Substitute W-9 - Request for Taxpayer Identification Number and Certification

SUBSTITUTE IRS FORM W-9
Request for Taxpayer Identification Number and Certification

This online form fulfills the basic requirements of IRS Form W-9. If additional or more detailed information is needed, please complete and submit your own version of the form. You can find form instructions at www.irs.gov
1) Name of Entity or Individual
2) Business Name
If different from above
2a) Check the appropriate federal tax classification

Individual/sole proprietorC corporationS corporationPartnershipTrust/estateLLC
LLC Classification (If you selected LLC in 2a)
C = Corporation, S = S corporation, P= Partnership
Address

Mailing Address

Street Address Line 2

CityState

Zip Code
Requester’s Name and Address
Patrick Bell & Associates LLC
d/b/a Bell & Associates Property Management
505 Lakeland Plaza, #201, Cumming, GA 30040
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
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.
Completed By

First NameLast Name
Signature of U.S. Person

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Date Signed*

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Date
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SUBSTITUTE IRS FORM W-9

Request for Taxpayer Identification Number and Certification

Part I - Taxpayer Identification Number (TIN)

Part II - Certification