Give the SOCIAL |
||
SECURITY number |
||
For this type of account | of: | |
1. An individuals account
|
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 account (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 account
|
The owner(3) | |
|
Give the EMPLOYER |
||
IDENTIFICATION number |
||
For this type of account | of: | |
6. A valid trust, estate, or
pension trust
|
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) | |
7. Corporate account
|
The corporation | |
8. Association, club,
religious, charitable, educational or other tax-exempt
organization account
|
The organization | |
9. Partnership account
|
The partnership | |
10. A broker or registered
nominee
|
The broker or nominee | |
11. 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. | |
(2) | Circle the minors name and furnish the minors 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 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 IRA, 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 of its agencies or instrumentalities. |
| A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities. |
| A foreign government or any of its political subdivisions, agencies, or instrumentalities. |
| An international organization or any of its agencies or instrumentalities. |
| A corporation. |
| A foreign central bank of issue. |
| A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States. |
| A futures commission merchant registered with the Commodity Futures Trading Commission. |
| A real estate investment trust. |
| An entity registered at all times during the tax year under the Investment Company Act of 1940. |
| A common trust fund operated by a bank under section 584(a). |
| A financial institution. |
| A middleman known in the investment community as a nominee or custodian. |
| 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 United States and that have at least one nonresident alien partner. |
| Payments of patronage dividends where the amount received is 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 payers trade of 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. |