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Majestic Investor Holdings LLC, et al. – ‘S-4’ on 1/29/02 – EX-99.5

On:  Tuesday, 1/29/02   ·   Accession #:  950137-2-403   ·   File #s:  333-81584, -01, -02, -03, -04

Previous ‘S-4’:  None   ·   Next:  ‘S-4/A’ on 3/19/02   ·   Latest:  ‘S-4/A’ on 7/26/02

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  As Of                Filer                Filing    For·On·As Docs:Size              Issuer               Agent

 1/29/02  Majestic Investor Holdings LLC    S-4                   88:3.7M                                   Bowne Boc/FA
          Barden Nevada Gaming LLC
          Barden Colorado Gaming LLC
          Barden Mississippi Gaming LLC
          Majestic Investor Capital Corp

Registration of Securities Issued in a Business-Combination Transaction   —   Form S-4
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: S-4         Registration Statement                               181    972K 
 2: EX-1.1      Purchase Agreement                                    93    331K 
 3: EX-3.1      Certificate of Formation                               1     22K 
12: EX-3.10     Amended and Restated Operating Agreement              11     53K 
13: EX-3.11     Articles of Organization                               3     27K 
14: EX-3.12     Certificate of Amendment of the Art. of Org.           2     25K 
15: EX-3.13     Operating Agreement                                   14     59K 
 4: EX-3.2      Limited Liability Company Agreement                    5     40K 
 5: EX-3.3      Certificate of Incorporation                           2     25K 
 6: EX-3.4      By-Laws                                               15     81K 
 7: EX-3.5      Amended and Restated Articles of Organization          3     28K 
 8: EX-3.6      Operating Agreement                                   14     68K 
 9: EX-3.7      Certificate of Formation                               3     27K 
10: EX-3.8      Certificate of Amendment to Certif. of Formation       3     25K 
11: EX-3.9      Certificate of Amendment to Certif. of Formation       4     27K 
16: EX-4.1      Indenture                                            106    405K 
25: EX-4.10     Deed of Trust                                         44    160K 
26: EX-4.11     Intercreditor Agreement                               15     75K 
27: EX-4.12     Loan and Security Agreement                           98    386K 
28: EX-4.13     General Continuing Guaranty                           11     57K 
29: EX-4.14     Guarantor Security Agreement                          17     76K 
30: EX-4.15     First Preferred Vessel Mortgage                       16     79K 
31: EX-4.16     Deed of Trust                                         51    193K 
32: EX-4.17     Deed of Trust                                         56    214K 
33: EX-4.18     Deed of Trust                                         51    181K 
34: EX-4.19     Stock Pledge Agreement                                15     67K 
17: EX-4.2      Registration Rights Agreement                         37    126K 
35: EX-4.20     Guarantor Trademark Security Agreement                12     54K 
36: EX-4.21     Subordination of First Referred Vessel Mortgage        2     27K 
37: EX-4.22     Subordination Agreement                                7     38K 
38: EX-4.23     Subordination Agreement                                7     38K 
39: EX-4.24     Subordination Agreement                                8     38K 
18: EX-4.3      Guarantee                                              2     25K 
19: EX-4.4      Pledge and Security Agreement                         48    186K 
20: EX-4.5      Pledge Agreement                                      23    110K 
21: EX-4.6      Trademark Security Agreement                           4     31K 
22: EX-4.7      First Preferred Vessel Mortgage                       22     97K 
23: EX-4.8      Deed of Trust                                         47    165K 
24: EX-4.9      Deed of Trust                                         50    175K 
