Form W-9 - Request For Taxpayer Identification Number And Certification - 2007 Page 4

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Form W-9 (Rev. 10-2007)

Page

3. Real estate transactions. You must sign the certification.

Secure Your Tax Records from Identity Theft

You may cross out item 2 of the certification.

Identity theft occurs when someone uses your personal

4. Other payments. You must give your correct TIN, but you

information such as your name, social security number (SSN), or

do not have to sign the certification unless you have been

other identifying information, without your permission, to commit

notified that you have previously given an incorrect TIN. “Other

fraud or other crimes. An identity thief may use your SSN to get

payments” include payments made in the course of the

a job or may file a tax return using your SSN to receive a refund.

requester’s trade or business for rents, royalties, goods (other

To reduce your risk:

than bills for merchandise), medical and health care services

(including payments to corporations), payments to a

Protect your SSN,

nonemployee for services, payments to certain fishing boat crew

Ensure your employer is protecting your SSN, and

members and fishermen, and gross proceeds paid to attorneys

Be careful when choosing a tax preparer.

(including payments to corporations).

Call the IRS at 1-800-829-1040 if you think your identity has

5. Mortgage interest paid by you, acquisition or

been used inappropriately for tax purposes.

abandonment of secured property, cancellation of debt,

Victims of identity theft who are experiencing economic harm

qualified tuition program payments (under section 529), IRA,

or a system problem, or are seeking help in resolving tax

Coverdell ESA, Archer MSA or HSA contributions or

problems that have not been resolved through normal channels,

distributions, and pension distributions. You must give your

may be eligible for Taxpayer Advocate Service (TAS) assistance.

correct TIN, but you do not have to sign the certification.

You can reach TAS by calling the TAS toll-free case intake line

at 1-877-777-4778 or TTY/TDD 1-800-829-4059.

What Name and Number To Give the Requester

Protect yourself from suspicious emails or phishing

For this type of account:

Give name and SSN of:

schemes. Phishing is the creation and use of email and

websites designed to mimic legitimate business emails and

1. Individual

The individual

websites. The most common act is sending an email to a user

2. Two or more individuals (joint

The actual owner of the account or,

falsely claiming to be an established legitimate enterprise in an

account)

if combined funds, the first

attempt to scam the user into surrendering private information

individual on the account

that will be used for identity theft.

3. Custodian account of a minor

The minor

(Uniform Gift to Minors Act)

The IRS does not initiate contacts with taxpayers via emails.

Also, the IRS does not request personal detailed information

4. a. The usual revocable savings

The grantor-trustee

trust (grantor is also trustee)

through email or ask taxpayers for the PIN numbers, passwords,

b. So-called trust account that is

The actual owner

or similar secret access information for their credit card, bank, or

not a legal or valid trust under

other financial accounts.

state law

If you receive an unsolicited email claiming to be from the IRS,

5. Sole proprietorship or disregarded

The owner

forward this message to phishing@irs.gov. You may also report

entity owned by an individual

misuse of the IRS name, logo, or other IRS personal property to

For this type of account:

Give name and EIN of:

the Treasury Inspector General for Tax Administration at

Disregarded entity not owned by an

The owner

1-800-366-4484. You can forward suspicious emails to the

individual

Federal Trade Commission at: spam@uce.gov or contact them at

A valid trust, estate, or pension trust

Legal entity

or 1-877-IDTHEFT(438-4338).

Corporate or LLC electing

The corporation

Visit the IRS website at to learn more about

corporate status on Form 8832

identity theft and how to reduce your risk.

Association, club, religious,

The organization

charitable, educational, or other

tax-exempt organization

10.

Partnership or multi-member LLC

The partnership

11.

A broker or registered nominee

The broker or nominee

12.

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

List first and circle the name of the person whose number you furnish. If only one person

on a joint account has an SSN, that person’s number must be furnished.

Circle the minor’s name and furnish the minor’s SSN.

You must show your individual name and you may also enter your business or “DBA”

name on the second name line. You may use either your SSN or EIN (if you have one),

but the IRS encourages you to use your SSN.

List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN

of the personal representative or trustee unless the legal entity itself is not designated in

the account title.) Also see Special rules for partnerships on page 1.

Note. If no name is circled when more than one name is listed,

the number will be considered to be that of the first name listed.

Privacy Act Notice

Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest,

dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or

contributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return.

The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S.

possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal

nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other

payments to a payee who does not give a TIN to a payer. Certain penalties may also apply.