Note: You may wish to consult with the financial institution requesting this form to determine whether
the FATCA code and/or exempt payee code should be completed.
Line 5
Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will
mail your information returns. If this address differs from the one the requester already has on file, enter NEW at the top. If a new address is provided, there is still a chance the old address will be used until the payor changes your
address in their records.
Line 6
Enter your city,
state, and ZIP code.
Part I. Taxpayer Identification Number (TIN)
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 ITIN.
Enter it in the entry space for the Social security number. If you do not have an ITIN, see How to get a TIN below.
If you are a
sole proprietor and you have an EIN, you may enter either your SSN or EIN.
If you are a single-member LLC that is disregarded as an
entity separate from its owner, enter the owners SSN (or EIN, if the owner has one). If the LLC is classified as a corporation or partnership, enter the entitys EIN.
Note: See What Name and Number To Give the Requester, later, for further clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5,
Application for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 800-772-1213. Use
Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for
an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/EIN. Go to www.irs.gov/Forms to view, download, or print Form W-7 and/or Form
SS-4. Or, you can go to www.irs.gov/OrderForms to place an order and have Form W-7 and/or Form SS-4 mailed to you within
15 business days.
If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN
and enter 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 with respect to readily tradable instruments, you will generally have 60
days to get 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 the requester.
Note: Entering Applied For means that you have already applied for a
TIN or that you intend to apply for one soon. See also Establishing U.S. status for purposes of chapter 3 and chapter 4 withholding, earlier, for when you may instead be subject to withholding under chapter 3 or 4 of the Code.
Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.
Part II. Certification
To establish to the withholding
agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, 4, or 5 below indicates otherwise.
For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person
identified on line 1 must sign. Exempt payees, see Exempt payee code, earlier.
Signature requirements. Complete the certification as
indicated in items 1 through 5 below.
1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts
considered active during 1983. You must give your correct TIN, but you do not have to sign the certification.
2. Interest,
dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely
providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form.
3. Real estate
transactions. You must sign the certification. You may cross out item 2 of the certification.
4. Other payments. You must give
your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. Other payments include payments made in the course of the requesters trade or business
for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third-party network
transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments
(under section 529), ABLE accounts (under section 529A), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification.
What Name and Number To Give the Requester
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For this type of account: |
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Give name and SSN of: |
1. |
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Individual |
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The individual |
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2. |
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Two or more individuals (joint account) other than an account maintained by an FFI |
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The actual owner of the account or, if combined funds, the first individual on the account1 |
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3. |
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Two or more U.S. persons (joint account maintained by an FFI) |
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Each holder of the account |
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4. |
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Custodial account of a minor (Uniform Gift to Minors Act) |
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The minor2 |
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a. The usual revocable savings trust (grantor is also trustee) |
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The grantor-trustee1 |
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b. So-called trust account that is not a legal or valid trust under state law |
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The actual owner1 |
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Sole proprietorship or disregarded entity owned by an individual |
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The owner3 |
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Grantor trust filing under Optional Filing Method 1 (see Regulations section 1.671-4(b)(2)(i)(A))** |
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The grantor* |
For this type of account: |
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Give name and EIN of: |
8. |
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Disregarded entity not owned by an individual |
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The owner |
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A valid trust, estate, or pension trust |
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Legal entity4 |
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10. |
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Corporation or LLC electing corporate status on Form 8832 or Form 2553 |
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The corporation |
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Association, club, religious, charitable, educational, or other tax-exempt organization |
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The organization |
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Partnership or multi-member LLC |
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The partnership |
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A broker or registered nominee |
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The broker or nominee |
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Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments |
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The public entity |
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Grantor trust filing Form 1041 or under the Optional Filing Method 2, requiring Form 1099 (see Regulations section 1.671-4(b)(2)(i)(B))** |
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The trust |
1 |
List first and circle the name of the person whose number you furnish. If only one person on a joint account
has an SSN, that persons number must be furnished. |
2 |
Circle the minors name and furnish the minors SSN. |
3 |
You must show your individual name on line 1, and enter your business or DBA name, if any, on line 2. You may
use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. |
4 |
List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal
representative or trustee unless the legal entity itself is not designated in the account title.) |
* Note: The grantor must also
provide a Form W-9 to the trustee of the trust.
** For more information on optional filing methods for grantor
trusts, see the Instructions for Form 1041.
Note: If no name is circled when more than one name is listed, the number will be considered to be
that of the first name listed.
Secure Your Tax Records From Identity Theft
Identity theft occurs when someone uses your personal information, such as your name, SSN, or other identifying information, without your permission to commit
fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund.
To
reduce your risk:
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Ensure your employer is protecting your SSN, and |
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Be careful when choosing a tax return preparer. |
If your tax records are affected by identity
theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter.
If your
tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity, or a questionable credit report, contact the IRS Identity Theft Hotline at 800-908-4490 or submit Form 14039.
For more information, see
Pub. 5027, Identity Theft Information for Taxpayers.
Victims of identity theft who are experiencing economic harm or a systemic problem,
or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 877-777-4778 or TTY/TDD 800-829-4059.