Form W-9 - Request For Taxpayer Identification Number And Certification - 2017 Page 3
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Form W-9 (Rev. 11-2017)
Page
Criminal penalty for falsifying information. Willfully falsifying
IF the entity/person on line 1 is
THEN check the box for . . .
certifications or affirmations may subject you to criminal penalties
a(n) . . .
including fines and/or imprisonment.
• Corporation
Corporation
Misuse of TINs. If the requester discloses or uses TINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
• Individual
Individual/sole proprietor or single-
member LLC
• Sole proprietorship, or
Specific Instructions
• Single-member limited liability
company (LLC) owned by an
Line 1
individual and disregarded for U.S.
federal tax purposes.
You must enter one of the following on this line; do not leave this line
blank. The name should match the name on your tax return.
• LLC treated as a partnership for
Limited liability company and enter
If this Form W-9 is for a joint account (other than an account
U.S. federal tax purposes,
the appropriate tax classification.
maintained by a foreign financial institution (FFI)), list first, and then
(P= Partnership; C= C corporation;
• LLC that has filed Form 8832 or
circle, the name of the person or entity whose number you entered in
or S= S corporation)
2553 to be taxed as a corporation,
Part I of Form W-9. If you are providing Form W-9 to an FFI to document
or
a joint account, each holder of the account that is a U.S. person must
• LLC that is disregarded as an
provide a Form W-9.
entity separate from its owner but
a. Individual. Generally, enter the name shown on your tax return. If
the owner is another LLC that is
you have changed your last name without informing the Social Security
not disregarded for U.S. federal tax
Administration (SSA) of the name change, enter your first name, the last
purposes.
name as shown on your social security card, and your new last name.
• Partnership
Partnership
Note: ITIN applicant: Enter your individual name as it was entered on
• Trust/estate
Trust/estate
your Form W-7 application, line 1a. This should also be the same as the
name you entered on the Form 1040/1040A/1040EZ you filed with your
Line 4, Exemptions
application.
If you are exempt from backup withholding and/or FATCA reporting,
b. Sole proprietor or single-member LLC. Enter your individual
enter in the appropriate space on line 4 any code(s) that may apply to
name as shown on your 1040/1040A/1040EZ on line 1. You may enter
you.
your business, trade, or “doing business as” (DBA) name on line 2.
Exempt payee code.
c. Partnership, LLC that is not a single-member LLC, C
• Generally, individuals (including sole proprietors) are not exempt from
corporation, or S corporation. Enter the entity's name as shown on the
backup withholding.
entity's tax return on line 1 and any business, trade, or DBA name on
• Except as provided below, corporations are exempt from backup
line 2.
withholding for certain payments, including interest and dividends.
d. Other entities. Enter your name as shown on required U.S. federal
• Corporations are not exempt from backup withholding for payments
tax documents on line 1. This name should match the name shown on the
made in settlement of payment card or third party network transactions.
charter or other legal document creating the entity. You may enter any
business, trade, or DBA name on line 2.
• Corporations are not exempt from backup withholding with respect to
attorneys’ fees or gross proceeds paid to attorneys, and corporations
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
that provide medical or health care services are not exempt with respect
disregarded as an entity separate from its owner is treated as a
to payments reportable on Form 1099-MISC.
“disregarded entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter
the owner's name on line 1. The name of the entity entered on line 1
The following codes identify payees that are exempt from backup
should never be a disregarded entity. The name on line 1 should be the
withholding. Enter the appropriate code in the space in line 4.
name shown on the income tax return on which the income should be
1—An organization exempt from tax under section 501(a), any IRA, or
reported. For example, if a foreign LLC that is treated as a disregarded
a custodial account under section 403(b)(7) if the account satisfies the
entity for U.S. federal tax purposes has a single owner that is a U.S.
requirements of section 401(f)(2)
person, the U.S. owner's name is required to be provided on line 1. If
2—The United States or any of its agencies or instrumentalities
the direct owner of the entity is also a disregarded entity, enter the first
owner that is not disregarded for federal tax purposes. Enter the
3—A state, the District of Columbia, a U.S. commonwealth or
disregarded entity's name on line 2, “Business name/disregarded entity
possession, or any of their political subdivisions or instrumentalities
name.” If the owner of the disregarded entity is a foreign person, the
4—A foreign government or any of its political subdivisions, agencies,
owner must complete an appropriate Form W-8 instead of a Form W-9.
or instrumentalities
This is the case even if the foreign person has a U.S. TIN.
5—A corporation
Line 2
6—A dealer in securities or commodities required to register in the
United States, the District of Columbia, or a U.S. commonwealth or
If you have a business name, trade name, DBA name, or disregarded
possession
entity name, you may enter it on line 2.
7—A futures commission merchant registered with the Commodity
Line 3
Futures Trading Commission
Check the appropriate box on line 3 for the U.S. federal tax
8—A real estate investment trust
classification of the person whose name is entered on line 1. Check only
9—An entity registered at all times during the tax year under the
one box on line 3.
Investment Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section
4947
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