Form Ac 3237-S - Substitute Form W-9: Request For Taxpayer Identification Number & Certification Page 2
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2AC 3237-S (11/11)
NYS Office of the State Comptroller
Instructions for Completing Substitute W-9
New York State (NYS) must obtain your correct Taxpayer Identification Number (TIN) to report
income paid to you or your organization.
NYS Office of the State Comptroller uses the
Substitute Form W-9 to obtain certification of your TIN in order to ensure accuracy of
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information contained in its payee/vendor database and to avoid backup withholding.
We ask
for the information on the Substitute Form W-9 to carry out the Internal Revenue laws of the
United States. You are required to give us the information.
Any payee/vendor who wishes to do business with New York State must complete the
Substitute Form W-9. Substitute Form W-9 is the only acceptable documentation. We will not
accept IRS Form W-9.
Part I: Vendor Information
1. Legal Business Name: For individuals, enter the name of the person who will do
business with NYS as it appears on the Social Security card or other required Federal tax
documents. An organization should enter the name shown on its charter or other legal
documents that created the organization. Do not abbreviate names.
2. DBA (Doing Business As): Enter your DBA name.
3. Entity Type: Mark the Entity Type doing business with New York State.
Part II: Taxpayer Identification Number (TIN) and Taxpayer Identification Type
1. Taxpayer Identification Number: Enter your nine-digit Social Security Number,
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Individual Taxpayer Identification Number (ITIN)
or Employer Identification Number.
2. Taxpayer Identification Type: Mark the type of identification number provided.
Part III: Address
1. Physical Address: List the location of where your business is physically located.
2. Remittance Address: List the location where payments should be delivered.
Part IV: Exemption from Backup Withholding and Certification
Generally, reportable payments made by New York State are subject to Backup Withholding.
Exemption from Backup Withholding applies to government and non-United States Business
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Entities
. Please sign, date, provide the preparer’s name, telephone and email address. The
preparer should be employed by your organization.
Part V: Contact Information
Please provide the contact information for an executive at your organization. This individual
should be a person who makes legal and financial decisions for your organization.
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According to IRS Regulations, OSC must withhold 28% of all payments if a payee/vendor fails to provide OSC its certified TIN. The
Substitute Form W-9 certifies a payee/vendor’s TIN.
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An ITIN is a nine-digit number used by the United States Internal Revenue Service for individuals not eligible to obtain a Social Security
Number, but are required to file income taxes. To obtain an ITIN, submit a completed W-7 to the IRS. The IRS will notify you in writing within
4 to 6 weeks about your ITIN status. In order to do business with New York State, you must submit IRS Form W-8 along with our Substitute
Form W-9 showing your ITIN. IRS Form W-8 certifies your foreign status. To obtain IRS FormsW-7 and W-8, call 1-800-829-3676 or visit the
IRS website at
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In order to do business with New York State, you must submit IRS Form W-8 along with our Substitute Form W-9. IRS Form W-8 certifies
your foreign status and exempts you from United States information return reporting and backup withholding rules. To obtain IRS Form W-8,
call 1-800-829-3676 or visit the IRS website at
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