YTCD - W9 From

Form W9

Request for Taxpayer Identification Number and Certification
General Instructions
Vendors and qualfied Independant Contractors, will need to submit the following prior to receiving payment.
- Completed and submitted W9 Form below.
- Invoices for every project or period of service must be submitted. Please includie dates of service and description of work or services provided.
- Invoices should be submitted to bookkeeper@ytc.edu.
If you have any questions or require additional information, please contact bookkeeper@ytc.edu or 303-536-1803 x 1.

Please complete and submit the W9 Form below
Individual/Business Information
1. Name as shown on your income tax return
2. Business/Entity name, if different from above
3. Check appropriate box for federal tax classification of the person whose name is entered on line 1.

Other
If you selected "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)
Exemption from FATCA reporting code(if any)
5. Address

Number, Street, and Apt. or Suite No.

Street Address Line 2

CityState

Zip Code
Part I - Taxpayer Identification Number (TIN)
Will you be using a Social Security Number or Employer Identification Number?
Social Security Number
Employer 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 from 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 notified 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.
Signature
Date

MonthDayYear
Date
Email Address
example@example.com
Additional Details
Please see details and general instructions below:
Payment Information
Would you like to be paid via Direct Deposit or check?
Name on Bank Account
Routing Number
Account Number
Account Type
Should be Empty:

Form W9

General Instructions

Individual/Business Information

Part I - Taxpayer Identification Number (TIN)

Part II - Certification

Additional Details

Payment Information