40: EX-5.1      Opinion of Latham & Watkins                            3     30K 
41: EX-5.2      Opinion of Schreck Brignone Godfrey                    2     27K 
42: EX-5.3      Opinion of Watkins Ludlam Winter & Stennis, P.A.       3     30K 
43: EX-5.4      Opinion of Robinson Waters & O'Dorisio                 2     27K 
44: EX-10.1     Employment Agreement                                   1     24K 
58: EX-10.10    Lease Agreement                                       17     60K 
59: EX-10.10.1  Amendment to Lease Agreement                           7     39K 
68: EX-10.10.10  Second Amendment to Masonic Ground Lease              7     38K 
69: EX-10.10.11  Lease Agreement and Estoppel Certificate             17     65K 
70: EX-10.10.12  Assignment of Ground Lease                           10     45K 
60: EX-10.10.2  Assignment                                             7     36K 
61: EX-10.10.3  Supplemental Agreement                                 3     28K 
62: EX-10.10.4  Assignment                                             7     36K 
63: EX-10.10.5  Assignment                                             4     32K 
64: EX-10.10.6  Articles of Amendment                                 11     47K 
65: EX-10.10.7  Assignment                                             5     30K 
66: EX-10.10.8  Amendment to Masonic Lodge Ground Lease               21     73K 
67: EX-10.10.9  Lease Agreement                                       11     49K 
71: EX-10.11    Lease                                                 16     52K 
72: EX-10.11.1  Amendments to Ham Ground Lease                        23     77K 
73: EX-10.11.2  Lease Agreement                                        6     39K 
74: EX-10.11.3  Second Amendment to Ham Ground Lease                  12     49K 
75: EX-10.11.4  Assignment of Ground Lease                            10     43K 
76: EX-10.12    Agreement Regarding Ground Leases                      8     36K 
77: EX-10.13    Agreement Regarding Ground Leases                      6     34K 
45: EX-10.2     Employment Agreement                                   8     51K 
46: EX-10.3     Amended and Restated Management Agreement              6     38K 
47: EX-10.4     Expense Reimbursement Agreement                        3     28K 
48: EX-10.5     Member Agreement                                       7     42K 
49: EX-10.6     Assignment of Membership                               1     23K 
50: EX-10.7     Contribution and Assignment Agreement                  3     28K 
51: EX-10.8     Lease Agreement                                       37     90K 
52: EX-10.8.1   Assigment of Ground Lease                              7     35K 
53: EX-10.9     Lease Agreement                                       27     75K 
54: EX-10.9.1   Amendment to Kramer Ground Lease                      20     66K 
55: EX-10.9.2   Lease Amendment                                       10     47K 
56: EX-10.9.3   Second Amendment to the Kramer Ground Lease            6     37K 
57: EX-10.9.4   Assignment of Ground Lease                            11     43K 
78: EX-12.1     Computation of Ratio of Earnings to Fixed Charges      1     22K 
79: EX-21.1     List of Subsidiaries                                   1     21K 
80: EX-23.5     Consent of Pricewaterhousecoopers LLP                  1     22K 
81: EX-23.6     Consent of Deloitte & Touche LLP                       1     23K 
82: EX-25.1     Statement of Eligibility                               6     36K 
83: EX-99.1     Form of Letter of Transmittal                         11     76K 
84: EX-99.2     Form of Notice of Guaranteed Delivery                  5     37K 
85: EX-99.3     Form of Letter to Dtc Participants                     2     25K 
86: EX-99.4     Form of Letter to Beneficial Owners                    4     30K 
87: EX-99.5     Guidelines for Cert. of Taxpayer Id Number             4±    32K 
88: EX-99.6     Form of Exchange Agent Agreement                      10     47K 


EX-99.5   —   Guidelines for Cert. of Taxpayer Id Number

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EXHIBIT 99.5 FORM OF GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 GUIDELINES FOR DETERMINING THE PROPER IDENTIFICATION NUMBER TO GIVE THE PAYER -- Social Security Numbers have nine digits separated by two hyphens: i.e., 000-00-0000. Employer Identification Numbers have nine digits separated by only one hyphen: i.e., 00-0000000. The table below will help determine the type of number to give the Payer. [Download Table] ------------------------------------------------------------ GIVE THE SOCIAL SECURITY FOR THIS TYPE OF ACCOUNT: NUMBER OF -- ------------------------------------------------------------ 1. An individual's account The individual 2. Two or more individuals (joint The actual owner of account) the account or, if combined funds, the first individual on the account(1) 3. Husband and wife (joint account) The actual owner of the account or, if joint funds, either person(1) 4. Custodian account of a minor The minor(2) (Uniform Gift to Minors Act) 5. Adult and minor (joint account) The adult or, if the minor is the only contributor, the minor(1) 6. Account in the name of guardian or The ward, minor, or committee for a designated ward, incompetent minor, or incompetent person person(3) 7. a. The usual revocable saving The grantor- trust account (grantor is also trustee(1) trustee) b. So-called trust account that is The actual owner(1) not a legal or valid trust under state law ------------------------------------------------------------ [Download Table] ------------------------------------------------------------ GIVE THE EMPLOYER IDENTIFICATION FOR THIS TYPE OF ACCOUNT: NUMBER OF -- ------------------------------------------------------------ 8. Sole proprietorship account The owner(4) 9. A valid trust, estate or pension The legal entity trust (Do not furnish the tax identifying number of the personal representative or trustee unless the legal entity itself is not designated in the account title)(5) 10. Corporate account The corporation 11. Religious, charitable, or The organization educational organization account 12. Partnership account held in the The partnership name of the business 13. Association, club, or other tax- The organization exempt organization 14. A broker or registered nominee The broker or nominee 15. Account with the Department of The public entity Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments ------------------------------------------------------------ (1) List first and circle the name of the person whose number you furnish. If only one person on a joint account has a Social Security Number, that person's number must be furnished. (2) Circle the minor's name and furnish the minor's Social Security Number. (3) Circle the ward's, minor's or incompetent person's name and furnish such person's Social Security Number. (4) You must show your individual name, but you may also enter your business or "doing business" name. You may use either your Social Security Number or Employer Identification Number. (5) List first and circle the name of the legal trust, estate, or pension trust. NOTE: If no name is circled when there is more than one name, the number will be considered to be that of the first name listed.
EX-99.5Last “Page” of 2TOC1stPreviousNextBottomJust 2nd
GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 PAGE 2 OBTAINING A NUMBER If you do not have a taxpayer identification number or if you do not know your number, obtain Form SS-5, Application for Social Security Number Card, or Form SS-4, Application for Employer Identification Number, at the local office of the Social Security Administration or the Internal Revenue Service (the "IRS") and apply for a number. Payees specifically exempted from backup withholding on ALL payments by brokers include the following: - A corporation. - A financial institution. - An organization exempt from a tax under Section 501(a), or an individual retirement plan or a custodial account under Section 403(b)(7) if the account satisfies the requirements of Section 401(F)(2). - The United States or any agency or instrumentality thereof. - A State, the District of Columbia, a possession of the United States, or any subdivision or instrumentality thereof. - A foreign government, a political subdivision of a foreign government, or any agency or instrumentality thereof. - An international organization or any agency or instrumentality thereof. - A registered dealer in securities or commodities registered in the U.S. or a possession of the U.S. - A real estate investment trust. - A common trust fund operated by a bank under Section 584(a). - An entity registered at all times under the Investment Company Act of 1940. - A foreign central bank of issue. - A futures commission merchant registered with the Commodity Futures Trading Commission. - A person registered under the Investment Advisors Act of 1940 who regularly acts as a broker. Payments of dividends and patronage dividends not generally subject to backup withholding include the following: - Payments to nonresident aliens subject to withholding under Section 1441. - Payments to partnerships not engaged in a trade or business in the U.S. and which have at least one nonresident alien partner. - Payments of patronage dividends where the amount received is not paid in money. - Payments made by certain foreign organizations. - Payments made to a nominee. Payments of interest not generally subject to backup withholding include the following: - Payments of interest on obligations issued by individuals. Note: You may be subject to backup withholding if this interest is $600 or more and is paid in the course of the Payer's trade or business and you have not provided your correct taxpayer identification number to the Payer. - Payments of tax-exempt interest (including exempt-interest dividends under Section 852). - Payments described in Section 6049(b)(5) to nonresident aliens. - Payments on tax-free covenant bonds under Section 1451. - Payments made by certain foreign organizations. - Payments made to a nominee. Exempt Payees described above should file Form W-9 to avoid possible erroneous backup withholding. FILE THIS FORM WITH THE PAYER, FURNISH YOUR TAXPAYER IDENTIFICATION NUMBER, CHECK "EXEMPT" IN PART II OF THE FORM, SIGN AND DATE THE FORM AND RETURN IT TO THE PAYER. Certain payments other than interest, dividends, and patronage dividends, which are not subject to information reporting are also not subject to backup withholding. For details, see the regulations under Section 6041, 6041(A), 6045, 6050A and 6050N. PRIVACY ACT NOTICE. -- Section 6109 of the Internal Revenue Code requires most recipients of dividend, interest, or other payments to give taxpayer identification numbers to payers who must report the payments to IRS. IRS uses the numbers for identification purposes. Payers must be given the numbers whether or not recipients are required to file tax returns. Payers must generally withhold up to 31% of taxable interest, dividend, and certain other payments to a Payee who does not furnish a taxpayer identification number to a Payer. Certain penalties may also apply. PENALTIES (1) PENALTY FOR FAILURE TO FURNISH TAXPAYER IDENTIFICATION NUMBER. -- If you fail to furnish your taxpayer identification number to a Payer, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. (2) CIVIL PENALTY FOR FALSE INFORMATION WITH RESPECT TO WITHHOLDING. -- If you make a false statement with no reasonable basis that results in no imposition of backup withholding, you are subject to a penalty of $500. (3) CRIMINAL PENALTY FOR FALSIFYING INFORMATION. -- Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. FOR ADDITIONAL INFORMATION CONTACT YOUR TAX CONSULTANT OR THE INTERNAL REVENUE SERVICE.
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