Section II: E-Sign Notice- Consent to Electronic Record
E-Sign, the Electronic Signatures in Global and National Commerce Act (15 U.S.D. 7001, et seq.), requires that you consent to entering into an electronic agreement with Genusity before a Genusity Associate Agreement can be executed.
Please read the following information carefully:
To access these documents and submit your online Associate Application, you will need a personal computer or Mac with Internet access and operational Internet browser software.
Section III: IRS W9 Information
The Tax ID number must match the name as shown on your income tax return to avoid backup withholding. For individuals, this is your social security number.
Please verify the information submitted on your enrollment form. If correct, acknowledge by checking the box below, which will serve as your digital signature. For further information, please see the official IRS W9 form instructions: http://www.irs.gov/pub/irs-pdf/fw9.pdf
Under penalties of perjury, I certify that:
The information submitted is correct
You are not an exempt payee (generally, individuals, sole proprietors are not exempt from backup withholding)
The IRS has not notified you that you are currently subject to backup withholding
I am a U.S. citizen or U.S. resident alien (individual/sole proprietor)
I consent to the use of electronic records and have read, understand and agree to the Genusity Associate Agreement and Policies and Procedures.
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