WASHINGTON COUNTY MD. TAX SALE REGISTRATION FORM
Tax Sale Date – June 5, 2018 @ 9:00am
Registration closes at 4:00pm on Monday June 4, 2018
Late Bidder Registration forms cannot be accepted.
(Please call the Washington County Treasurer’s Office at 240-313-2110 if you wish to confirm receipt of your Bidder Registration Form.)
Section 14-818 of the Tax Property Article of the Annotated Code of Maryland provides that payment of the purchase price on tax sales shall be made on the terms required by the collector. Washington County requires that all purchasers remit by 2:00pm on the day of the tax sale the full amount of taxes and other outstanding charges due on the property, whether in arrears or not, together with interest and penalties on the outstanding amounts and expenses incurred in making the sale. This amount is set forth as the Minimum Bid Sale Amount/Opening Bid on the “Tax Sale Properties To Be Sold” report that is distributed on the day of sale. By signing below, you are registering as a bidder for the sale, certifying that the information given hereon is true and accurate to the best of your knowledge, information and belief. By signing below, you are further agreeing to remit the Opening Bid amount to the collector of taxes for Washington County prior to 2:00pm on the day of sale. If the tax collector for Washington County deems it necessary to take legal action against you to enforce this agreement to remit said amount to him, then you hereby agree to pay all court costs, expenses and legal fees incurred by him as the result of said action. Regarding conduct of sale, the Washington County Treasurer reserves the right to take appropriate action under 14-817 (a)(3) of the Tax Property Article of the Annotated Code of Maryland.
WASHINGTON COUNTY TREASURER’S OFFICE
35 WEST WASHINGTON STREET SUITE 102
HAGERSTOWN, MARYLAND 21740-4868
Email: OR FAX TO: (240)-313-2111
Required Information
BIDDERS MUST LEGIBLY AND THOROUGHLY COMPLETE AND SIGN TAX SALE BIDDER REGISTRATION FORM.
BIDDERS MUST LEGIBLY AND THOROUGHLY COMPLETEAND SIGN IRS FORM W-9.
BIDDERS MUST PRESENT VALID DRIVER’S LICENSE OR GOVERNMENT ISSUED PHOTO ID TO RECEIVE BIDDER NUMBER.
CORPORATE/LLC ENTITIES MUST PROVIDE EVIDENCE OF GOOD STANDING FROM MARYLAND COMPTROLLER’S OFFICE OR SDAT.
______
NAME (AS IT SHOULD APPEAR ON THE CERTIFICATE OF SALE)
______ ______
MAILING ADDRESS (FOR CORRESPONDENCE, REDEMPTIONS, ETC.)SOCIAL SECURITY NUMBER OR FEDERAL EIN
______
CITY, STATE, ZIP E-MAIL ADDRESS
______
HOME PHONE BUSINESS PHONE CELL PHONE
______
______
NAME, ADDRESS, PHONE OF THE ATTORNEY/RESIDENT AGENT FOR THE ABOVE NAMED BIDDER (IF APPLICABLE)
By signing below, I hereby certify that the contents of the aforegoingare true and correct to the best of my knowledge, information and belief.
Date: ______Signature ______
Below information to be completed by Treasurer’s Office
Date Received ______BIDDER NO. ______
EnteryourTINintheappropriatebox.TheTINprovidedmustmatchthenamegivenonline1toavoidbackupwithholding.Forindividuals,thisisgenerallyyoursocialsecuritynumber(SSN).However,foraresidentalien,soleproprietor,ordisregardedentity,seethePartIinstructionsonpage3.Forotherentities, itis youremployeridentification number(EIN).If youdonot haveanumber, see Howto geta
TINonpage3.or
Note.Iftheaccountisinmorethanonename,seetheinstructionsforline1andthechartonpage4forguidelinesonwhosenumbertoenter.
