FORM W-9
RETURN TO REQUESTER, DO NOT SEND TO IRS
Request for Taxpayer Identification Number
First Name: ____________________________
Last Name:___________________________________
Home Address: ______________________________ City, State, Zip ____________________________________
United States Citizen
Yes
No
We are required under Section 6041 of the Internal Revenue Code to report to the Internal
Revenue Service certain payments made in a calendar year in excess of $600 to a payee.
In order to do so we request that you complete the section below. Receipt of this information
will provide us with your name and taxpayer identification number (TIN). Failure to furnish your TIN
may subject future payments to backup withholding.
Enter your taxpayer identification number on the Appropriate line. For individuals and sole
proprietors, This is your social security number. For other entities, It is your employer
identification number.
Social Security Number (no dashes please):
Employer Identification Number
____________________
___________________________
Please indicate your type of Business by checking the appropriate box below:
Corporation
Sole Proprietor
Partnership
Individual
Signature: _________________________________________________
(Address Changes) Home Address
Requester Address
Street: ________________________________
Princeton University
Accounts Payable
City/State: _____________________________
P.O. Box 35
Princeton, New Jersey 08544
Zip Code: ______________________________
FAX# (609) 258-2873
NOTE: Mailing address, Signature and Identification Number Required
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