IRS W-9 Request for Taxpayer Identification Number and Certification

IRS W-9 Request for Taxpayer Identification Number and Certification
Department of the Treasury Internal Revenue Service

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 of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2
1

First NameLast Name
2 Business name/disregarded entity name, if different from above.
Check the appropriate box for tax classification.
.

Individual/sole proprietorC corporationS corporationPartnershipTrust/estateLLC.
If you selected LLC above, Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its 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 Foreign Account Tax Compliance Act (FATCA) reporting code (if any)
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 form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See Specific Instructions
5 Address (number, street, and apt. or suite no.)
Street Address
6 City, state, and ZIP code
7 List account number(s) here (optional)
Requester's Address

Requester’s name and address (optional)

Street Address Line 2

CityState / Province

Postal / Zip Code
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.
Social Security Number
Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter.
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

Powered by Jotform SignClear
Date

MonthDayYear
Date
Your privacy is important to us. Your information provided is encrypted by this leading, reputable Jotform platform and will be shared only with our accounting department as needed to process commission payments to you as a consignor of the Woman's Exchange. All local, state, and Federal laws apply. Thank you for consigning with us.
Should be Empty:

IRS W-9 Request for Taxpayer Identification Number and Certification

Part I

Taxpayer Identification Number (TIN)

Certification