. Rating must be on tires.
Any tire side wall measuring less than 3 ½ inches will result in a
disqualification.
E.
One (1) inch lug nuts are required for right side wheels.
SAFETY EQUIPMENT:
A.
An aluminum racing seat is required.
B.
SFI Five Point harness with a date of manufacture no older than 5 years.
C.
Only Snell approved full face Helmets are allowed. It is highly recommend the use
of a Snell SA2005 or newer full face helmet.
D.
SFI Window net is required.
E.
SFI Fire Suit required must be in good condition, no holes, grease etc.
F.
SFI Racing Gloves required.
G.
SFI Racing Shoes are highly recommended. Proper foot wear is required
(Non-SFI sneakers are not allowed).
6
H.
19.
Head and Neck restraints are highly recommended and should be used.
TRANSPONDER:
Transponders are mandatory in all divisions. Ironman division transponder must be located
35 inches back from the front bumper.
All cars must be equipped with a transponder and be in operation at all times; during practices,
heats and features.
AMB Transponders can be purchased by calling 678-816-4000 or go to website: www.Amb-it.com.
20.
NASCAR LICENSE:
A.
A NASCAR License is required for ALL drivers in our weekly NASCAR Whelen AllAmerican Series which includes the Small Block Super Modifieds, Late Model Sportsman,
Hobby Stock and the Ironman Divisions. It is highly recommended for all pit crew members
entering the pit area to hold a current NASCAR License so you too can acquire additional
insurance coverage. Only License holders will receive a discount on pit tickets.
B.
Any driver under the age of 18 must complete the necessary releases (NASCAR
License Form & Addendum “A” Form which needs to be signed by a parent or legal guardian
in order to get a NASCAR license.)
C.
Learners Permit License - (Tan Form): Drivers between the ages of 14 & 15 years old
in the Late Model Sportsman, Hobby Stock and Ironman Divisions only can get a Learners
Permit License. A driver applying for a Learners Permit License must also have an
Addendum “A” Form signed by a parent or legal guardian in order to get a NASCAR license.
D.
Additionally, only current NASCAR holders are eligible to receive points that will
accumulate during the racing season. Therefore, only the NASCAR licensed drivers will be
competing for the top ten positions in the year end point fund and sponsor money. This
NASCAR license needs to be purchased prior to the first point race at the beginning of the
racing season in order to receive all your points earned. (Points will not start to accumulate
until you have purchased the NASCAR License. Any points earned before being licensed will
not count.) To receive the special awards, point fund or sponsor money you must attend the
annual banquet which is held on the third weekend of November.
21.
POINTS:
A.
You will be running for Championship points. Points will be awarded, and
handicapped along with all the other divisions. See points system in the General Rules.
B.
This division is intended to draw entry-level fans into the sport. It is designed for
those with little racing expertise and money to participate in the sport. However it is also intended
to put on the best possible show for the fans, requiring a certain amount of professionalism in race
preparation and attitude on the track. Competitors are urged to race hard to win, not merely to
crash and cause havoc. In this class, the playing field is leveled in a way that virtually all have a
significant chance to win.
C.
Everything about the vehicle must remain stock for the year, make and
model of vehicle being used. Except as permitted or required in this guidebook, vehicles must
remain completely stock in appearance, configuration, set-up, and running gear including motors,
transmission. Any variances from this guidebook will result in the disallowance of competition
until the variance is corrected, this will be at the discretion of LEE Tech Staff.
7
22.
RESPONSIBILITY:
IT IS THE RESPONSIBILITY OF THE COMPETITOR TO OBTAIN AND BECOME
FAMILIAR WITH THE GENERAL RULES OF LEE USA SPEEDW AY AND THE CURRENT
RULES PERTAINING TO THE DIVISION IN WHICH HE/SHE CHOOSES TO PARTICIPATE.
The rules and/or regulations set forth herein are designed to provide for the orderly
conduct of racing events and to establish minimum acceptable requirements for such events.
