Form W-9, Request for Taxpayer Identification Number (TIN) and Certification

In the case of wanting to request the identification number of a taxpayer from the IRS, the following form has to be completed and submitted.

Extracted Text for Proper Search

Form    	W-9	
(Rev. December 2014)Department of the Treasury  
Internal Revenue Service 	
Request for Taxpayer 
Identification Number and Certification	Give Form to the  
requester. Do not 
send to the IRS.	
Print or type 
See Specific Instructions on page 2.	
1  Name (as shown on your income tax return). Name is required on this \
line; do not leave this line blank.
2  Business name/disregarded entity name, if different from above
3  Check appropriate box for federal tax classification; check only  one of the following seven boxes: 	
Individual/sole proprietor or   
single-member LLC	 C Corporation	S Corporation	Partnership	Trust/estate	
Limited liability company. Enter the tax classification (C=C corporatio\
n, S=S corporation,  P=partnership) 	▶  	
Note. For a single-member LLC that is disregarded, do not check LLC; check th\
e appropriate box in the line above for 
the tax classification of the single-member owner. 
Other (see instructions) 	▶
 	
4  Exemptions (codes apply only to 
certain entities, not individuals; see 
instructions on page 3):
Exempt payee code (if any)
Exemption from FATCA reporting
 code (if any)
(Applies to accounts maintained outside the U.S.)	
5  Address (number, street, and apt. or suite no.)
6  City, state, and ZIP code	
Requester’s name and address (optional)	
7  List account number(s) here (optional)	
Part I	Taxpayer Identification Number (TIN)	
Enter your TIN in the appropriate box. The TIN provided must match the n\
ame given on line 1 to avoid 
backup withholding. For individuals, this is generally your social secur\
ity number (SSN). However, for a 
resident alien, sole proprietor, or disregarded entity, see the Part I i\
nstructions on page 3. For other 
entities, it is your employer identification number (EIN). If you do n\
ot have a number, see  How to get a 
TIN on page 3.
Note. If the account is in more than one name, see the instructions for line 1\
 and the chart on page 4 for 
guidelines on whose number to enter.	Social security number	
– –	
orEmployer identification number 	
–	
Part II	Certification	
Under penalties of perjury, I certify that:
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 fr\
om 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 notif\
ied 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 tha\
t 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, cancellat\
ion of debt, contributions to an individual retirement  arrangement (IRA), and 
generally, payments other than interest and dividends, you are not requi\
red to sign the certification, but you must  provide your correct TIN. See the 
instructions on page 3.
Sign 
Here	Signature of 
U.S. person 	▶	Date 	▶	
General Instructions
Section references are to the Internal Revenue Code unless otherwise not\
ed.
Future developments. Information about developments affecting Form W-9 (such 
as legislation enacted after we release it) is at www.irs.gov/fw9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file a\
n information 
return with the IRS must obtain your correct taxpayer identification num\
ber (TIN) 
which may be your social security number (SSN), individual taxpayer id\
entification 
number (ITIN), adoption taxpayer identification number (ATIN), or em\
ployer 
identification number (EIN), to report on an information return the am\
ount paid to 
you, or other amount reportable on an information return. Examples of in\
formation 
returns include, but are not limited to, the following:
• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual fu\
nds)
• Form 1099-MISC (various types of income, prizes, awards, or gross \
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transact\
ions by 
brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interes\
t), 1098-T 
(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien)\
, to 
provide your correct TIN. 
If you do not return Form W-9 to the requester with a TIN, you might be \
subject 
to backup withholding. See What is backup withholding? on page 2.
By signing the filled-out form, you: 
1. Certify that the TIN you are giving is correct (or you are waiting f\
or 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 paye\
e. If 
applicable, you are also certifying that as a U.S. person, your allocabl\
e share of 
any partnership income from a U.S. trade or business is not subject to t\
he 
withholding tax on foreign partners' share of effectively connected inco\
me, and 
4. Certify that FATCA code(s) entered on this form (if any) indicati\
ng that you are 
exempt from the FATCA reporting, is correct. See What is FATCA reporting? on 
page 2 for further information.	
Cat. No. 10231X	Form 	W-9	 (Rev. 12-2014)

