Form W-9 - Request For Taxpayer Identification Number And Certification - Internal Revenue Service Page 2

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2
Form W-9 (Rev. 11-99)
Page
Specific Instructions
Part II—For Payees Exempt From
persons who must file information returns
Backup Withholding
with the IRS to report interest, dividends,
Name. If you are an individual, you must
and certain other income paid to you,
Individuals (including sole proprietors) are
generally enter the name shown on your
mortgage interest you paid, the acquisition
not exempt from backup withholding.
social security card. However, if you have
or abandonment of secured property,
Corporations are exempt from backup
changed your last name, for instance, due
cancellation of debt, or contributions you
withholding for certain payments, such as
to marriage, without informing the Social
made to an IRA or MSA. The IRS uses the
interest and dividends. For more
Security Administration of the name
numbers for identification purposes and to
information on exempt payees, see the
change, enter your first name, the last
help verify the accuracy of your tax return.
separate Instructions for the Requester of
name shown on your social security card,
The IRS may also provide this information
Form W-9.
and your new last name.
to the Department of Justice for civil and
If you are exempt from backup
criminal litigation, and to cities, states, and
If the account is in joint names, list first
withholding, you should still complete this
the District of Columbia to carry out their
and then circle the name of the person or
form to avoid possible erroneous backup
tax laws.
entity whose number you enter in Part I of
withholding. Enter your correct TIN in Part
the form.
You must provide your TIN whether or
I, write “Exempt” in Part II, and sign and
not you are required to file a tax return.
Sole proprietor. You must enter your
date the form.
Payers must generally withhold 31% of
individual name as shown on your social
If you are a nonresident alien or a foreign
taxable interest, dividend, and certain other
security card. You may enter your
entity not subject to backup withholding,
payments to a payee who does not give a
business, trade, or “doing business as”
give the requester a completed Form W-8
TIN to a payer. Certain penalties may also
name on the business name line.
(certification of foreign status).
apply.
Other entities. Enter your business
name as shown on required Federal tax
Part III—Certification
What Name and Number To
documents. This name should match the
For a joint account, only the person whose
name shown on the charter or other legal
Give the Requester
TIN is shown in Part I should sign (when
document creating the entity. You may
required).
enter any business, trade, or “doing
For this type of account:
Give name and SSN of:
business as” name on the business name
1. Interest, dividend, and barter
1. Individual
The individual
line.
exchange accounts opened before 1984
2. Two or more
The actual owner of the
and broker accounts considered active
individuals (joint
account or, if combined
account)
funds, the first individual
Part I—Taxpayer Identification Number
during 1983. You must give your correct
1
on the account
(TIN)
TIN, but you do not have to sign the
3. Custodian account of
The minor
2
certification.
a minor (Uniform Gift
You must enter your TIN in the appropriate
to Minors Act)
2. Interest, dividend, broker, and
box. If you are a resident alien and you do
1
4. a. The usual
The grantor-trustee
barter exchange accounts opened after
not have and are not eligible to get an
revocable savings
1983 and broker accounts considered
SSN, your TIN is your IRS individual
trust (grantor is
inactive during 1983. You must sign the
also trustee)
taxpayer identification number (ITIN). Enter
1
certification or backup withholding will
b. So-called trust
The actual owner
it in the social security number box. If you
account that is not
apply. If you are subject to backup
do not have an ITIN, see How to get a
a legal or valid trust
withholding and you are merely providing
TIN below.
under state law
your correct TIN to the requester, you must
5. Sole proprietorship
The owner
3
If you are a sole proprietor and you have
cross out item 2 in the certification before
an EIN, you may enter either your SSN or
signing the form.
For this type of account:
Give name and EIN of:
EIN. However, using your EIN may result in
3. Real estate transactions. You must
6.
Sole proprietorship
The owner
3
unnecessary notices to the requester.
sign the certification. You may cross out
4
7.
A valid trust, estate, or
Legal entity
Note: See the chart on this page for further
pension trust
item 2 of the certification.
clarification of name and TIN combinations.
8.
Corporate
The corporation
4. Other payments. You must give your
How to get a TIN. If you do not have a
9.
Association, club,
The organization
correct TIN, but you do not have to sign
religious, charitable,
TIN, apply for one immediately. To apply
educational, or other
the certification unless you have been
for an SSN, get Form SS-5, Application for
tax-exempt
notified that you have previously given an
a Social Security Card, from your local
organization
incorrect TIN. “Other payments” include
10.
Partnership
The partnership
Social Security Administration office. Get
payments made in the course of the
11.
A broker or registered
The broker or nominee
Form W-7, Application for IRS Individual
requester’s trade or business for rents,
nominee
Taxpayer Identification Number, to apply
royalties, goods (other than bills for
12.
Account with the
The public entity
for an ITIN or Form SS-4, Application for
Department of
merchandise), medical and health care
Employer Identification Number, to apply
Agriculture in the name
services (including payments to
of a public entity (such
for an EIN. You can get Forms W-7 and
corporations), payments to a nonemployee
as a state or local
SS-4 from the IRS by calling
government, school
for services, payments to certain fishing
1-800-TAX-FORM (1-800-829-3676) or
district, or prison) that
boat crew members and fishermen, and
receives agricultural
from the IRS’s Internet Web Site at
gross proceeds paid to attorneys (including
program payments
payments to corporations).
1
If you do not have a TIN, write “Applied
List first and circle the name of the person whose
5. Mortgage interest paid by you,
number you furnish. If only one person on a joint
For” in the space for the TIN, sign and
acquisition or abandonment of secured
account has an SSN, that person’s number must be
date the form, and give it to the requester.
furnished.
property, cancellation of debt, qualified
For interest and dividend payments, and
state tuition program payments, IRA or
2
Circle the minor’s name and furnish the minor’s SSN.
certain payments made with respect to
MSA contributions or distributions, and
3
readily tradable instruments, generally you
You must show your individual name, but you may also
pension distributions. You must give your
enter your business or “doing business as” name. You
will have 60 days to get a TIN and give it
correct TIN, but you do not have to sign
may use either your SSN or EIN (if you have one).
to the requester. Other payments are
the certification.
4
List first and circle the name of the legal trust, estate,
subject to backup withholding.
or pension trust. (Do not furnish the TIN of the personal
Note: Writing “Applied For” means that
representative or trustee unless the legal entity itself is
Privacy Act Notice
not designated in the account title.)
you have already applied for a TIN OR that
Section 6109 of the Internal Revenue Code
Note: If no name is circled when more than one
you intend to apply for one soon.
requires you to give your correct TIN to
name is listed, the number will be considered to
be that of the first name listed.

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