Form W-9 - Request For Taxpayer Identification Number And Certification - 2014 Page 3
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Form W-9 (Rev. 12-2014)
Page
Line 2
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However, the following payments made to a corporation and reportable on Form
1099-MISC are not exempt from backup withholding: medical and health care
If you have a business name, trade name, DBA name, or disregarded entity name,
payments, attorneys' fees, gross proceeds paid to an attorney reportable under
you may enter it on line 2.
section 6045(f), and payments for services paid by a federal executive agency.
Line 3
Exemption from FATCA reporting code. The following codes identify payees
that are exempt from reporting under FATCA. These codes apply to persons
Check the appropriate box in line 3 for the U.S. federal tax classification of the
submitting this form for accounts maintained outside of the United States by
person whose name is entered on line 1. Check only one box in line 3.
certain foreign financial institutions. Therefore, if you are only submitting this form
Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a
for an account you hold in the United States, you may leave this field blank.
partnership for U.S. federal tax purposes, check the “Limited Liability Company”
Consult with the person requesting this form if you are uncertain if the financial
box and enter “P” in the space provided. If the LLC has filed Form 8832 or 2553 to
institution is subject to these requirements. A requester may indicate that a code is
be taxed as a corporation, check the “Limited Liability Company” box and in the
not required by providing you with a Form W-9 with “Not Applicable” (or any
space provided enter “C” for C corporation or “S” for S corporation. If it is a
similar indication) written or printed on the line for a FATCA exemption code.
single-member LLC that is a disregarded entity, do not check the “Limited Liability
A—An organization exempt from tax under section 501(a) or any individual
Company” box; instead check the first box in line 3 “Individual/sole proprietor or
retirement plan as defined in section 7701(a)(37)
single-member LLC.”
B—The United States or any of its agencies or instrumentalities
Line 4, Exemptions
C—A state, the District of Columbia, a U.S. commonwealth or possession, or
If you are exempt from backup withholding and/or FATCA reporting, enter in the
any of their political subdivisions or instrumentalities
appropriate space in line 4 any code(s) that may apply to you.
D—A corporation the stock of which is regularly traded on one or more
Exempt payee code.
established securities markets, as described in Regulations section
• Generally, individuals (including sole proprietors) are not exempt from backup
1.1472-1(c)(1)(i)
withholding.
E—A corporation that is a member of the same expanded affiliated group as a
• Except as provided below, corporations are exempt from backup withholding
corporation described in Regulations section 1.1472-1(c)(1)(i)
for certain payments, including interest and dividends.
F—A dealer in securities, commodities, or derivative financial instruments
• Corporations are not exempt from backup withholding for payments made in
(including notional principal contracts, futures, forwards, and options) that is
settlement of payment card or third party network transactions.
registered as such under the laws of the United States or any state
• Corporations are not exempt from backup withholding with respect to attorneys'
G—A real estate investment trust
fees or gross proceeds paid to attorneys, and corporations that provide medical or
H—A regulated investment company as defined in section 851 or an entity
health care services are not exempt with respect to payments reportable on Form
registered at all times during the tax year under the Investment Company Act of
1099-MISC.
1940
The following codes identify payees that are exempt from backup withholding.
I—A common trust fund as defined in section 584(a)
Enter the appropriate code in the space in line 4.
J—A bank as defined in section 581
1—An organization exempt from tax under section 501(a), any IRA, or a
K—A broker
custodial account under section 403(b)(7) if the account satisfies the requirements
of section 401(f)(2)
L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
2—The United States or any of its agencies or instrumentalities
M—A tax exempt trust under a section 403(b) plan or section 457(g) plan
3—A state, the District of Columbia, a U.S. commonwealth or possession, or
Note. You may wish to consult with the financial institution requesting this form to
any of their political subdivisions or instrumentalities
determine whether the FATCA code and/or exempt payee code should be
completed.
4—A foreign government or any of its political subdivisions, agencies, or
instrumentalities
Line 5
5—A corporation
Enter your address (number, street, and apartment or suite number). This is where
6—A dealer in securities or commodities required to register in the United
the requester of this Form W-9 will mail your information returns.
States, the District of Columbia, or a U.S. commonwealth or possession
Line 6
7—A futures commission merchant registered with the Commodity Futures
Trading Commission
Enter your city, state, and ZIP code.
8—A real estate investment trust
Part I. Taxpayer Identification Number (TIN)
9—An entity registered at all times during the tax year under the Investment
Company Act of 1940
Enter your TIN in the appropriate box. If you are a resident alien and you do not
have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer
10—A common trust fund operated by a bank under section 584(a)
identification number (ITIN). Enter it in the social security number box. If you do not
11—A financial institution
have an ITIN, see How to get a TIN below.
12—A middleman known in the investment community as a nominee or
If you are a sole proprietor and you have an EIN, you may enter either your SSN
custodian
or EIN. However, the IRS prefers that you use your SSN.
13—A trust exempt from tax under section 664 or described in section 4947
If you are a single-member LLC that is disregarded as an entity separate from its
The following chart shows types of payments that may be exempt from backup
owner (see Limited Liability Company (LLC) on this page), enter the owner’s SSN
withholding. The chart applies to the exempt payees listed above, 1 through 13.
(or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC
is classified as a corporation or partnership, enter the entity’s EIN.
IF the payment is for . . .
THEN the payment is exempt for . . .
Note. See the chart on page 4 for further clarification of name and TIN
combinations.
Interest and dividend payments
All exempt payees except
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply
for 7
for an SSN, get Form SS-5, Application for a Social Security Card, from your local
SSA office or get this form online at You may also get this form by
Broker transactions
Exempt payees 1 through 4 and 6
calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer
through 11 and all C corporations. S
Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer
corporations must not enter an exempt
Identification Number, to apply for an EIN. You can apply for an EIN online by
payee code because they are exempt
accessing the IRS website at and clicking on Employer
only for sales of noncovered securities
Identification Number (EIN) under Starting a Business. You can get Forms W-7 and
acquired prior to 2012.
SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM
(1-800-829-3676).
Barter exchange transactions and
Exempt payees 1 through 4
If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN
patronage dividends
and write “Applied For” in the space for the TIN, sign and date the form, and give it
to the requester. For interest and dividend payments, and certain payments made
Payments over $600 required to be
Generally, exempt payees
with respect to readily tradable instruments, generally you will have 60 days to get
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reported and direct sales over $5,000
1 through 5
a TIN and give it to the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you provide your TIN to
Payments made in settlement of
Exempt payees 1 through 4
the requester.
payment card or third party network
transactions
Note. Entering “Applied For” means that you have already applied for a TIN or that
you intend to apply for one soon.
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See Form 1099-MISC, Miscellaneous Income, and its instructions.
Caution: A disregarded U.S. entity that has a foreign owner must use the
appropriate Form W-8.
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