IRS form W9

download IRS form W9

of 4

Transcript of IRS form W9

  • 8/14/2019 IRS form W9

    1/4

    Give form to therequester. Do notsend to the IRS.

    Form W-9 Request for TaxpayerIdentificat ion Number and Cert ificat ion(Rev. J anua ry 2003)

    Depa rtment of the Treas ury

    Internal Revenue Service

    Name

    List account number(s) here (optional)

    Address (number, street, and apt. or suite no.)

    City, state, a nd ZIP code

    Printor

    type

    S

    ee

    Specific

    Instructions

    on

    page

    2.

    Taxpayer Identification Number (TIN)

    Enter your TIN in the a pprop riat e bo x. For individua ls, this is your soc ial sec urity numb er (S S N).

    However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions onpage 3. For other entities, it is your employer identifica tion number (EIN). If you d o not ha ve a number,see How to get a TIN on page 3.

    Social security number

    or

    Requesters name and address (optional)

    Employer identification numberNote: If the acco unt is in more than one name, see the chart on page 4 for guidelines on whose num ber

    to enter. Certification

    1. The number sho wn o n this form is my c orrect taxpa yer identifica tion number (or I am wa iting for a numb er to be iss ued to m e), and

    I am not s ubject to ba ckup withholding b eca use: (a) I am exempt from backup withholding, or (b) I have not been notified by the InternalRevenue 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 hasnotified me that I am no longer subject to backup withholding, and

    2.

    Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backupwithholding 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 retirementarrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you mustprovide your co rrect TIN. (Se e the instructions o n pa ge 4.)

    SignHere

    Signature of

    U.S. person Date

    Purpose of Form

    Form W-9 (Rev. 1-2003)

    Part I

    Part II

    Business name, if different from a bove

    Cat. No. 10231X

    Check appropriate box:

    Under pe nalties of pe rjury, I certify tha t:

    U.S. person. Use Form W-9 only if you are a U.S. person(including a reside nt a lien), to provide yo ur co rrec t TIN to th eperson requesting it (the requester) and, when applicable, to:

    1. Certify that th e TIN you are g iving is c orrect (or you arewaiting 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 aU.S. exempt payee.

    Foreign person. If you are a foreign person, use theappropriate Form W-8 (see Pub. 515, Withho lding o f Ta x onNonresident Aliens and Foreign Entities).

    3. I am a U.S. person (including a U.S. resident alien).

    A person who is required to file an information return withthe IRS, must obtain your correct taxpayer identificationnumber (TIN) to report, for exa mple, income pa id to y ou, rea lestate transactions, mortgage interest you paid, acquisitionor abandonment of secured property, cancellation of debt, orcontributions you made to an IRA.

    Individua l/

    S ole proprietor Corpora tion P artnership Other Exempt from b ac kup

    withholding

    Note: If a requester gives you a form o ther than Form W- 9to request your TIN, you must use the requesters form if it issubstantially similar to this Form W- 9.

    Nonresident alien who becomes a resident alien.Generally, only a nonresident alien individual may use theterms of a tax treaty to reduce or eliminate U.S. tax oncertain types of income. However, most tax treaties contain aprovision known as a saving clause. Exceptions specif iedin the sa ving c lause may permit a n exemption from tax tocontinue for certain types of income even after the recipienthas otherwise become a U.S. resident alien for tax purposes.

    If you are a U.S. resident alien who is relying on anexception contained in the saving clause of a tax treaty toclaim an exemption from U.S. tax on certain types of income,you must attach a statement that specifies the following fiveitems:

    1. The treaty c ountry. G enerally, this m ust be the sa metreaty under which yo u claimed exemption from tax a s anonresident alien.

    2. The trea ty article add res sing the income.

    3. The a rticle numb er (or loca tion) in the ta x treaty t ha tcontains the saving clause and its exceptions.

    4. The type a nd a mount of income tha t q ualifies fo r theexemption from tax.

    5. Sufficient facts to justify the exemption from tax underthe terms of the treaty article.

  • 8/14/2019 IRS form W9

    2/4

    Form W-9 (Rev. 1-2003) P a g e 2

    Sole proprietor. Enter your individual name as shown onyour social sec urity ca rd o n the Name line. You may enteryour business, trade, or doing business a s (DBA) na me o nthe Bus iness name line.

    Other entities. Enter your business name as shown onrequired Federal tax documents on the Name line. Thisname should match the name shown on the charter or otherlega l document c rea ting the entity. You ma y enter a nybusiness, trade, or DBA name on the Bus iness name line.

