<DOCUMENT>
<TYPE>EX-99.6
<SEQUENCE>12
<FILENAME>dex996.txt
<DESCRIPTION>EXHIBIT 99.6
<TEXT>
<PAGE>

                                                                    Exhibit 99.6

                                                  Hometown / First Capital, Inc.

         GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER
                             ON SUBSTITUTE FORM W-9


     Guidelines for Determining the Proper Identification Number for Shareholder
(You) to Give 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 number
to give the payer. All "Section" references are to the Internal Revenue Code of
1986, as amended. "IRS" means the Internal Revenue Service.

<TABLE>
<CAPTION>
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                                  Give the SOCIAL                                                         Give the EMPLOYER
                                  SECURITY                                                                IDENTIFICATION
For this type of account:         number of __                      For this type of account:             number of __
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<S>                               <C>                               <C>                                   <C>
1.  Individual                    The individual                      6. Sole proprietorship              The owner(3)

2.  Two or more individuals       The actual owner of the             7. A valid trust, estate, or        The legal entity(4)
    (joint account)               A valid trust, estate, or              pension trust
                                  account or, if combined funds,
                                  any one of the individuals(1)       8. Corporate                        The corporation

3.  Custodian account of a        The minor(2)                        9. Association, club, religious,    The organization
    minor (Uniform Gift to                                               charitable, educational or
    Minors Act)                                                          other tax-exempt organization

4.  a. The usual revocable        The grantor-trustee(1)             10. Partnership                      The partnership
       savings trust account
       (grantor is also trustee)                                     11. A broker or registered           The broker or nominee
                                                                         nominee
4.  b. So-called trust account    The actual owner(1)
       that is not a legal or                                        12. Account with the Department      The public entity
       valid trust under state                                           of Agriculture in the name
       law                                                               of a public entity (such as
                                                                         a State or local government,
5.  Sole proprietorship           The owner(3)                           school district or prison)
    guardian or committee for                                            that receives agricultural
    a designated ward, minor,                                            program payments
    or incompetent person
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</TABLE>

(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)  You must show your individual name, but you may also enter your business or
     "doing business as" name. You may use either your social security number or
     your employer identification number (if you have one).

(4)  List first and circle the name of the legal trust, estate, or pension
     trust. (Do not furnish the taxpayer identification number of the personal
     representative or trustee unless the legal entity itself is not designated
     in the account title.)

Note: If no name is circled when there is more than one name listed, the number
      will be considered to be that of the first name listed.

<PAGE>

         GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER
                             ON SUBSTITUTE FORM W-9
                                     Page 2


OBTAINING A NUMBER

     If you don't have a taxpayer identification number, obtain Form SS-5,
Application for a Social Security Card, at the local Social Security
Administration office, or Form SS-4, Application for Employer Identification
Number, by calling 1(800) TAX-FORM, and apply for a number.

Payees Exempt From Backup Withholding

Payees specifically exempted from withholding include:

     . An organization exempt from tax under Section 501(a), an individual
       retirement account (IRA), or a custodial account under Section 403(b)(7),
       if the account satisfies the requirements of Section 401(f)(2).

     . The United States or a state thereof, the District of Columbia, a
       possession of the United States, or a political subdivision or wholly
       owned agency or instrumentality of any one or more of the foregoing.

     . An international organization or any agency or instrumentality thereof.

     . A foreign government or any political subdivision, agency or
       instrumentality thereof.

Payees that may be exempt from backup withholding include:

     . A corporation.

     . A financial institution.

     . A dealer in securities or commodities required to register in the United
       States, the District of Columbia, or possession of the United States.

     . A real estate investment trust.

     . A common trust fund operated by a bank under Section 584(a).

     . An entity registered at all times during the tax year under the
       Investment Company Act of 1940.

     . A middleman known in the investment community as a nominee or custodian.

     . A futures commission merchant registered with the Commodity Futures
       Trading Commission.

     . A foreign central bank of issue.

     . A trust exempt from tax under Section 664 or described in Section 4947.

Payments of dividends and patronage dividends generally exempt from backup
withholding include:

     . Payments to nonresident aliens subject to withholding under Section 1441.

     . Payments to partnerships not engaged in a trade or business in the United
       States and that have at least one nonresident alien partner.

     . Payments of patronage dividends not paid in money.

     . Payment made by certain foreign organizations.

     . Section 404(k) payments made by an ESOP.

Payments of interest generally exempt from backup withholding include:

     . Payment of interest or 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).

     . Payment of tax-exempt interest (including exempt-interest dividends under
       Section 852).

     . Payments described in Section 6049(b)(5) to nonresidential aliens.

     . Payments on tax-free covenant bonds under Section 1451.

     . Payments made by certain foreign organizations.

     . Mortgage or student loan interest paid to you.

     Certain payments, other than payments of interest, dividends, and patronage
dividends, that are exempt from information reporting are also exempt form
backup withholding. For details, see Sections 6041, 6041A, 6042, 6044, 6045,
6049, 6050A and 6050N and the regulations thereunder.

     Exempt payees should complete a Substitute Form W-9 to avoid possible
erroneous backup withholding. Furnish your taxpayer identification number, write
"exempt" on the face of the form, sign and date the form and return it to the
payer.

Privacy Act Notice

     Section 6109 requires you to provide your correct taxpayer identification
number to payers who must report the payments to the IRS. The IRS uses the
numbers for identification purposes and to help verify the accuracy of your
return and may also provide this information to various government agencies for
tax enforcement or litigation purposes. Payers must be given the numbers whether
or not recipients are required to file tax returns. Payers must generally
withhold 30% of taxable interest, dividend, and certain other payments made in
2002 and 2003 to a payee who does not furnish a taxpayer identification number
to a payer. Certain penalties may also apply.

Penalties

(1)  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 backup
withholding, you are subject to a $500 penalty.

(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 CONSULT YOUR TAX CONSULTANT OR THE INTERNAL REVENUE
SERVICE.

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