Form W-9 (Rev. 12-2014)	Page 	2 	
Note. If you are a U.S. person and a requester gives you a form other than For\
m 
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 orga\
nized 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 under section 
1446 on any foreign partners’ share of effectively connected taxable \
income from 
such business. Further, in certain cases where a Form W-9 has not been received, 
the rules under section 1446 require a partnership to presume that a partner is a 
foreign person, and pay the section 1446 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 section 1446 withholding on your share of partnership income.
In the cases below, the following person must give Form W-9 to the partn\
ership 
for purposes of establishing its U.S. status and avoiding withholding on\
 its 
allocable share of net income from the partnership conducting a trade or\
 business 
in the United States:
• In the case of a disregarded entity with a U.S. owner, the U.S. own\
er of the 
disregarded entity and not the entity;
• In the case of a grantor trust with a U.S. grantor or other U.S. ow\
ner, generally, 
the U.S. grantor or other U.S. owner of the grantor trust and not the tr\
ust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S\
. trust (other than a 
grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U.S. branch of a foreign bank 
that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use 
the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax 
on Nonresident Aliens and Foreign Entities).
Nonresident alien who becomes a resident alien. Generally, only a nonresident 
alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on 
certain types of income. However, most tax treaties contain a provision known as 
a “saving clause.” Exceptions specified in the saving clause may permit an 
exemption from tax to continue for certain types of income even after the payee 
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception containe\
d in the 
saving clause of a tax treaty to claim an exemption from U.S. tax on cer\
tain types 
of income, you must attach a statement to Form W-9 that specifies the fo\
llowing 
five items:
1. The treaty country. Generally, this must be the same treaty under whi\
ch you 
claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains th\
e saving 
clause and its exceptions.
4. The type and amount of income that qualifies for the exemption from t\
ax.
5. Sufficient facts to justify the exemption from tax under the terms of\
 the treaty 
article.
Example. Article 20 of the U.S.-China income tax treaty allows an exemption 
from tax for scholarship income received by a Chinese student temporarily present 
in the United States. Under U.S. law, this student will become a resident alien for 
tax purposes if his or her stay in the United States exceeds 5 calendar years. 
However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 
1984) allows the provisions of Article 20 to continue to apply even after the 
Chinese student becomes a resident alien of the United States. A Chinese  student 
who qualifies for this exception (under paragraph 2 of the first protocol) and is 
relying on this exception to claim an exemption from tax on his or her scholarship 
or fellowship income would attach to Form W-9 a statement that includes the  
information described above to support that exemption.
If you are a nonresident alien or a foreign entity, give the requester t\
he 
appropriate completed Form W-8 or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you must 
under certain conditions withhold and pay to the IRS 28% of such payments. This 
is called “backup withholding.”  Payments that may be subject to backup 
withholding include interest, tax-exempt interest, dividends, broker and barter  
exchange transactions, rents, royalties, nonemployee pay, payments made \
in 
settlement of payment card and third party network transactions, and  certain 
payments from fishing boat operators. Real estate transactions are not subject to 
backup withholding.
You will not be subject to backup withholding on payments you receive if\
 you 
give the requester your correct TIN, make the proper certifications, and\
 report all 
your taxable interest and dividends on your tax return.
Payments you receive will be subject to backup withholding if: 
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructi\
ons on page 
3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding because \
you did 
not report all your interest and dividends on your tax return (for repo\
rtable interest 
and dividends only), or
5. You do not certify to the requester that you are not subject to backu\
p 
withholding under 4 above (for reportable interest and dividend account\
s opened 
after 1983 only).
Certain payees and payments are exempt from backup withholding. See  Exempt 
payee code on page 3 and the separate Instructions for the Requester of Form 
W-9 for more information.
Also see Special rules for partnerships above.	
What is FATCA reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a participatin\
g foreign 
financial institution to report all United States account holders that a\
re specified 
United States persons. Certain payees are exempt from FATCA reporting. S\
ee 
Exemption from FATCA reporting code on page 3 and the Instructions for the 
Requester of Form W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you claimed t\
o be 
an exempt payee if you are no longer an exempt payee and anticipate rece\
iving 
reportable payments in the future from this person. For example, you may\
 need to 
provide updated information if you are a C corporation that elects to be\
 an S 
corporation, or if you no longer are tax exempt. In addition, you must f\
urnish a new 
Form W-9 if the name or TIN changes for the account; for example, if the\
 grantor 
of a grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are 
subject to a penalty of $50 for each such failure unless your failure is due to 
reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you make a 
false statement with no reasonable basis that results in no backup withholding, 
you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying certifications or 
affirmations may subject you to criminal penalties including fines and/or 
imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, 
the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line blank. The 
name should match the name on your tax return.If this Form W-9 is for a joint account, list first, and then circle, th\
e name of the 
person or entity whose number you entered in Part I of Form W-9.
a.  Individual. Generally, enter the name shown on your tax return. If you have 
changed your last name without informing the Social Security Administrat\
ion (SSA) 
of the name change, enter your first name, the last name as shown on you\
r social 
security card, and your new last name.  
Note. ITIN applicant: Enter your individual name as it was entered on your Form 
W-7 application, line 1a. This should also be the same as the name you e\
ntered on 
the Form 1040/1040A/1040EZ you filed with your application.
b.  Sole proprietor or single-member LLC. Enter your individual name as 
shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, 
or “doing business as” (DBA) name on line 2.
c.  Partnership, LLC that is not a single-member LLC, C Corporation, or S \
Corporation. Enter the entity's name as shown on the entity's tax return on line 1 
and any business, trade, or DBA name on line 2.
d.  Other entities. Enter your name as shown on required U.S. federal tax 
documents on line 1. This name should match the name shown on the charte\
r or 
other legal document creating the entity. You may enter any business, tr\
ade, or 
DBA name on line 2.
e.  Disregarded entity. For U.S. federal tax purposes, an entity that is 
disregarded as an entity separate from its owner is treated as a “dis\
regarded 
entity.”  See Regulations section 301.7701-2(c)(2)(iii). Enter \
the owner's name on 
line 1. The name of the entity entered on line 1 should never be a disre\
garded 
entity. The name on line 1 should be the name shown on the income tax re\
turn on 
which the income should be reported. For example, if a foreign LLC that \
is treated 
as a disregarded entity for U.S. federal tax purposes has a single owner\
 that is a 
U.S. person, the U.S. owner's name is required to be provided on line 1.\
 If the 
direct owner of the entity is also a disregarded entity, enter the first\
 owner that is 
not disregarded for federal tax purposes. Enter the disregarded entity's\
 name on 
line 2, “Business name/disregarded entity name.” If the owner of t\
he disregarded 
entity is a foreign person, the owner must complete an appropriate Form \
W-8 
instead of a Form W-9.  This is the case even if the foreign person has \
a U.S. TIN.

