This is a request for Taxpayer Identification Number and Certification.
IRS regulations require that we issue 1099 forms. In order to accurately prepare these forms, the IRS requires that we obtain and maintain form W-9 for all of our officers. Failure to provide your Social Security Number or EIN may result in the delay of future payments or backup withholdings.
Please fill out the information below even if you are exempt from backup withholding.
Tips for accurately completing form:
Line 1 or 2: Name to enter if selecting:
- Individual/sole proprietor or single-member LLC – Enter your individual name as shown on your 1040 line 1. You may enter your business or “doing business as” (DBA) name on line 2.
- C-Corporation, S-Corporation, Partnership, Trust/estate or Limited liability company – Enter name as shown on the business tax return (1120, 1120S, 1065, 1041).
Part 1: Taxpayer Identification Number (TIN)
- If Individual/sole proprietor or single-member LLC box is checked, enter Social security number
- If any other classification boxes are checked, enter Employer identification number
Go to www.irs.gov/FormW9 for more instructions and the latest information.
As shown on your income tax return
Disregarded entity name if different from above
Part I - Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.
Part II - Certification
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. 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. See the instructions for Part II, later.
