Form W-7a - Application For Taxpayer Identification Number For Pending U.s. Adoptions
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1W-7A
Application for Taxpayer Identification Number
Form
for Pending U.S. Adoptions
OMB No. 1545-0074
(Rev. October 2017)
Department of the Treasury
Go to for instructions and the latest information.
▶
Internal Revenue Service
Note: Don't file this form if you are eligible to obtain a U.S. social security number (SSN) for your adoptive child.
1
Adoptive
1a Parent’s last name
First name
Social security number
parent(s)
information
1b Parent’s last name
First name
Social security number
(see instructions)
2
Adoptive
Street address, apartment number, or rural route number. If you have a P.O. box, see the instructions.
parent(s)
address
City or town, state, and ZIP code
(see instructions)
3
Child’s name:
3a Last name
First name
Middle name
As it will appear
▶
on your tax return
3b Last name
First name
Middle name
Birth name if different
and known .
.
▶
4
Child’s birth
Date of birth (month, day, year)
Place of birth (city or town, and state) (If foreign address, see instructions)
Female
information
Male
Name
Address
Date child
5
Placement
was placed
agency
with adoptive
parents
information
Note: Be sure to attach the required documentation to Form W-7A. See instructions.
Sign
Under penalties of perjury, I declare that I have examined this application, including accompanying documentation and statements, and to
Here
the best of my knowledge and belief, it is true, correct, and complete.
Signature of parent
Date (month, day, year)
Daytime phone number
Keep a copy of this
form for your
records.
Signature of parent
Date (month, day, year)
Daytime phone number
W-7A
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Form
(Rev. 10-2017)
Cat. No. 24309E
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