Substitute W9 Form - Town Of Derry, New Hampshire

ADVERTISEMENT

TOWN OF DERRY NH
SUBSTITUTE W9 FORM
Pursuant to Internal Revenue Service Regulations, you must furnish your Taxpayer Identification Number (TIN) to the
Town of Derry. If this number is not provided, you may be subject to backup withholding on each payment. To avoid this
withholding and to insure that accurate tax information is reported to the Internal Revenue Service, please use this form to
provide the requested information.
ALL INFORMATION SHOULD BE AS IT APPEARS ON YOUR TAX RETURN!
(as reported to the IRS) ________________ _______________________________________________
LEGAL NAME
(if different from above) ______________________________________________________
DOING BUSINESS AS
(street, city, state, zip)___________________________________________________________
LEGAL ADDRESS
(if different from above) ____________________ ____________________________
REMIT (MAILING) ADDRESS
_____________________________________________________________________________________
CITY/STATE/ZIP
_________________________________________________________________________________
WEBSITE ADDRESS
___________________________________________________________________________________
EMAIL ADDRESS
(
TAXPAYER IDENTIFICATION NUMBER
AS IT APPEARS ON YOUR TAX RETURNS)
Social Security number (if individual/sole proprietor) ____ ____ ____ -- ____ ____ -- ____ ____ ____ ____
Federal Employer Identification Number (all others) ____ ____ -- _____ ____ ____ ____ ____ ____ ____
TAXPAYER TYPE (Please check one)
Individual/Sole Proprietor
_______
Partnership
________
LLC 1099 Vendor
_______
Corporation
________ (C) ______ (S) ______
LLC Exempt
_______
Estate or Trust
________
Non-Profit Corporation
_______
Other (Please specify) ________
Non-Profit Not Incorporated _______
(List Type of Service or Product Provided) ________________________________
PRINCIPAL BUSINESS ACTIVITY
_____________________________
______________________________
TELEPHONE NUMBER
FAX NUMBER
Under penalties of perjury, I declare that the information provided is true, correct, and complete to the best of my
knowledge and belief.
SIGNATURE __________________________________________DATE __________________________
PRINTED NAME _____________________________________TITLE_______________________________
Please mail or fax this form back to the Town of Derry, Finance Dept, 14 Manning St, Derry NH 03038 Fax
number 603-432-6760 Attention Debbie

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form 49464 - Of A New Hampshire Limited Liability Company Of A New Hampshire Limited Liability Company - 2012 Form 49464 - Of A New Hampshire Limited Liability Company Of A New Hampshire Limited Liability Company - 2012 Business
Application For Site Plan Approval Form - Town Of Somers, New York Application For Site Plan Approval Form - Town Of Somers, New York Legal
Form Llc-1 - Certificate Of Formation Of A New Hampshire Limited Liability Company, Form Sra - Addendum To Business Organization And Registration Forms Form Llc-1 - Certificate Of Formation Of A New Hampshire Limited Liability Company, Form Sra - Addendum To Business Organization And Registration Forms Business
Form Nhct-1 - Register Of Charitable Trusts Application For Registration - Office Of The New Hampshire Attorney General Charitable Trust Unit Form Nhct-1 - Register Of Charitable Trusts Application For Registration - Office Of The New Hampshire Attorney General Charitable Trust Unit Legal
Form Cd-57 - Real Estate Transfer Tax Declaration Of Consideration - New Hampshire Department Of Revenue Administration Form Cd-57 - Real Estate Transfer Tax Declaration Of Consideration - New Hampshire Department Of Revenue Administration Financial
Form Dp-160 - Schedule Of Credits - New Hampshire Department Of Revenue Administration - 2011 Form Dp-160 - Schedule Of Credits - New Hampshire Department Of Revenue Administration - 2011 Financial
Form Ms-1 - Summary Inventory Of Valuation - New Hampshire Department Of Revenue Administration - 2007 Form Ms-1 - Summary Inventory Of Valuation - New Hampshire Department Of Revenue Administration - 2007 Financial
Form Dp-2848 - Power Of Attorney - New Hampshire Department Of Revenue Administration Form Dp-2848 - Power Of Attorney - New Hampshire Department Of Revenue Administration Financial
Form Pllc-1 - Certificate Of Formation New Hampshire Professional Limited Liability Company, Form Sra - Addendum To Business Organization And Registration Forms Form Pllc-1 - Certificate Of Formation New Hampshire Professional Limited Liability Company, Form Sra - Addendum To Business Organization And Registration Forms Financial
Form Dsss 41 - Application For Swim Line Permit - Department Of Safety - New Hampshire Form Dsss 41 - Application For Swim Line Permit - Department Of Safety - New Hampshire Legal

Related Categories

Parent category: Financial
Download
Go