Underpenaltiesofperjury,Icertifythat:
1.Thenumbershownonthisformismycorrecttaxpayeridentificationnumber(orIamwaitingforanumbertobeissuedtome);and
2.Iamnotsubjecttobackupwithholdingbecause:(a)Iamexemptfrombackupwithholding,or(b)IhavenotbeennotifiedbytheInternalRevenueService (IRS)thatI amsubjectto backupwithholdingasa resultofa failuretoreport allinterestordividends, or(c)the IRShasnotifiedme thatIam nolongersubjecttobackupwithholding;and
3.Iam aU.S. citizenor otherU.S. person(defined below);and
4.TheFATCAcode(s)enteredonthisform(ifany)indicatingthatIamexemptfrom FATCAreportingiscorrect.
Certificationinstructions.Youmustcrossoutitem2aboveifyouhavebeennotifiedbytheIRSthatyouarecurrentlysubjecttobackupwithholdingbecauseyouhavefailedtoreportallinterestanddividendsonyourtaxreturn.Forrealestatetransactions,item2doesnotapply.Formortgageinterestpaid,acquisitionorabandonmentofsecuredproperty,cancellationofdebt,contributionstoanindividualretirementarrangement(IRA),andgenerally,paymentsotherthaninterestanddividends,youarenotrequiredtosignthecertification,butyoumustprovideyourcorrectTIN.Seetheinstructionsonpage3.
GeneralInstructions
Sectionreferencesareto theInternalRevenueCode unlessotherwisenoted.
Futuredevelopments.InformationaboutdevelopmentsaffectingFormW-9(suchaslegislationenactedafterwereleaseit)isat.
PurposeofForm
An individualor entity(Form W-9requester) whois requiredto filean informationreturnwiththeIRSmustobtainyourcorrecttaxpayeridentificationnumber(TIN)whichmaybeyoursocialsecuritynumber(SSN),individualtaxpayeridentificationnumber(ITIN),adoptiontaxpayeridentificationnumber(ATIN),oremployer identificationnumber(EIN),toreportonaninformationreturntheamountpaidtoyou,orotheramountreportableonaninformationreturn.Examplesofinformationreturnsinclude,butarenotlimitedto,thefollowing:
•Form1099-INT(interestearnedorpaid)
•Form1099-DIV(dividends,includingthosefromstocksormutualfunds)
•Form1099-MISC(varioustypesofincome,prizes,awards,orgrossproceeds)
•Form1099-B(stockormutualfundsalesandcertainothertransactionsbybrokers)
•Form 1099-S(proceeds fromreal estatetransactions)
•Form1099-K(merchantcardandthirdpartynetworktransactions)
•Form1098(homemortgageinterest),1098-E(studentloaninterest),1098-T (tuition)
•Form1099-C (canceleddebt)
•Form1099-A(acquisitionorabandonmentofsecuredproperty)
UseFormW-9onlyifyouareaU.S.person(includingaresidentalien),toprovideyourcorrectTIN.
IfyoudonotreturnFormW-9totherequesterwithaTIN,youmightbesubjecttobackupwithholding.SeeWhatisbackupwithholding?onpage2.
Bysigningthefilled-outform,you:
1.CertifythattheTINyouaregivingiscorrect(oryouarewaitingforanumbertobeissued),
2.Certifythatyouarenotsubjecttobackupwithholding,or
3.ClaimexemptionfrombackupwithholdingifyouareaU.S.exemptpayee.Ifapplicable, youarealsocertifyingthatasaU.S.person,yourallocableshareofanypartnershipincomefromaU.S.tradeorbusinessisnotsubjecttothewithholdingtaxonforeignpartners'shareofeffectivelyconnectedincome,and
4.CertifythatFATCAcode(s)enteredonthisform(ifany)indicatingthatyouareexempt fromtheFATCA reporting,iscorrect. SeeWhatis FATCAreporting?onpage2forfurtherinformation.
