Coach 2013 Annual Report Download - page 1146

EXHIBIT 3
Form of FIRPTA Affidavit

Pursuant to Section 1445
of the
Internal Revenue Code of 1986, as amended
Section 1445 of the Internal Revenue Code provides that a transferee of a U.S. real property interest must withhold tax if the transferor is a
foreign person. To inform the transferee that withholding of tax is not required upon the disposition of a U.S. real property interest by [504-514 WEST 34 th
STREET CORP., a Maryland corporation][516 WEST 34th STREET LLC, a Delaware limited liability company] (“ ”), the undersigned hereby
certifies the following on behalf of Seller.
1. Seller is not a foreign corporation, foreign partnership, foreign trust, or foreign estate (as such terms are defined in the Internal
Revenue Code and Income Tax Regulations).
2. Seller’s U.S. employer identification number is: ________________.
3. Seller’s office address is:
c/o Coach, Inc.
516 West 34th Street
New York, New York 10001
The undersigned understands that this certification may be disclosed to the Internal Revenue Service by the 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, and I further declare that I have authority to sign this document on behalf of Seller.
_____________________________________
_______________________________,
as _______________, and not individually
Dated: _________________, 201___