Looking for a Substitute Form W-9 Templates? Download it for free!

State Of South Dakota Substitute W-9 - Taxpayer Identification Number (Tin) Verification - Northern State University Page 2

Instructions for Completing Taxpayer Identification Number Verification

(Substitute W-9)

Legal Name As entered with IRS

Individuals: Enter Last Name, First Name MI

Sole Proprietorships: Enter Last Name, First Name MI

All Others: Enter Legal Name of Business

Trade Name

Individuals: Leave Blank

Sole Proprietorships: Enter Business Name

All Others: Complete only if doing business as a DBA

Order Address

Address where orders should be sent.

Remit Address

Address where checks should be sent.

Entity Designation

ONE

Check

box which describes the type of business entity.

Taxpayer Identification Number

LIST ONLY ONE:

Social Security Number

Employer Identification Number

Individual Taxpayer Identification Number.

If you do not have a TIN, apply for one immediately. Individuals use federal form SS-05 which can be obtained from the Social

Security Administration. Businesses and all other entities use federal form SS-04 which can be obtained from the Internal

Revenue Service.

Certification

You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding

because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.

For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual

retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the

Certification, but you must provide your correct TIN.

Privacy Act Notice

Section 6109 requires you to furnish your correct TIN to persons who must file information returns with the IRS to report interest,

dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property,

or contributions you made to an IRA. The IRS uses the numbers for identification purposes and to help verify the accuracy of

your tax return. You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold

28% of taxable interest, dividend, and certain other payments to a payee who does not furnish a TIN to a payer. Certain penalties

may also apply.

State Of South Dakota Substitute W-9 - Taxpayer Identification Number (Tin) Verification - Northern State University Page 2