W 8BENn
W 8BENn
W 8BENn
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any
withholding agent that can disburse or make payments of the income of which I am the beneficial owner. I agree that I will submit a new form within 30 days if any certification
made on this form becomes incorrect.
✔
Sign Here I certify that I have the
capacity to line 1 of this form.
sign for the
person
identified on
▲ 09-03-2024
Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY)
Bryan Fabricio Checa Recalde
Print name of signer
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25047Z Form W-8BEN (Rev. 10-2021)