Cat.No.10231XFormW-9(Rev.12-2014)
Note. If you area U.S. personand a requester givesyou a formother than Form W-9torequestyourTIN,youmustusetherequester’sformifitissubstantiallysimilartothisFormW-9.
DefinitionofaU.S.person.For federaltaxpurposes,youare consideredaU.S.person if youare:
•An individual whois a U.S.citizen orU.S. resident alien;
•Apartnership,corporation,company,orassociationcreatedororganizedintheUnitedStatesorunderthelawsoftheUnitedStates;
•Anestate(otherthanaforeignestate);or
•A domestictrust(asdefinedinRegulations section301.7701-7).
Special rulesforpartnerships.Partnerships thatconductatradeor businessin theUnitedStatesaregenerallyrequiredtopayawithholdingtaxundersection1446onanyforeignpartners’shareofeffectivelyconnectedtaxableincomefromsuchbusiness. Further,in certain caseswhere aForm W-9 hasnot been received, therulesundersection1446requireapartnershiptopresumethatapartnerisaforeignperson,andpaythesection1446withholdingtax.Therefore,ifyouarea
U.S.personthatisapartnerinapartnershipconductingatradeorbusinessintheUnitedStates,provideFormW-9tothepartnershiptoestablishyourU.S.statusandavoidsection1446withholdingonyourshareofpartnershipincome.
Inthecasesbelow,thefollowingpersonmustgiveFormW-9tothepartnershipforpurposesofestablishingitsU.S.statusandavoidingwithholdingonitsallocableshareofnetincomefromthepartnershipconductingatradeorbusiness intheUnitedStates:
•InthecaseofadisregardedentitywithaU.S.owner,theU.S.ownerofthedisregardedentityandnottheentity;
•InthecaseofagrantortrustwithaU.S.grantororotherU.S.owner,generally,theU.S.grantororotherU.S.ownerofthegrantortrustandnotthetrust;and
•Inthe caseof a U.S.trust (otherthan a grantortrust), the U.S.trust (otherthan agrantortrust)andnotthebeneficiariesofthetrust.
Foreign person. If you are a foreign person or the U.S. branch of a foreign bankthathaselectedtobetreatedasaU.S.person,donotuseFormW-9.Instead,usetheappropriateFormW-8orForm8233(seePublication515,WithholdingofTaxonNonresidentAliensandForeignEntities).
Nonresidentalienwhobecomesaresidentalien.Generally,onlyanonresidentalienindividualmayusethetermsofataxtreatytoreduceoreliminateU.S.taxoncertaintypesofincome.However,mosttaxtreatiescontainaprovisionknownasa“savingclause.”ExceptionsspecifiedinthesavingclausemaypermitanexemptionfromtaxtocontinueforcertaintypesofincomeevenafterthepayeehasotherwisebecomeaU.S.residentalienfortaxpurposes.
If youareaU.S.residentalienwhoisrelyingonanexceptioncontainedinthesavingclauseofataxtreatytoclaimanexemptionfromU.S.taxoncertaintypesofincome,youmustattachastatementtoFormW-9thatspecifiesthefollowingfiveitems:
1.Thetreatycountry.Generally,thismustbethesametreatyunderwhichyouclaimedexemptionfromtaxasanonresidentalien.
2.Thetreatyarticleaddressingtheincome.
3.The articlenumber(orlocation)in thetaxtreatythatcontains thesavingclauseanditsexceptions.
4.Thetypeandamountofincomethatqualifiesfortheexemptionfromtax.
5.Sufficientfactstojustifytheexemptionfromtaxunderthetermsofthetreatyarticle.
Example.Article20oftheU.S.-ChinaincometaxtreatyallowsanexemptionfromtaxforscholarshipincomereceivedbyaChinesestudenttemporarilypresentintheUnitedStates.UnderU.S.law,thisstudentwillbecomearesidentalienfortax purposesif hisorher stayin theUnitedStates exceeds5 calendaryears.