    If the account is in joint names, list first, and then circle,the name of the person or entity whose number you enteredin Part I of the form.

    Limited liability company (LLC). If you a re a single-memberLLC (including a foreign LLC with a domestic owner) that isdisregarded as an entity separate from its owner underTrea sury reg ulations s ec tion 301.7701-3, enter the ownersname on the Name line. Enter the LLC s name on the Bus iness name line.

    Specific Instructions

    Name

    Exempt From Backup Withholding

    G ene rally, individua ls (including so le proprietors) a re notexempt from ba ckup withholding. C orporations a re exemp tfrom backup withholding for certain payments, such as

    interest and dividends.

    5. You do not certify to the requester that you are notsubject to ba ckup withholding under 4 above (for reportableinterest and dividend ac co unts opened after 1983 only).

    Certain payees and payments are exempt from backupwithholding. See the instructions below and the separateInstructions for the Requester of Form W-9.

    Civil penalty for false information with respect towithholding. If you make a false statement with noreasonable basis that results in no backup withholding, youare subject to a $500 penalty.

    Criminal penalty for falsifying information. Willfullyfalsifying certifications or affirmations may subject you tocriminal p ena lties including fines a nd/or impriso nment.

    PenaltiesFailure to furnish TIN. If you fa il to furnish yo ur co rrec t TINto a requester, you are subject to a penalty of $50 for eachsuch failure unless your failure is due to reasonable cause

    and not to willful neglect.

    Misuse of TINs. If the reque ste r disc los es or uses TINs inviolation o f Federal law, the reques ter may be subject to c iviland criminal penalties.

    If you are an individual, you must generally enter the nameshown on your social security card. However, if you havechanged your last name, for instance, due to marriagewithout informing the Social Security Administration of thename change, enter your first name, the last name shown onyour social security card, and your new last name.

    Exempt payees. Backup withholding is not required on anypayments ma de to the following payees :

    1. An organization exempt from tax under section 501(a),any IRA, or a custodial account under section 403(b)(7) if theaccount satisfies the requirements of section 401(f)(2);

    2. The United S tates or any of its a ge ncies orinstrumentalities;

    3. A state, the District of Columbia, a possession of theUnited States, or any of their political subdivisions orinstrumentalities;

    4. A foreign government or any of its political subdivisions,

    agencies, or instrumentalities; or5. An international organization or any of its agencies or

    instrumentalities.

    Other payees that may be exempt from b ac kupwithholding include:

    6. A co rporation;

    7. A foreign central bank of issue;

    8. A dealer in securities or commodities required to registerin the United Sta tes, the District o f Co lumbia, or aposse ssion of the United S tates;

    If you are exempt, enter your name as described above andcheck the appropriate box for your status, then check the Exempt from ba ckup withholding bo x in the line follow ingthe business name, sign and date the form.

    4. The IRS tells yo u that you a re s ubjec t to ba ckupwithholding because you did not report all your interest anddividends on your tax return (for reportable interest anddividends only), or

    3. The IRS tells the req ues ter that you furnishe d a ninco rrec t TIN, o r

    2. You d o no t c ertify yo ur TIN when required (se e the P artII instructions on page 4 for details), or

    You w ill not be subject to backup withholding on paymentsyou rece ive if you give the req ues ter your co rrec t TIN, makethe proper certifications, and report all your taxable interestand dividend s o n your tax return.

    1. You d o no t furnish y our TIN to the req ues ter, or

    What is backup withholding? Persons making certainpayments to you must under certain conditions withhold andpay to the IRS 30% of such payments (29% after December31, 2003; 28% after Dec embe r 31, 2005). This is ca lledbac kup withholding. Pa yments that may be subject tobackup withholding include interest, dividends, broker andbarter exchange transactions, rents, royalties, nonemployee

    pay, and certain payments from fishing boat operators. Realestate transactions are not subject to backup withholding.

    Payments you receive will be subject to backupwithholding if:

    If you are a nonresident alien or a foreign entity no tsubject to b ac kup w ithholding, give the reques ter theappropriate completed Form W-8.

    Example. Article 20 of the U.S.-China income tax treatyallow s a n exemption from ta x for scholarship incomerece ived b y a Chinese s tudent temporarily present in theUnited States. Under U.S. law, this student will become aresident alien for tax purposes if his or her stay in the UnitedSta tes exceed s 5 c alenda r years. However, paragraph 2 ofthe first Protocol to the U.S.-China treaty (dated April 30,1984) allows the provisions of Article 20 to continue to applyeven after the Chinese student becomes a resident alien ofthe United States. A Chinese student who qualifies for this

    exception (under paragraph 2 of the first protocol) and isrelying on this exception to claim an exemption from tax onhis or her scholarship or fellow ship income wo uld atta ch toForm W-9 a statement that includes the informationdescribed above to support that exemption.

