NCG030224_Name-Owner Change Supporting Info (4)_20210125

Form W-8ECI
Certificate of Foreign Person's Claim That Income Is
Effectively Connected With the Conduct of a Trade or
(Rev. July2017)
Business in the United States
OMB No.1545-1621
► Section references are to the Internal Revenue Code.
Department of the Treasury
► Go to www.irs.gov/FormW8EC/ for instructions and the latest information.
Internal Revenue Service
► Give this form to the withholding agent or payer. Do not send to the IRS.
Note: Persons submitting this form must file an annual U.S. income tax return to report income claimed to be effectively
connected with a U.S. trade or business. See instructions.
Do not use this form for: Instead, use Form:
• A beneficial owner solely claiming foreign status or treaty benefits . . . . . . . . . . . . . . . . . W-8BEN or W-8BEN-E
• A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private
foundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) . . . . W-8EXP
Note: These entities should use Form W-8ECI if they received effectively connected income and are not eligible to claim an exemption for chapter 3
or 4 purposes on Form W-8EXP.
• A foreign partnership or a foreign trust (unless claiming an exemption from U.S. withholding on income effectively connected with the
conduct of a trade or business in the United States) . . . . . . . . . . . . . . . . . . . . W-8BEN-E or W-81MY
• A person acting as an intermediary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-81MY
Note: See instructions for additional exceptions.
Identification of Beneficial Owner (see instructions)
1 Name of individual or organization that is the beneficial owner 2 Country of incorporation or organization
Clarios International LP Canada
3 Name of disregarded entity receiving the payments (if applicable)
Clarios, LLC (EIN 39-1684871)
4 Type of entity (check the appropriate box): ❑ Individual ❑ Corporation
El Partnership ❑ Simple trust ❑ Complex trust ❑ Estate
❑ Government ❑ Grantor trust ❑ Central bank of issue ❑ Tax-exempt organization
❑ Private foundation ❑ International organization
5 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in -care -of address.
250 Vesey Street, 15th Floor
City or town, state or province. Include postal code where appropriate. Country
New York. NY 10281 United States
6 Business address in the United States (street, apt. or suite no., or rural route). Do not use a P.O. box or in -care -of address.
5757 N. Green Bay Ave, Florist Tower, MS X-31
City or town, state, and ZIP code
Glendale, WI 53209
7 U.S. taxpayer identification number (required —see instructions) 8 Foreign tax identifying number
❑ SSN or ITIN 0 EIN 98-1474281 1 Not Legally Required
9 Reference number(s) (see instructions) 110 Date of birth (MM-DD-YYYY)
11 Specify each item of income that is, or is expected to be, received from the payer that is effectively connected with the conduct of a trade or
business in the United States (attach statement if necessary).
All income earned by Clarios, LLC (EIN: 39-1684871).
Sign
Here
Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true,
complete. I further certify under penalties of perjury that:
• I am the beneficial owner (or I am authorized to sign for the beneficial owner) of all the payments to which this form relates,
• The amounts for which this certification is provided are effectively connected with the conduct of a trade or business In the United States,
• The income for which this form was provided is includible in my gross Income (or the beneficial owner's gross income) for the taxable year, and
• The beneficial owner is not a U.S. person.
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the payments of which I am the
beneficial owner or any withholding agent that can disburse or make payments of the amounts of which I am the beneficial owner.
I agree that I will submit a new form within 30 days if any pertification made on this form becomes incorrect.
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Signature of beneficial owner (or individual authorized to sign for the beneficial owner) Print name
❑. I certify that I have the capacity to sign for the person identified on line 1 of this form.
Date (MM-DD-YYYY)
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25045D Form HIV-8ECI (Rev. 7-2017)