Form Ss-4 - Application For Employer Identification Number - 2017

Download a blank fillable Form Ss-4 - Application For Employer Identification Number - 2017 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Ss-4 - Application For Employer Identification Number - 2017 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

What is Form Ss-4 and Instructions on filling it out

SS-4

Application for Employer Identification Number

OMB No. 1545-0003

(For use by employers, corporations, partnerships, trusts, estates, churches,

Form

EIN

government agencies, Indian tribal entities, certain individuals, and others.)

(Rev. December 2017)

Go to for instructions and the latest information.

▶

Department of the Treasury

See separate instructions for each line.

Keep a copy for your records.

Internal Revenue Service

▶

Legal name of entity (or individual) for whom the EIN is being requested

Trade name of business (if different from name on line 1)

Executor, administrator, trustee, “care of” name

Mailing address (room, apt., suite no. and street, or P.O. box) 5a

Street address (if different) (Do not enter a P.O. box.)

City, state, and ZIP code (if foreign, see instructions)

County and state where principal business is located

Name of responsible party

SSN, ITIN, or EIN

Is this application for a limited liability company (LLC)

8b If 8a is “Yes,” enter the number of

(or a foreign equivalent)?

LLC members .

Yes

▶

If 8a is “Yes,” was the LLC organized in the United States?

Yes

Type of entity (check only one box). Caution. If 8a is “Yes,” see the instructions for the correct box to check.

Sole proprietor (SSN)

Estate (SSN of decedent)

Partnership

Plan administrator (TIN)

Corporation (enter form number to be filed)

Trust (TIN of grantor)

▶

Personal service corporation

Military/National Guard

State/local government

Church or church-controlled organization

Farmers’ cooperative

Federal government

Other nonprofit organization (specify)

REMIC

Indian tribal governments/enterprises

▶

Other (specify)

Group Exemption Number (GEN) if any

▶

If a corporation, name the state or foreign country (if

State

Foreign country

applicable) where incorporated

Reason for applying (check only one box)

Banking purpose (specify purpose)

▶

Started new business (specify type)

Changed type of organization (specify new type)

▶

Purchased going business

Hired employees (Check the box and see line 13.)

Created a trust (specify type)

▶

Compliance with IRS withholding regulations

Created a pension plan (specify type)

▶

Other (specify)

▶

Closing month of accounting year

Date business started or acquired (month, day, year). See instructions.

If you expect your employment tax liability to be $1,000 or

less in a full calendar year and want to file Form 944

Highest number of employees expected in the next 12 months (enter -0- if none).

annually instead of Forms 941 quarterly, check here.

If no employees expected, skip line 14.

(Your employment tax liability generally will be $1,000

or less if you expect to pay $4,000 or less in total wages.)

Agricultural

Household

Other

If you do not check this box, you must file Form 941 for

every quarter.

First date wages or annuities were paid (month, day, year). Note: If applicant is a withholding agent, enter date income will first be paid to

nonresident alien (month, day, year) .

▶

Check one box that best describes the principal activity of your business.

Health care & social assistance

Wholesale-agent/broker

Construction

Rental & leasing

Transportation & warehousing

Accommodation & food service

Wholesale-other

Retail

Real estate

Manufacturing

Finance & insurance

Other (specify)

▶

Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.

Has the applicant entity shown on line 1 ever applied for and received an EIN?

Yes

If “Yes,” write previous EIN here

▶

Complete this section only if you want to authorize the named individual to receive the entity’s EIN and answer questions about the completion of this form.

Third

Designee’s name

Designee’s telephone number (include area code)

Party

Designee

Address and ZIP code

Designee’s fax number (include area code)

Applicant’s telephone number (include area code)

Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.

Name and title (type or print clearly)

▶

Applicant’s fax number (include area code)

Signature

Date

▶

SS-4

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.

Form

(Rev. 12-2017)

Cat. No. 16055N