Form W-13 - Exstars Reporting Information Request For Taxpayer Identification Number And Certification
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1
2W-13
ExSTARS Reporting Information Request for
Form
Employer Identification Number and Certification
(January 2014)
Department of the Treasury
▶
Information about Form W-13 and its instructions is at
Internal Revenue Service
Name (as shown on your tax returns; see instructions)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
C corporation
S corporation
Partnership
Trust/estate
Individual/sole proprietor
Limited liability company (see instructions). Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
▶
Other (see instructions)
▶
Address (number, street, and apt. or suite no.)
Requester’s name and address
City, state, and ZIP code
Part I
Employer Identification Number (EIN)
Social security numbers not permitted in
Enter your EIN in the appropriate box. The EIN provided must be for the ExSTARS transaction entity.
ExSTARS reporting.
Report the disregarded entity's EIN, not the owner's EIN, when applicable.
Employer identification number
–
Part II
Certification
Under penalties of perjury, I certify that the number shown on this form is my correct employer identification number.
Sign
Signature of
Here
U.S. person
Date
▶
▶
Type or write
name and title
▶
Section references are to the Internal Revenue Code unless otherwise noted.
Misuse of EINs. If the requester discloses or uses EINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Future Developments
Specific Instructions
For the latest information about developments related to Form W-13
and its instructions, such as legislation enacted after they were
Name
published, go to
Sole proprietor. Enter your individual name as shown on your income
General Instructions
tax return on the “Name” line. You may enter your business, trade, or
“doing business as (DBA)” name on the “Business name/disregarded
Purpose of Form
entity name” line.
Partnership, C corporation, or S corporation. Enter the entity's name
Filers should use this form to request a valid employer identification
on the “Name” line and any business, trade, or “doing business as
number (EIN) for purposes of Excise Summary Terminal Activity
(DBA) name” on the “Business name/disregarded entity name” line.
Reporting System (ExSTARS) reporting.
Limited liability company (LLC). If the person identified on the “Name”
A person who is required to file an ExSTARS information return with
line is an LLC, check the “Limited liability company” box only and enter
the IRS must obtain your correct EIN to report. For example, a truck
the appropriate code for the tax classification in the space provided. If
carrier making a delivery to a terminal must provide the carrier
you are an LLC that is treated as a partnership for federal tax purposes,
company's EIN to the terminal operator.
enter “P” for partnership.
The receiving party returns the form to the requester after providing a
Note. If you are an LLC that has elected to be treated as a disregarded
correct EIN.
entity separate from its owner under Regulation section 301.7701-3,
Updating Your Information
check the LLC box and select the appropriate classification of the
disregarded entity, not the owner listed in the “Name” line.
You must provide the requester with updated information if the name or
EIN changes while still engaged in ExSTARS reporting activities.
Disregarded entity. Enter the owner's name on the “Name” line. The
name of the entity entered on the “Name” line should never be a
Penalties
disregarded entity. The name on the “Name” line must be the name
Failure to furnish EIN. If you fail to furnish your correct EIN to a
shown on the income tax return on which the income will be reported.
requester, you are subject to a penalty of $50 for each such failure
For example, if a foreign LLC that is treated as a disregarded entity for
unless your failure is due to reasonable cause and not to willful neglect.
U.S. federal tax purposes has a domestic owner, the domestic owner's
name is required to be provided on the “Name” line. If the direct owner
Civil penalty for false information with respect to withholding. If you
of the entity is also a disregarded entity, enter the first owner that is not
make a false statement with no reasonable basis that results in no
disregarded for federal tax purposes. Enter the disregarded entity's
backup withholding, you are subject to a $500 penalty.
name on the “Business name/disregarded entity name” line.
Criminal penalty for falsifying information. Willfully falsifying
Note. Check the appropriate box for the federal tax classification of the
certifications or affirmations may subject you to criminal penalties
person whose name is entered on the “Name” line (Individual/sole
including fines and/or imprisonment.
proprietor, partnership, C corporation, S corporation, trust/estate).
W-13
Form
(1-2014)
Cat. No. 62958V
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