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Give the
SOCIAL |
Give the
EMPLOYER |
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|
SECURITY
number |
IDENTIFICATION
number |
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| For this type of account: | of— | For this type of account: | of— | |||
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1 Individual
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The individual |
6. Disregarded entity not owned by an individual
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The owner | |||
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2. Two or more individuals (joint account)
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The actual owner of the account or, if combined funds, the first individual on the account1 |
7. A valid trust, estate, pension trust
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Legal entity (Do not furnish the identifying number of the personal representative or trustee unless the legal entity itself is not designated in the account title.)4 | |||
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3. Custodian account of a minor (Uniform Gift to
Minors Act)
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The minor2 |
8. Corporate or LLC electing corporate status on Form 8832
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The corporation | |||
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4. a. The usual revocable
savings trust account (grantor is also trustee)
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The grantor-trustee1 |
9. Religious, charitable, or educational organization
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The organization | |||
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b. So-called trust account
that is not a legal or valid trust under State law
|
The actual owner1 |
10. Partnership or multi member LLC
|
The partnership | |||
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5: Sole proprietorship or disregarded entity owned by
an individual
|
The owner3 |
11. Association, club or other tax-exempt organization
|
The organization | |||
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12. A broker or registered nominee
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The broker or nominee | |||||
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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 | |||||
| (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 social security 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. You may use either your social security number or your employer identification number (if you have one). |
| (4) | List first and circle the name of the legal trust, estate or pension trust. |
| • | An organization exempt from tax under Section 501(a), any individual retirement plan, or a custodial account under Section 403(b)(7) if the account satisfies the requirements of Section 401(f)(2). |
| • | The United States or any agency or instrumentality thereof. |
| • | A state, the District of Columbia, a possession of the United States, or any subdivision or instrumentality thereof. |
| • | A foreign government, a political subdivision of a foreign government, or any agency or instrumentality thereof. |
| • | An international organization or any agency or instrumentality thereof. |
| • | A corporation. |
| • | A financial institution. |
| • | A registered dealer in securities or commodities registered in the U.S. or a possession of the U.S. |
| • | A real estate investment trust. |
| • | A common trust fund operated by a bank under Section 584(a). |
| • | An entity registered at all times under the Investment Company Act of 1940. |
| • | A foreign central bank of issue. |
| • | A middleman known in the investment community as a nominee or custodian. |
| • | A futures commission merchant registered with the Commodity Futures Trading Commission. |
| • | A trust exempt from tax under Section 664 or described in Section 4947. |
| • | Payments to nonresident aliens subject to withholding under Section 1441. |
| • | Payments to partnerships not engaged in a trade or business in the U.S. and which have at least one nonresident partner. |
| • | Payments of patronage dividends not paid in money. |
| • | Payments made by certain foreign organizations. |
| • | Payments of interest on obligations issued by individuals. Note: You may be subject to backup withholding if this interest is $600 or more and is paid in the course of the payer’s trade or business and you have not provided your correct taxpayer identification number to the payer. |
| • | Payments of tax-exempt interest (including exempt-interest dividends under Section 852). |
| • | Payments described in Section 6049(b)(5) to nonresident aliens. |
| • | Payments on tax-free covenant bonds under Section 1451. |
| • | Payments made by certain foreign organizations. |