Form W-9 (Rev. 12-2014)	Page 	3 	
Line 2
If you have a business name, trade name, DBA name, or disregarded entity\
 name, 
you may enter it on line 2.
Line 3
Check the appropriate box in line 3 for the U.S. federal tax classificat\
ion of the 
person whose name is entered on line 1. Check only one box in line 3.
Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a 
partnership for U.S. federal tax purposes, check the “Limited Liabili\
ty Company” 
box and enter “P” in the space provided. If the LLC has filed Form\
 8832 or 2553 to 
be taxed as a corporation, check the “Limited Liability Company” b\
ox and in the 
space provided enter “C” for C corporation or “S” for S corp\
oration. If it is a   
single-member LLC that is a disregarded entity, do not check the “Lim\
ited Liability 
Company” box; instead check the first box in line 3 “Individual/so\
le proprietor or 
single-member LLC.”
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter \
in the 
appropriate space in line 4 any code(s) that may apply to you.
Exempt payee code.
•  Generally, individuals (including sole proprietors) are not exem\
pt from backup 
withholding.
•  Except as provided below, corporations are exempt from backup with\
holding 
for certain payments, including interest and dividends.
•  Corporations are not exempt from backup withholding for payments m\
ade in 
settlement of payment card or third party network transactions.
•  Corporations are not exempt from backup withholding with respect t\
o attorneys' 
fees or gross proceeds paid to attorneys, and corporations that provide \
medical or 
health care services are not exempt with respect to payments reportable \
on Form 
1099-MISC.The following codes identify payees that are exempt from backup withhold\
ing. 
Enter the appropriate code in the space in line 4.
1—An organization exempt from tax under section 501(a), any IRA, or\
 a 
custodial account under section 403(b)(7) if the account satisfies t\
he requirements 
of section 401(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or possessio\
n, or 
any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies\
, or 
instrumentalities 
5—A corporation
6—A dealer in securities or commodities required to register in the U\
nited 
States, the District of Columbia, or a U.S. commonwealth or possession 
7—A futures commission merchant registered with the Commodity Futures\
 