    Note: You are requested to check the appropr iate box foryour status (individual/sole prop rieto r, corporation, etc. ).

    Note: If you are exempt from backup withholding, you shouldstill com plete this form to avoid possible erroneous backup

    withholding.

  • 8/14/2019 IRS form W9

    3/4

    Form W-9 (Rev. 1-2003) P a g e 3

    Part I. Taxpayer IdentificationNumber (TIN)

    Enter your TIN in the appropriate box. If you are a residentalien and you do not have and are not eligible to get anS S N, your TIN is your IRS individua l taxpa yer identifica tionnumb er (ITIN). Ente r it in the s oc ial se c urity numbe r box . Ifyou d o not ha ve a n ITIN, see How to get a TIN below.

    How to get a TIN. If you d o no t ha ve a TIN, apply for oneimmediate ly. To a pply for an S S N, get Form SS-5,Applica tion for a S ocial S ecurity C ard, from your loc al S ocialSecurity Administration office or get this form on-line atwww.ssa.gov/online/ss5.html . You may also get this formby calling 1-800-772-1213. Use Form W-7, Application forIRS Individua l Taxpa yer Identifica tion Numbe r, to a pply for a nITIN, or Form SS-4, Application for Employer IdentificationNumber, to apply for an EIN. You can get Forms W-7 andS S -4 from the IRS b y c a lling 1-800-TAX-FORM(1-800-829-3676) or from t he IRS Web S ite a t www.irs.gov.

    If you are asked to complete Form W-9 but do not have aTIN, write Applied For in the spa ce for the TIN, sign a nddate the form, and give it to the requester. For interest anddividend payments, and certain payments made with respectto readily tradable instruments, generally you will have 60da ys to get a TIN and g ive it to the req uester before you a resub jec t to ba ckup withholding o n paym ents . The 60-da y ruledoes not apply to other types of payments. You will besubject to b ac kup w ithholding on all such payme nts until youprovide y our TIN to the req ues ter.

    If you are a sole proprietor and you have an EIN, you may

    enter either your SSN or EIN. However, the IRS prefers thatyou use your SSN.

    If you are a single-owner LLC that is d isregarded as anentity se parate from its o wner (see Limited liabilitycompany (LLC) on page 2), enter your SSN (or EIN, if youhave one). If the LLC is a corporation, partnership, etc., enterthe entitys EIN.

    Note: See the chart on page 4 for further clarification ofname and TIN com binations.

    Note:WritingApplied Formeans that you have alreadyapplied fo r a TIN or that you intend to apply for one soon.

    Caution: A disregarded domestic entity that has a foreignowner must use the approp riate Form W- 8.

    9. A futures commission merchant registered with theCo mmo dity Futures Trad ing C omm ission;

    10. A real estate investment trust;

    11. An entity registered at all times during the tax yearunder the Investment Company Act of 1940;

    12. A common trust fund operated by a bank undersection 584(a);

    13. A financial institution;

    14. A middleman known in the investment community as anominee or custodian; or

    15. A trust exempt from tax under section 664 ordes cribed in se ction 4947.

    THEN the payment is exemptfor . . .

    If the payment is for . . .

    All exempt recipients exce ptfor 9

    Interest and dividend payments

    Exempt recipients 1 through 13.

    Also, a person registered underthe Investment Advisers Act of1940 who regularly ac ts a s abroker

    Broker transactions

    Exempt recipients 1 through 5Barter exchange transactionsand patronage dividends

    Generally, exempt recipients1 through 7 2

    Payments over $600 requiredto be reported a nd directsales over $5,000 1

    1See Form 1099-MISC, Miscellaneous Income, and its instructions.

    2However, the following payments made to a corporation (including gross

    proceeds paid to an attorney under section 6045(f), even if the attorney is acorporation) and reportab le on Form 1099-MISC are not exempt from backupwithholding: medical and health care payments, attorneys fees; and payments

    for services paid by a Federal executive agency.

    The cha rt below s hows types of pay ments that may b eexemp t from b a ckup withholding. The cha rt a pplies to theexempt recipients listed ab ove, 1 through 15.

  • 8/14/2019 IRS form W9

    4/4

    Form W-9 (Rev. 1-2003) P a g e 4

    What Name and Number To Give theRequester

    Give name and SSN of:For this type of account:

    The individua l1. Individual

    The ac tual owner of the ac countor, if combined funds, the firstindividual on the account 1

    2. Tw o or m ore individua ls (jointaccount)

    The minor 23. Custodian account of a minor(Uniform Gift to Minors Act)

    The granto r-truste e 14. a. The usual revoca blesavings trust (grantor isalso trustee)

    1. Interest, dividend, and barter exchange accountsopened before 1984 and broker accounts consideredactive during 1983. You mus t give yo ur correc t TIN, but yo udo not have to sign the certification.

    The a ctua l owner 1b. So-called trust acco untthat is not a legal or validtrust under state law2. Interest, dividend, broker, and barter exchange

    accounts opened after 1983 and broker accountsconsidered inactive during 1983. You must sign thecertification or backup withholding will apply. If you aresubject to backup withholding and you are merely providingyour correct TIN to the req ueste r, you mus t cross out item 2in the certification before signing the form.

    The o wn er 35. Sole proprietorship orsingle-owner LLC

    Give name and EIN of:For this type of account:

    3. Real estate transactions. You must sign thecertification. You may cross out item 2 of the certification.

    A valid trust, estate, orpension trust

    6.

    Legal entity 4

    4. Other payments. You must g ive your c orrect TIN, butyou do not have to sign the certification unless you havebee n notified that you ha ve previous ly given an inco rrec t TIN.Other payments include payments made in the course ofthe requesters trade or business for rents, royalties, goods(other than bills for merchandise), medical and health careservice s (including pa yments to c orporations), pa yments to anonemployee for services, payments to certain fishing boatcrew members and fishermen, and gross proceeds paid toattorneys (including payments to corporations).

    The co rpora tionCorporate or LLC electingcorporate status on Form8832

    7.

    The orga niza tionAss oc iation, club, religious,charitable, ed ucational, o rother tax-exempt organization

    8.

    5. Mortgage interest paid by you, acquisition orabandonment of secured property, cancellation of debt,qualified tuition program payments (under section 529),IRA or Archer MSA contributions or distributions, andpension distributions. You mus t g ive your c orrect TIN, but

    you do not have to sign the certification.

    The p a rtnershipPartnership or multi-memberLLC

    9.

    The b roker or nom ineeA broker or registerednominee

    10.

    The public e ntityAccount with the Departmentof Agriculture in the name ofa public entity (such as a

    state or loca l government,school district, or prison) thatreceives agricultural programpayments

    11.

    Privacy Act Notice

    1List first a nd c ircle the na me of the person whos e number you furnish. If only

    one person on a joint acc ount has an SS N, that persons number must befurnished.

    2Circle the minors name and furnish the minors SS N.

    3You must show your individual name, but you may also enter yourbusiness or DB A name. You may use either your SS N or EIN (if you haveone).

    4List first a nd c ircle the na me o f the legal trust, esta te, or pens ion trust. (Do

    not furnish the TIN of the perso nal representa tive or trustee un less the leg alentity itself is not designated in the account title.)

    Note: If no name is circled when more than one name islisted, the number w ill be considered to be that of the first

    name listed.

    Sole proprietorship orsingle-owner LLC

    The o wn er 3

    12.

    Part II. Certification

    For a joint ac co unt, only the person w hos e TIN is s how n inPart I should sign (when required). Exempt recipients, seeExempt from backup withholding on page 2.

    You mus t provide your TIN whethe r or not you a re req uired to file a tax return. P a yers m ust g enera lly withhold 30% of taxa bleinterest, d ividend , and certain other payme nts to a paye e w ho do es not give a TIN to a pa yer. Ce rtain penalties may also a pply.

    To e sta blish to the withholding a gent tha t you a re a U.S.person, or resident alien, sign Form W-9. You may berequested to sign by the withholding agent even if items 1, 3,and 5 below indicate otherwise.

    S ec tion 6109 of the Internal Revenue Co de req uires you to provide your co rrec t TIN to persons who must file information returnswith the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition orab a ndo nment of s ec ured p roperty, ca nce lla tion of d ebt, o r contributions you ma de to a n IRA or Arche r MSA. The IRS use s thenumbe rs for ide ntifica tion purpos es and to help verify the ac curac y of your tax return. The IRS ma y also p rovide this informationto the Depa rtment of J ustice for civil and criminal litiga tion, a nd to c ities , sta tes , and the District of C olumbia to ca rry out theirtax laws . We ma y a lso disclose this information to other co untries under a ta x trea ty, or to Fede ral and sta te ag encies to e nforceFederal nontax c riminal law s and to c omba t terrorism.

    Signature requirements. Co mplete the ce rtifica tion a sindicated in 1 through 5 below.