PROFESSIONAL BULL RIDERS LLC - W9 Form & Vendor Creation

Vendor Creation and Change
Vendor Name*
Vendor Contact Person*
Vendor Email Address*
example@example.com
Vendor Phone Number*
Please enter a valid phone number.
Banking and Direct Deposit Authorization

I authorize the Professional Bull Riders, LLC. (PBR) to initiate direct deposit of all funds due me by PBR forAccounts Payables. Additionally, I authorize PBR to initiate adjustments for any transactions credited ordebited in error to the account(s) indicated below.I understand this authority will remain in effect until I notify PBR in writing to request cancellation. In theevent I terminated the account listed below, I agree to notify PBR immediately. I understand my failure to doso may result in the delay of receipt of my payment.Please leave banking blank if you wish to receive a hard check via USPS. Prior banking is necessary to add ifrequesting a banking change in order to combat potential fraud
NEW Bank Account Holder
NEW Bank Name
NEW Bank Address
NEW Bank ABA Routing #
NEW Bank Account #
PRIOR Bank Account Holder
PRIOR Bank Name
PRIOR Bank Address
PRIOR Bank ABA Routing #
PRIOR Bank Account #
REMOVE PRIOR Banking information from PBR System
Request for Taxpayer Identification Number and Certification

Go to www.irs.gov/FormW9 for instructions and the latest information.
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
3a. 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.*

Individual/sole proprietor or single-member LLCC CorporationS CorporationPartnershipTrust/estateLimited liability company.Other
If you are an individual/sole proprietor/ single member LLC, you must provide your Social Security Number as we will not accept an EIN. Your personal name must also be on line 1
If you selected "Limited liability company", enter the tax classification*
(C=C corporation, S=S corporation, P=Partnership)
3b. If on line 3a you checked "Partnership" or "Trust/estate" or checked "LLC" and entered "P" as its tax classification, and you are providing this for to a partnership, trust, or estate in which you have an ownership interest, check the box below if you have any foreign partners, owners, or beneficiaries.

Check this box if you have any foreign partners, owners, or beneficiaries.
3b. If on line 3a you checked "Partnership" or "Trust/estate" or checked "LLC" and entered "P" as its tax classification, and you are providing this for to a partnership, trust, or estate in which you have an ownership interest, check the box below if you have any foreign partners, owners, or beneficiaries.

Check this box if you have any foreign partners, owners, or beneficiaries.
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
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 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. 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.
Social security number
A*
A*
A*
-
G*
G*
-
S*
S*
S*
S*
Employer identification number
X*
X*
-
X*
X*
X*
X*
X*
X*
X*
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. 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 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 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 for Part II, later.
Signature*

Clear
Date

MonthDayYear
Date
You can check out the details and general instructions below:
Should be Empty:

Vendor Creation and Change

Request for Taxpayer Identification Number and Certification

If you are an individual/sole proprietor/ single member LLC, you must provide your Social Security Number as we will not accept an EIN. Your personal name must also be on line 1

Part I - Taxpayer Identification Number (TIN)

Social security number

Employer identification number

Part II - Certification