These rules shall govern the condition of all events, and by participating in these events all
participants are deemed to have obtained, read and understood a copy of the current rules, and
complied with these rules. NO EXPRESS OR IMPLIED W ARRANTY OF SAFETY SHALL
RESULT FROM PUBLICATION OF OR COMPLIANCE W ITH THESE RULES AND/OR
REGULATIONS. They are intended as a guide for the conduct of the sport and are in no way
a guarantee against injury or death to a participant, or official.
PAINT SCHEMES & CHARACTER CARS:
No factory paint jobs, cars must have a scheme or character look. Bright colors, it does not need a
professional spray job, just a couple cans of bright paint and a brush. Schemes and Characters,
like The Destroyer, The Gravedigger, The Crusher, The Orange Crush, Batman, Bulldog,
Godzilla, Spider-man, and ETC. Use your imagination but keep it family orientated. Schemes and
Characters must be registered along with the Number of the car with Lee USA Speedway office,
on first come first served basics.
This racing series is to have fun and entertaining for the spectators. This is not a racecar but a
car that you race.
Rules may be adjusted to meet the needs to
equal the playing field without notice.
REVISED ON: 10/02/2015
(ALL RULE CHANGES MUST BE APPROVED BY THE LEE USA SPEEDWAY OFFICE
WHICH IS A NASCAR SANCTIONED TRACK.)
Mailing Address of the speedway’s office:
Lee USA Speedway
P. O. Box 344
Rowley, MA 01969
Office Number is: 978-462-4252
If you see any important safety issues Technical questions should be directed
as with any other rules to LeeTech: Bob McIlveen at: 603-918-0698
8
SIX (6) CYLINDER IRONMAN DIVISION - CAR
P. O. BOX 344, ROWLEY, MA 01969
OFFICE NO. 978-462-4252
__________________________________________________________________________________________________________
2016 REGISTRATION FORM FOR THE
SIX (6) CYLINDER IRONMAN DIVISION:
FEE: $50.00
PAYOFF INFORMATION:
Information must be completed for payoff check.
Legal Name on check:________________________________ SS #/Tax I.D. #_______________________
Address: __________________________City: __________________ State: _______ Zip: ___________
OWNERS INFORMATION:
PLEASE PRINT:
Owner’s Name: ___________________________ EMAIL ADDRESS: __________________________
Address: _______________________________________________________________________________
City:_________________________________
State:___________ Zip:____________________________
Evening#:___________________________ Daytime Phone #: __________________________________
S.S.#:______-____-______D.O.B.:________________Nascar#___________________________________
Occupation_________________________
Chief Mechanic__________________________________
DRIVER’S INFORMATION: (PLEASE PRINT) CHECK BOX IF A ROOKIE IN THIS DIVISION:
Driver’s Name:_____________________________ EMAIL ADDRESS: __________________________
Address:_______________________________________________________________________________
City:__________________________________________State:___________ Zip:____________________
Evening:Phone#:______________________________ Daytime Phone #:__________________________
S.S. #:____-___-_____ Nascar Lic. #:___________________________D.O.B. _____________________
Occupation__________________________ Major Sponsor: ____________________________
CAR INFORMATION:
IRONMAN
Transponder No: __________________
Year:__________ Make & Model:____________________________ Car #:_______________________
DRIVER AND OWNER PARTICIPATION IS REQUIRED IN THE ANNUAL LEE USA SPEEDWAY BANQUET OF CHAMPIONS 11/19/16. THE TOP
10 TEAMS IN EACH DIVISION ARE REQUIRED TO ATTEND, FAILURE TO ATTEND THE BANQUET WILL RESULT IN THE LOSS OF ALL LEE
& NASCAR POINT FUND MONEY AND AWARDS, PLUS ANY SPECIAL SERIES AWARDS. A CURRENT NASCAR LICENSE IS REQUIRED FOR
ANY DRIVER AND OWNER TO RECEIVE LEE & NASCAR POINT FUND MONEY. THE UNDERSIGNED DRIVER AND CAR OWNER AGREE TO
ATTEND THE ANNUAL LEE USA SPEEDWAY BANQUET OF CHAMPIONS. NO ONE ELSE CAN PICK UP YOUR TROPHY AND AWARDS AT
THE BANQUET.
