W9 Information Form
1. Name of entity/individual. As shown on your tax return
*
2. If you entered under a nickname at the event or put a business name above - please enter name below
3. federal tax classification
*
Individual/sole proprietor
C corporation
S corporation
Partnership
Trust/estate
LLC. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)
Other (see instructions)
5. Address (number, street, and apt. or suite no.)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
6. City, State, Zip
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Taxpayer Identification Number
Social security number OR EIN
*
Signature certifies everything you have entered is correct
Signature of U.S. person
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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