However,paragraph2ofthefirstProtocoltotheU.S.-Chinatreaty(datedApril30, 1984)allowstheprovisionsofArticle20tocontinuetoapplyevenaftertheChinese studentbecomes aresidentalien ofthe UnitedStates.A Chinese studentwhoqualifiesforthisexception(underparagraph2ofthefirstprotocol)andis relyingonthisexceptiontoclaimanexemptionfromtaxonhisorherscholarshiporfellowshipincomewouldattachtoFormW-9astatementthatincludestheinformationdescribedabovetosupportthatexemption.
If you area nonresidentalien ora foreignentity, givethe requestertheappropriatecompletedFormW-8orForm8233.
BackupWithholding
What isbackupwithholding? Personsmaking certainpaymentsto youmustundercertainconditionswithholdandpaytotheIRS28%ofsuchpayments.Thisiscalled“backupwithholding.” Paymentsthatmaybesubjecttobackupwithholdingincludeinterest,tax-exemptinterest,dividends,brokerandbarterexchangetransactions,rents,royalties,nonemployeepay,paymentsmadein settlementofpaymentcardandthirdpartynetworktransactions,andcertainpaymentsfromfishingboatoperators.Realestatetransactionsarenotsubjecttobackupwithholding.
YouwillnotbesubjecttobackupwithholdingonpaymentsyoureceiveifyougivetherequesteryourcorrectTIN,makethepropercertifications,andreportallyourtaxableinterestanddividendsonyourtaxreturn.
Paymentsyoureceivewillbesubjecttobackupwithholdingif:
1.YoudonotfurnishyourTINtotherequester,
2.You do not certify your TIN when required (see the PartII instructions on page 3fordetails),
3.TheIRStellstherequester thatyoufurnishedanincorrect TIN,
4.TheIRStellsyouthatyouaresubjecttobackupwithholdingbecauseyoudidnotreportallyourinterestanddividendsonyourtaxreturn(forreportableinterestanddividendsonly),or
5.Youdonotcertifytotherequesterthatyouarenotsubjecttobackupwithholdingunder4above(forreportableinterestanddividendaccountsopenedafter1983only).
Certainpayeesandpaymentsareexemptfrombackupwithholding.SeeExemptpayeecodeonpage3andtheseparateInstructionsfortheRequesterofForm
W-9formoreinformation.
AlsoseeSpecialrulesforpartnershipsabove.
WhatisFATCAreporting?
TheForeignAccountTaxComplianceAct(FATCA)requiresaparticipatingforeignfinancialinstitutiontoreportallUnitedStatesaccountholdersthatarespecifiedUnitedStatespersons.CertainpayeesareexemptfromFATCAreporting.SeeExemptionfromFATCAreportingcodeonpage3andtheInstructionsfortheRequesterofFormW-9formoreinformation.
UpdatingYourInformation
Youmustprovideupdatedinformationtoanypersontowhomyouclaimedtobeanexemptpayeeifyouarenolongeranexemptpayeeandanticipatereceiving reportablepaymentsinthefuturefromthisperson.Forexample,youmayneedtoprovideupdatedinformationifyouareaCcorporationthatelectstobeanScorporation,orifyounolongeraretaxexempt.Inaddition,youmustfurnishanew FormW-9ifthenameorTINchangesfortheaccount;forexample,ifthegrantor ofagrantortrustdies.
Penalties
Failureto furnishTIN. Ifyou failto furnishyour correctTIN toa requester,you aresubjecttoapenaltyof$50foreachsuchfailureunlessyourfailureisduetoreasonablecauseandnottowillfulneglect.
Civilpenaltyforfalseinformationwithrespecttowithholding.Ifyoumakeafalsestatementwithnoreasonablebasisthatresultsinnobackupwithholding,youaresubjecttoa$500penalty.
