Form 2
FIRPTA  NON-FOREIGN STATUS CERTIFICATION
ENTITY TRANSFEROR/SELLER

Escrow No.:  	 Escrow Officer:  		

Section 1445 of the Internal Revenue Code provides that a transferee (buyer) of a U.S. real property interest must withhold tax if the transferor (seller) is a foreign person.  For U. S. tax purposes (including Section 1445), the owner of a disregarded entity (which has legal title to a U.S. real property interest under local law) will be the transferor of the property and not the disregarded entity. To inform the transferee (buyer) that withholding of tax is not required upon the disposition of a U. S. real property interest by  	 (hereinafter referred to as "Transferor”), the undersigned hereby certifies the following on behalf of Transferor:

1.	Transferor is not a foreign corporation, foreign partnership, foreign trust, or foreign estate (as those terms are defined in the Internal Revenue Code and Income Tax Regulations);

2.     Transferor is  not a disregarded entity as defined in Treasury Regulation §1.1445-
2(b)(2)(iii);

3.     Transferor's U.S. employer identification number is                                            ; and

4.      Transferor's office address is 	
                                                                                                                                        .
(P.O. Box and mailing address may be provided in addition to, but not in lieu of, the office address.)

Transferor understands that this certification may be disclosed to the Internal Revenue Service by transferee and that any false statement contained herein could be punished by fine, imprisonment, or both.

Under penalties of perjury, I declare that I have examined this certification; and to the best of my knowledge and belief, it is true, correct and complete.  I further declare that I have authority to sign this document on behalf of Transferor.

Signed:            	

Print Name:     	

Title:                	

Dated: