Form 214 - Substitute Form W-9 - Energy Trust Of Oregon
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1Substitute Form W-9
214
Legal/Finance | Form
Request for Taxpayer Identification and Certification (collected on behalf of Energy Trust and its subcontractors)
I. Type of Entity: Choose One of the Options Below
Individual or Sole Proprietor
Individuals or Sole Proprietors may receive a 1099 from Energy Trust. Persons known to file as self-employed are required to
pay self-employment taxes and file using their Social Security number. Self-employed filers are not eligible for unemployment
benefits.
-
-
Name (as shown on your last income tax return)
Social Security Number or
-
Business or Trade Name (assumed business name if different than above)
EIN, if applicable
Business, Partnership, Trust or Joint Venture, LLC or LLP
Business entities other than corporations may receive a 1099 from Energy Trust.
-
Business Name (as shown on income tax return)
Business EIN
Business or Trade Name (assumed business name if different than above)
Corporations
(including not-for-profit corporations) While corporations will not receive a 1099 from Energy Trust, we still require a W-9 for our
files.
-
Name of Corporation (as shown on income tax return)
Corporation EIN
Business or Trade Name (assumed business name if different than above)
Government
Public school districts, city, county, state, and federal entities in some cases may receive a 1099 form from Energy Trust.
-
Name of Government Entity (as shown on income tax return)
Government EIN
Agency within Government Entity (if different than above)
II. Tax Filing Address
Street
Phone Number
City
State
Zip
III. Signature and Certification
Under penalties of perjury, I hereby certify that: 1) the above information is true and correct, 2) I am not subject to backup withholding,
and 3) I am a U.S. person (including a U.S. resident alien).
Signature:
Date:
Form 0214 v2016.1 160822
Page 1 of 1
Return completed form to:
Energy Trust of Oregon - New Manufactured Homes
PO Box 2445 ♦ Spokane, Washington 99210-2445
1.800.972.8793 ♦ Fax 503.575.4316
energyt
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