Request for Taxpayer Identification Number and Certification

Request for Taxpayer Identification Number and Certification
Go to www.irs.gov/FormW9 for instructions and the latest information.

Complete this form. Do not send to the IRS.

Purpose of form: An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they
must obtain your correct taxpayer identification number (TIN), which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples can be found on Page 2 of the IRS W-9 Form shown below.

General Instructions: Refer to theW-9 form shown below for complete instructions. Complete the following fields and select Preview PDF to view your completed form and check for accuracy. Contact your Mountain Heights Property Manager if you have any questions.
1. Name of entity/individual. (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*
2. Business name/disregarded entity name, if different from above.
3a. Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line Check only one of the following boxes:*

Individual/sole proprietorC corporationS CorporationPartnershipTrust/estateOther
Other (see instructions)
Is your Business an LLC?*

YesNo
Note: If Business is an LLC, 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.
Enter the tax classification of your LLC (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 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 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):
Address - This is your mailing address, not your rental address. *

5 Address number, street, and apt. or suite no See instructions. See

Street Address Line 2

6 City, state, and ZIP codeState / Province

Postal / Zip Code
7. 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. See also What Name and Number To Give the Requester for guidelines on whose number to enter.
Social Security Number
Employee 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.

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*

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Request for Taxpayer Identification Number and Certification

Part I - Taxpayer Identification Number (TIN)

Part II - Certification