Driver’s Signature_________________________________________________________
Date_________________________________
Owner’s Signature_________________________________________________________
Date_________________________________
____________________________________________________________________________________________________________________
OFFICE USE ONLY:
Date Paid: __________________
Amount Paid: ____________
Received by: ____________________
Check #: ______________________
Approved: ________________________________
Safety Inspection for Ironman - Worksheet
Division: _______________________________
Car Number: __________
Owner: ________________________________
Driver: ________________________________
DRIVERS COMPARTMENT
Window Net
Window Net Release
Padded Wheel
Quick Release
Roll Bars
Roll Bar Padding
Kill Switch
Fire Extinguisher
Drivers Seat
Seat Beat (dated)
/ /
Firewalls Front/Rear (Steel)
DRIVERS SIDE OF CAR
Battery Location
Battery Hold and Cover
Side Bars
Ground Clearance
REAR OF CAR
Rear Lifting Cable
Rear Spoiler Height/Side
Fuel Cell and Fuel Lines
Radiator Overflow
Secure Weights Numbered White
Drive Shaft Painted (White)
Drive Shaft Loop
Rear Bumper
Rear Suspension
PASSENGER SIDE
Muffler
Clutch Inspection Hole
Clutch Scattershield
Side Bars (Passenger Side)
FRONT OF CAR
Windshield
Hood Hold Downs
Front Bumper
Front Lifting Cable
Engine Location
Front Suspension
Carburetor
Intake Manifold
Exhaust Manifold
Heads
OTHER
Firesuit
Helmet
Gloves
Shoes
Comments: ____________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Inspected By: _______________________________________
Date of Inspection: _____/ _____ /_____
Accepted: __________________________________________
Rejected: ________________________________________
2016 SIX CYLINDER IRONMAN DIVISION PAYOFF
(Must Qualify and take the Green in the Feature to be in our car count.)
No. of Cars
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
10 to 13 Cars
$75.00
$50.00
$40.00
$35.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$470.00
14 Cars or More
$125.00
$75.00
$50.00
$45.00
$40.00
$40.00
$40.00
$40.00
$40.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$30.00
$885.00
W-9
Form
(Rev. December 2014)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification; check only one of the following seven boxes:
C Corporation
S Corporation
Partnership
Trust/estate
Individual/sole proprietor or
single-member LLC
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶
Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for
the tax classification of the single-member owner.
4 Exemptions (codes apply only to
certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
(Applies to accounts maintained outside the U.S.)
Other (see instructions) ▶
5 Address (number, street, and apt. or suite no.)
Requester’s name and address (optional)
6 City, state, and ZIP code
7 List account number(s) here (optional)
Part I
Taxpayer Identification Number (TIN)
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 Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter.
Part II
Social security number
–
–
or
Employer identification number
–
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I 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 on page 3.
Sign
Here
Signature of
U.S. person ▶
Date ▶
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
as legislation enacted after we release it) is at www.irs.gov/fw9.
Purpose of Form
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
An individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (TIN)
which may be your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), or employer
identification number (EIN), to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns include, but are not limited to, the following:
If you do not return Form W-9 to the requester with a TIN, you might be subject
to backup withholding. See What is backup withholding? on page 2.
• Form 1099-INT (interest earned or paid)
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
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
withholding tax on foreign partners' share of effectively connected income, and
• Form 1099-DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
By signing the filled-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. See What is FATCA reporting? on
page 2 for further information.
• Form 1099-K (merchant card and third party network transactions)
Cat. No. 10231X
Form W-9 (Rev. 12-2014)