This is a request for Taxpayer Identification Number and Certification.
IRS regulations require that we issue 1099 forms. In order to accurately prepare these forms, the IRS requires that we obtain and maintain form W-9 for all of our officers. Failure to provide your Social Security Number or EIN may result in the delay of future payments or backup withholdings.
Please fill out the information below even if you are exempt from backup withholding.
Tips for accurately completing form:
Line 1 or 2: Name to enter if selecting:
• Individual/sole proprietor or single-member LLC – Enter your individual name as shown on your 1040 line 1. You may enter your business or “doing business as” (DBA) name on line 2.
• C-Corporation, S-Corporation, Partnership, Trust/estate or Limited liability company – Enter name as shown on the business tax return (1120, 1120S, 1065, 1041).
Part 1: Taxpayer Identification Number (TIN)
• If Individual/sole proprietor or single-member LLC box is checked, enter Social security number
• If any other classification boxes are checked, enter Employer identification number
3. Choose one of the following:
Check appropriate box for federal tax classification of the person whose name is entered on line 1. (above) Check only one of the following seven boxes.
Individual/sole proprietor or single-member LLC
Limited liability company
Select the LLC Tax Classification
Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner.
4. Account is maintained outside the U.S.
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Use your mouse to sign or select
the keyboard icon to type signature.
Direct Deposit Form
For your convenience, LES and TSF offers Direct Deposit. No more waiting on the mail! In order to sign up for direct deposit we need the following information from you:
Pay Cycle: Jobs worked the 11-25th are paid on the 5th. Jobs worked the 26-10th are paid on the 20th. A pay stub will be emailed to the email address provided for your reference. If the pay date is on a weekend or holiday it will be paid/deposited the next business day.