Trading Commission
8—A real estate investment trust
9—An entity registered at all times during the tax year under the Inv\
estment 
Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or 
custodian
13—A trust exempt from tax under section 664 or described in section \
4947
The following chart shows types of payments that may be exempt from back\
up 
withholding. The chart applies to the exempt payees listed above, 1 thro\
ugh 13.
IF the payment is for . . .	THEN the payment is exempt for . . .	
Interest and dividend payments	All exempt payees except 
for 7	
Broker transactions	Exempt payees 1 through 4 and 6 
through 11 and all C corporations. S 
corporations must not enter an exempt 
payee code because they are exempt 
only for sales of noncovered securities 
acquired prior to 2012. 	
Barter exchange transactions and 
patronage dividends	Exempt payees 1 through 4	
Payments over $600 required to be 
reported and direct sales over $5,000	1	Generally, exempt payees 
1 through 5	2	
Payments made in settlement of 
payment card or third party network 
transactions 	Exempt payees 1 through 4	
1 See Form 1099-MISC, Miscellaneous Income, and its instructions.	
2 However, the following payments made to a corporation and reportable on \
Form 
1099-MISC are not exempt from backup withholding: medical and health car\
e 
payments, attorneys' fees, gross proceeds paid to an attorney reportable\
 under 
section 6045(f), and payments for services paid by a federal executive\
 agency.
Exemption from FATCA reporting code. The following codes identify payees 
that are exempt from reporting under FATCA. These codes apply to persons\
 
submitting this form for accounts maintained outside of the United State\
s by 
certain foreign financial institutions. Therefore, if you are only submi\
tting this form 
for an account you hold in the United States, you may leave this field b\
lank. 
Consult with the person requesting this form if you are uncertain if the\
 financial 
institution is subject to these requirements. A requester may indicate t\
hat a code is 
not required by providing you with a Form W-9 with “Not Applicable”\
 (or any 
similar indication) written or printed on the line for a FATCA exemptio\
n code.
A—An organization exempt from tax under section 501(a) or any indiv\
idual 
retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a U.S. commonwealth or possessio\
n, or 
any of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or more\
 
established securities markets, as described in Regulations section     \
    
1.1472-1(c)(1)(i)
E—A corporation that is a member of the same expanded affiliated grou\
p as a 
corporation described in Regulations section 1.1472-1(c)(1)(i)
F—A dealer in securities, commodities, or derivative financial instru\
ments 
(including notional principal contracts, futures, forwards, and options\
) that is 
registered as such under the laws of the United States or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an enti\
ty 
registered at all times during the tax year under the Investment Company\
 Act of 
1940
I—A common trust fund as defined in section 584(a)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section 4\
947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g)\
 plan
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). Th\
is is where 
the requester of this Form W-9 will mail your information returns.
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 individual taxpayer 
identification number (ITIN). Enter it in the social security number box. 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 y\
our SSN 
or EIN. However, the IRS prefers that you use your SSN.
If you are a single-member LLC that is disregarded as an entity separate\
 from its 
owner (see Limited Liability Company (LLC) on this page), enter the owner’s SSN 
(or EIN, if the owner has one). Do not enter the disregarded entity’\
s EIN. If the LLC 
is classified as a corporation or partnership, enter the entity’s EIN\
.
Note. See the chart on page 4 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 1-800-772-1213. 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/businesses and clicking on Employer 
Identification Number (EIN) under Starting a Business. You can get Forms W-7  and 
SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM 
(1-800-829-3676).
If you are asked to complete Form W-9 but do not have a TIN, apply for a\
 TIN 
and write “Applied For” in the space for the TIN, sign and date th\
e form, and give it 
to the requester. For interest and dividend payments, and certain paymen\
ts made 
with respect to readily tradable instruments, generally you will have 60\
 days to get 
a TIN and give it to the requester before you are subject to backup with\
holding 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 you\
r 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.
Caution: A disregarded U.S. entity that has a foreign owner must use the 
appropriate Form W-8.

