|
For this type of account:
|
Give the name and social security number of —
|
||||
|
1.
|
Individual
|
The individual
|
|||
|
2.
|
Two or more individuals (joint account)
|
The actual owner of the account or, if combined funds, the first individual on the account(1)
|
|||
|
3.
|
Custodian account of a minor (Uniform Gift to Minors Act)
|
The minor(2)
|
|||
|
4.
|
a.
|
The usual revocable savings trust (grantor is also trustee)
|
The grantor-trustee(1)
|
||
|
b.
|
So-called trust account that is not a legal or valid trust under state law
|
The actual owner(1)
|
|||
|
5.
|
Sole proprietorship or disregarded entity owned by an individual
|
The owner(3)
|
|||
|
6.
|
Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulation section 1.671-4(b)(2)(i)(A))
|
The grantor*
|
|||
|
For this type of account:
|
Give the name and employer identification number of —
|
||||
| 7. |
A disregarded entity not owned by an individual
|
The owner
|
|||
|
8.
|
A valid trust, estate, or pension trust
|
The legal entity(4)
|
|||
|
9.
|
Corporation or LLC electing corporate status on Form 8832 or Form 2553
|
The corporation
|
|||
|
10.
|
Association, club, religious, charitable, educational, or other tax-exempt organization
|
The organization
|
|||
|
11.
|
Partnership or multi-member LLC
|
The partnership
|
|||
|
12.
|
A broker or registered nominee
|
The broker or nominee
|
|||
|
13.
|
Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments
|
The public entity
|
|||
| 14. |
Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulation section 1.671-4(b)(2)(i)(B))
|
The trust
|
|||
|
(1)
|
List first and circle the name of the person whose number you furnish. If only one person on a joint account has a social security number, that person's number must be furnished.
|
|
(2)
|
Circle the minor's name and furnish the minor's social security number.
|
|
(3)
|
You must show your individual name, but you may also enter your business or "doing business as" name on the “Business name/disregarded entity” name line.. You may use either your social security number or your employer identification number (if you have one) but the IRS encourages you to use your social security number. Also see Special Rules for Partnerships on page 1 of the instructions to Form W-9 at http://www.irs.gov/pub/irs-pdf/fw9.pdf.
|
|
(4)
|
List first and circle the name of the legal trust, estate, or pension trust. (Do not furnish the taxpayer identification number of the personal representative or trustee unless the legal entity itself is not designated in the account title.)
|
|
1.
|
An organization exempt from tax under Section 501(a), an individual retirement account (IRA), or a custodial account under Section 403(b)(7) if the account satisfies the requirements of Section 401(f)(2).
|
|
2.
|
The United States or any of its agencies or instrumentalities.
|
|
3.
|
A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities.
|
|
4.
|
A foreign government or any of its political subdivisions, agencies or instrumentalities.
|
|
5.
|
A corporation.
|
|
6.
|
A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States.
|
|
7.
|
A futures commission merchant registered with the Commodity Futures Trading Commission.
|
|
8.
|
A real estate investment trust.
|
|
9.
|
An entity registered at all times during the tax year under the Investment Company Act of 1940.
|
|
10.
|
A common trust fund operated by a bank under Section 584(a).
|
|
11.
|
A financial institution.
|
|
12.
|
A middleman known in the investment community as a nominee or custodian.
|
|
13.
|
A trust exempt from tax under Section 664 or described in Section 4947.
|
|
If the payment is for . . .
|
THEN the payment is exempt for . . .
|
|
|
Interest and dividend payments
|
All exempt recipients except for 7
|
|
|
Broker transactions
|
Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012.
|
|
A –
|
An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37)
|
|
B –
|
The United States or any of its agencies or instrumentalities
|
|
C –
|
A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities
|
|
D –
|
A corporation the sotck of which is regularly traded on one or more established securities markets, as described in Reg. section 1.1472-1(c)(1)(i)
|
|
E –
|
A corporation that is a member of the same expanded affiliated group as a corporation described in Reg. section 1.1472-1(c)(1)(i)
|
|
F –
|
A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state
|
|
G –
|
A real estate investment trust
|
|
H –
|
A regulated investment company as defined in section 851 or any entity registered at all times during the tax year under the Investment Company Act of 1940
|
|
I –
|
A common trust fund as defined in section 584(a)
|
|
J –
|
A bank as defined in section 581
|
|
K –
|
A broker
|
|
L –
|
A trust exempt from tax under section 664 or described in section 4947(a)(1)
|
|
M –
|
A tax exempt trust under a section 403(b) plan or section 457(g) plan
|
|
(1)
|
Failure to Furnish Taxpayer Identification Number. If you fail to furnish your correct taxpayer identification number to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.
|
|
(2)
|
Civil Penalty for False Information with Respect to Withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.
|
|
(3)
|
Criminal Penalty for Falsifying Information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.
|
|
(4)
|
Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties.
|