W9 -Request for Taxpayer Identification Number and Certification

Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service
Request for Taxpayer Identification Number and Certification
Go to www.irs.gov/FormW9 for instructions and the latest information.

Give Form to the requester. Do not send to the IRS.
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 of the person whose name is entered on line 1. Check only one of the following seven boxes.

C CorporationIndividual/sole proprietor or single-member LLCS CorporationPartnershipTrust/estateLimited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)
4. Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):Exempt payee code (if any)
Specific Instructions
5 Address number, street, and apt. or suite number
5 Address cont. City, State, and Zip code
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.
Enter Employer Identification number above OR
Social security number
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.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Request for Taxpayer Identification Number and Certification

Specific Instructions

Taxpayer Identification Number (TIN)