Form W-9 (Rev. 12-2014)	Page 	4 
Part II. Certification	
To establish to the withholding agent that you are a U.S. person, or res\
ident alien, 
sign Form W-9. You may be requested to sign by the withholding agent eve\
n if 
items 1, 4, or 5 below indicate 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 ident\
ified 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  
requester’s 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, payment\
s 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 (und\
er 
section 529), 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	
For this type of account:	Give name and SSN of:
1. Individual	
The individual
2. Two or more individuals (joint              account)The actual owner of the account or, 
if combined funds, the first 
individual on the account	
1	
3. Custodian account of a minor 
 (Uniform Gift to Minors Act)	The minor	2	
4. a. The usual revocable savings  trust (grantor is also trustee) 
b. So-called trust account that is 
not a legal or valid trust under 
state law	The grantor-trustee	1	
The actual owner	1	
5. Sole proprietorship or disregarded entity owned by an individual	The owner	3	
6. Grantor trust filing under Optional Form 1099 Filing Method 1 (see 
Regulations section 1.671-4(b)(2)(i)
(A))	The grantor*	
For this type of account:	Give name and EIN of:
7. Disregarded entity not owned by an  individual	
The owner
8. A valid trust, estate, or pension trust
Legal entity	4	
9. Corporation or LLC electing  corporate status on Form 8832 or 
Form 2553	The corporation
10. Association, club, religious,  charitable, educational, or other tax-
exempt organization
The organization
11. Partnership or multi-member LLC
The partnership
12. A broker or registered nomineeThe broker or nominee
13. 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
The public entity	
14. Grantor trust filing under the Form 1041 Filing Method or the Optional 
Form 1099 Filing Method 2 (see 
Regulations section 1.671-4(b)(2)(i)
(B))	The trust	
1 List first and circle the name of the person whose number you furnish. I\
f only one person	 on a 
joint account has an SSN, that person’s number must be furnished.	
2  Circle the minor’s name and furnish the minor’s SSN.	
3 You must show your individual name and you may also enter your business \
or DBA	 name on 
the “Business name/disregarded entity” name line. You may use eith\
er 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.) Also see 	 Special rules for partnerships	 on page 2.
*Note. Grantor also must provide a Form W-9 to trustee of trust.	
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 a\
s 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 o\
r may file a 
tax return using your SSN to receive a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a not\
ice 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 credit report, contact the IRS Identity Theft Hotline at 1-800-908-44\
90 or submit 
Form 14039.
For more information, see Publication 4535, Identity Theft Prevention an\
d Victim 
Assistance.
Victims of identity theft who are experiencing economic harm or a system\
 
problem, or are seeking help in resolving tax problems that have not bee\
n 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 l\
ine at 
1-877-777-4778 or TTY/TDD 1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes.  Phishing is the 
creation and use of email and websites designed to mimic legitimate business 
emails and websites. The most common act is sending an email to a user falsely 
claiming to be an established legitimate enterprise in an attempt to scam the user 
into surrendering private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emails. Also, the \
IRS does 
not request personal detailed information through email or ask taxpayers\
 for the 
PIN numbers, passwords, or similar secret access information for their c\
redit card, 
bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS, forward\
 this 
message to [email protected]. You may also report misuse of the IRS name, logo, 
or other IRS property to the Treasury Inspector General for Tax Administ\
ration 
(TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Fe\
deral 
Trade Commission at: [email protected] or contact them at www.ftc.gov/idtheft or 
1-877-IDTHEFT (1-877-438-4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your c\
orrect 
TIN to persons (including federal agencies) who are required to file i\
nformation 
returns with the IRS to report interest, dividends, or certain other inc\
ome paid to 
you; mortgage interest you paid; the acquisition or abandonment of secur\
ed 
property; the cancellation of debt; or contributions you made to an IRA,\
 Archer 
MSA, or HSA. The person collecting this form uses the information on the\
 form to 
file information returns with the IRS, reporting the above information. \
Routine uses 
of this information include giving it to the Department of Justice for c\
ivil and 
criminal litigation and to cities, states, the District of Columbia, and\
 U.S. 
commonwealths and possessions for use in administering their laws. The 
information also may be disclosed to other countries under a treaty, to \
federal and 
state agencies to enforce civil and criminal laws, or to federal law enf\
orcement and 
intelligence agencies to combat terrorism. You must provide your TIN whe\
ther or 
not you are required to file a tax return. Under section 3406, payers mu\
st generally 
withhold a percentage of taxable interest, dividend, and certain other p\
ayments to 
a payee who does not give a TIN to the payer. Certain penalties may also\
 apply for 
providing false or fraudulent information.