Criminalpenaltyforfalsifyinginformation.Willfullyfalsifyingcertificationsoraffirmationsmaysubjectyoutocriminalpenaltiesincludingfinesand/orimprisonment.
Misuse of TINs. If therequester discloses or usesTINs in violation of federallaw, therequestermaybesubjecttocivilandcriminalpenalties.
SpecificInstructions
Line1
You must enter one of the following on this line; do not leave this line blank. Thenameshouldmatchthenameonyourtaxreturn.
IfthisFormW-9isforajointaccount,listfirst,andthencircle,thenameofthepersonorentitywhosenumberyouenteredinPartIofFormW-9.
a.Individual.Generally,enterthenameshownonyourtaxreturn.Ifyouhavechanged yourlastnamewithoutinformingthe SocialSecurityAdministration(SSA)of thename change,enteryour firstname,the lastnameas shownonyour socialsecuritycard,andyournewlastname.
Note. ITIN applicant:Enter your individualname as itwas enteredon your Form W-7 application, line1a. Thisshould alsobe thesame as thename youentered ontheForm1040/1040A/1040EZyoufiledwithyourapplication.
b.Soleproprietor orsingle-member LLC. Enteryour individualname asshown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade,or“doing business as” (DBA) name online 2.
c.Partnership,LLC that isnot a single-memberLLC, C Corporation, orSCorporation.Entertheentity'snameasshownontheentity'staxreturnonline1 andanybusiness, trade,or DBAnameon line2.
d.Otherentities.EnteryournameasshownonrequiredU.S.federaltaxdocumentsonline1.Thisnameshouldmatchthenameshownonthecharterorotherlegaldocumentcreatingtheentity.Youmayenteranybusiness,trade,orDBAnameonline2.
e.Disregarded entity.For U.S.federal taxpurposes, anentity thatis disregardedasanentityseparatefromitsowneristreatedasa“disregardedentity.”SeeRegulationssection301.7701-2(c)(2)(iii).Entertheowner'snameonline1. The nameof the entity enteredon line 1 shouldnever be adisregardedentity. Thenameonline1 shouldbethenameshown ontheincometaxreturnonwhichtheincomeshouldbereported.Forexample,ifaforeignLLCthatistreatedas adisregardedentityfor U.S.federaltaxpurposeshas asingleownerthatis a
U.S.person,theU.S.owner'snameisrequiredtobeprovidedonline1.Ifthedirectowneroftheentityisalsoadisregardedentity,enterthefirstownerthatis notdisregardedforfederaltaxpurposes.Enterthedisregardedentity'snameonline2,“Businessname/disregardedentityname.”Iftheownerofthedisregardedentityisaforeignperson,theownermustcompleteanappropriateFormW-8insteadof aForm W-9.This isthe caseeven ifthe foreignperson hasa U.S.TIN.
Line2
Ifyou havea businessname, tradename, DBAname, ordisregarded entityname,you may enter it on line2.
Line3
Checktheappropriateboxinline3fortheU.S.federaltaxclassificationoftheperson whosename isentered online1. Checkonly oneboxin line3.
LimitedLiabilityCompany(LLC).Ifthenameonline1isanLLCtreatedasapartnershipforU.S.federaltaxpurposes,checkthe“LimitedLiabilityCompany”boxandenter“P”inthespaceprovided.IftheLLChasfiledForm8832or2553tobetaxedasacorporation,checkthe“LimitedLiabilityCompany”boxandinthespaceprovidedenter“C”forCcorporationor“S”forScorporation.Ifitisa
single-memberLLCthatisadisregardedentity,donotcheckthe“LimitedLiabilityCompany”box;insteadcheckthefirstboxinline3“Individual/soleproprietororsingle-memberLLC.”
Line4,Exemptions
Ifyouareexemptfrombackupwithholdingand/orFATCAreporting,enterintheappropriatespaceinline4anycode(s)thatmayapplytoyou.
