PERSONAL SERVICE COPORATION EIN APPLICATION FORM
Complete this form to apply for an Employer Identification Number (EIN). Please provide accurate and complete information.
GENERAL INFORMATION
Legal Name of Personal Service Corporation
*
Does the Personal Service Corporation operate under a DBA?
Yes
No
Enter DBA Name
*
Where was the company organized?
*
Please Select
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Republic of Marshall Islands
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Principal Officer Information
First Name
*
Middle Name (optional)
Last Name
*
Name Suffix (optional)
Please Select
MD
PHD
Jr.
Sr.
I
II
III
IV
V
VI
VII
VIII
IX
X
Title
*
Please Select
Managing Member
Owner
President
CEO
Executor
Managing member/Owner
Other
Social Security Number (SSN)
*
Used for identity verification purposes (format: 123-45-6789).
Corporation Activity
Primary Purpose for Submitting this Form
*
Please Select
Started New Business
Changed Type of Organization
Hired Employees
Banking Purposes
Other
Main Line of Business or Service
*
Please Select
Construction
Real Estate
Rental & Leasing
Manufacturing
Transportation & Warehousing
Finance & Insurance
Health Care & Social Assistance
Accommodation & Food Service
Wholesale-Agent/Broker
Wholesale-Other
Retail
Other
General questions
Own or operate a highway vehicle weighing 55,000 lbs or more?
*
Yes
No
Engaged in gambling operations?
*
Yes
No
Involved in the sale or manufacture of alcohol, tobacco, or firearms?
*
Yes
No
Responsible for federal excise tax payments?
*
Yes
No
Has this Personal service corporation previously applied for or received an EIN?
*
Yes
No
Previous EIN number, first 2 digits:
*
0 of 2 max characters
Previous EIN number, last 7 digits:
*
0 of 7 max characters
Do you currently have, or plan to hire, employees within the next year (not including owners)?
*
Yes
No
Corporate Address
(P.O. boxes not accepted)
Street Address
*
City
*
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
*
Country
*
Would you like correspondence sent to a different address?
Yes
No
Street Address
*
City
*
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
*
Country
*
Key Dates
Date Personal service corporation was formed or acquired
*
-
Month
-
Day
Year
Date
Fiscal Year-End Month
*
Please Select
January
February
March
April
May
June
July
August
September
October
November
December
Applicants Contact Information
Mobile Phone Number
*
(Format: (123) 456-7890)
Format: (000) 000-0000.
Email Address
*
Provide the best email address for official correspondence and confirmation notices
Authorization and Acknowledgment
Please check all boxes to proceed
*
By checking this box, I confirm under penalty of perjury that all information provided is accurate, agree to the Terms of Use, and give my electronic authorization for einfastfiling.com and its representatives to act as my third-party designee, as described in the Form SS-4 instructions, to prepare, complete, sign as designee, and submit Form SS-4 to the IRS on my behalf, to answer IRS questions about this application, and to receive the EIN assigned to me or my entity. I understand that this electronic authorization has the same legal effect as a handwritten signature and that my name, timestamp, and IP address will be recorded as proof of my consent.
I authorize einfastfiling.com to charge my payment method for the applicable service fees.
Typed Name
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: