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    This document is an IRS Form W-9 used to request a taxpayer identification number from an individual or entity. It provides instructions on completing the form to ensure accurate reporting of income to avoid backup withholding. Key details include certifying one's taxpayer ID number is correct, certifying whether or not they are subject to backup withholding, and defining who qualifies as a U.S. person for tax purposes.

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    This document is an IRS Form W-9 used to request a taxpayer identification number from an individual or entity. It provides instructions on completing the form to ensure accurate reporting of income to avoid backup withholding. Key details include certifying one's taxpayer ID number is correct, certifying whether or not they are subject to backup withholding, and defining who qualifies as a U.S. person for tax purposes.

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    154 views1 page

    LG FF

    Uploaded by

    feem743
    This document is an IRS Form W-9 used to request a taxpayer identification number from an individual or entity. It provides instructions on completing the form to ensure accurate reporting of income to avoid backup withholding. Key details include certifying one's taxpayer ID number is correct, certifying whether or not they are subject to backup withholding, and defining who qualifies as a U.S. person for tax purposes.

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    of 1

    Form W-9 Request for Taxpayer Give Form to the

    (Rev. December 2011) Identification Number and Certification requester. Do not


    Department of the Treasury send to the IRS.
    Internal At '"ntie Service

    -r on your income tax return) \ .
    (.A, . W _
    ,r:;ifV ,/name/disregarded entity name, if different from above
    1\f..!l jK appropriate box lor federal tax
    proprietor 0 C Corporation o S Corporation
    'F.

    Umlted liability company. Enter the tax classification (C=C corporation. corporation, P=PMtnership)
    o Partnership D TrusVestate
    ______..._______ ________________ .;
    Exempt payee
    Requester's name and address (optionaQ
    ______
    Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line
    to avoid backup withholding. For individuals. this is your social security number (SSN). However. for a
    resident alien. sole proprietor. or disregarded entity, see the Part I instructions on page 3. For other
    entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
    TIN on page 3.
    Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
    identification IlUnmer .--.J
    number to enter.
    m-1111! III
    'dill Certification
    Under penalties of perjury, I certify that:
    1. The number shown on this fomn is my correct taxpayer identification number (or I am waiting for a n umber 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 Reven ""'"'
    Service ORS) 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
    no longer subject to backup withholding, and
    3. I am a U.s. citizen or other U.S. person (defined below).
    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 retum. 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 on page 4.
    Sign Signat.... of
    Here u.s. person...
    Section references are to the Intemal Revenue Code unless otherwise
    noted.
    Purpose of Form
    A person who is required to file an information return with the IRS must
    obtain your correct taxpayer identification number (TIN) to report, for
    example, incorne paid to you, real estate transactions, mortgage interest
    you paid, acquisition or abandonment of secured property, cancellation
    of debt, or contributions you made to an IRA
    Use Form W-9 only if you are a U.S. person (including a resident
    alien), to prOVide your correct TIN to the person requesting it (the
    requester) and, when applicable. to:
    1. Certify that the TIN you are giving is correct (or you are waiting for a
    number to be issued),
    2. Certify that you are not subject to backup withholding. or
    3. Claim exemption from backup withholding if you are a U.S. exempt
    payee. If applicable, you are also certifying that as a U.S. person, your
    allocable share of any partnership income from a U.S. trade or business
    is not subject to the withholding tax on foreign partners' share of
    effectively connected income.
    Date
    Note. If a requester gives you a form other than Form W-9 to request
    your TIN, you must use the requester's form if it is substantially similar
    to this Form W-9.
    Definition of a U.S. person. For federal tax purposes. you are
    considered a U.S. person if you are:
    An individual who is a U.S. citizen or U.S. resident alien,
    A partnership, corporation, company, or association created or
    organized in the United States or under the laws of the United States,
    An estate (other than a foreign estate), or
    A domestic trust (as defined in Regulations section 301.7701-7).
    Special rules for partnerships. Partnerships that conduct a trade or
    business in the United States are generally required to pay a withholding
    tax on any foreign partners' share of income from such business.
    Further, in certain cases where a Form W-9 has not been received. a
    partnership is required to presume that a partner is a foreign person.
    and pay the withholding tax. Therefore, if you are a U.S. person that is a
    partner in a partnership conducting a trade or business in the United
    States. provide Form W-9 to the partnership to establish your U.S.
    status and avoid withholding on your share of partnership income.
    Cat. No. 10231X Form W-9(Rev. 12

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