Exemptpayeecode.
•Generally,individuals(includingsoleproprietors)arenotexemptfrombackupwithholding.
•Exceptasprovidedbelow,corporationsareexemptfrombackupwithholdingforcertainpayments,includinginterestanddividends.
•Corporationsarenotexemptfrombackupwithholdingforpaymentsmadein settlementofpaymentcardorthirdpartynetworktransactions.
•Corporationsarenotexemptfrombackupwithholdingwithrespecttoattorneys'feesorgrossproceedspaidtoattorneys,andcorporationsthatprovidemedicalorhealthcareservicesarenotexemptwithrespecttopaymentsreportableonForm 1099-MISC.
Thefollowingcodesidentifypayeesthatareexemptfrombackupwithholding.Entertheappropriatecodeinthespaceinline4.
1—Anorganizationexemptfromtaxundersection501(a),anyIRA,oracustodialaccountundersection403(b)(7)iftheaccountsatisfiestherequirements ofsection401(f)(2)
2—The UnitedStatesoranyofitsagenciesorinstrumentalities
3—Astate,theDistrictofColumbia,aU.S.commonwealthorpossession,oranyoftheirpoliticalsubdivisionsorinstrumentalities
4—Aforeigngovernmentoranyofitspoliticalsubdivisions,agencies,orinstrumentalities
5—Acorporation
6—AdealerinsecuritiesorcommoditiesrequiredtoregisterintheUnitedStates,theDistrictofColumbia,oraU.S.commonwealthorpossession
7—AfuturescommissionmerchantregisteredwiththeCommodityFuturesTradingCommission
8—Arealestateinvestmenttrust
9—An entityregisteredatalltimesduringthetaxyearundertheInvestment CompanyActof1940
10—Acommontrustfundoperatedbyabankundersection584(a)11—Afinancialinstitution
12—Amiddlemanknownintheinvestmentcommunityasanomineeorcustodian
13—Atrustexemptfromtaxundersection664ordescribedinsection4947 Thefollowingchartshowstypesofpaymentsthatmaybeexemptfrombackup
withholding.Thechartappliestotheexemptpayeeslistedabove,1through13.
IFthepaymentis for.. . / THEN the payment is exempt for .. .Interestanddividendpayments / Allexemptpayeesexceptfor7
Brokertransactions / Exemptpayees1through4and6 through11andallCcorporations.Scorporationsmustnotenteranexemptpayeecodebecausetheyareexemptonlyforsalesofnoncoveredsecurities acquiredpriorto2012.
Barterexchangetransactionsandpatronagedividends / Exemptpayees1through4
Paymentsover$600requiredtobereportedanddirectsalesover$5,0001 / Generally,exemptpayees1through52
Paymentsmadeinsettlementofpaymentcardorthirdpartynetworktransactions / Exemptpayees1through4
1SeeForm1099-MISC,MiscellaneousIncome,anditsinstructions.
2However,thefollowingpaymentsmadetoacorporationandreportableonForm 1099-MISCarenotexemptfrombackupwithholding:medicalandhealthcarepayments,attorneys'fees,grossproceedspaidtoanattorneyreportableunder section 6045(f), and payments for services paid by a federal executive agency.
ExemptionfromFATCAreportingcode.ThefollowingcodesidentifypayeesthatareexemptfromreportingunderFATCA.ThesecodesapplytopersonssubmittingthisformforaccountsmaintainedoutsideoftheUnitedStatesbycertainforeignfinancialinstitutions.Therefore,ifyouareonlysubmittingthisformforanaccountyouholdintheUnitedStates,youmayleavethisfieldblank.
Consultwiththepersonrequestingthisformifyouareuncertainifthefinancial institutionissubjecttotheserequirements.Arequestermayindicatethatacodeis notrequiredbyprovidingyouwithaFormW-9with“NotApplicable”(oranysimilarindication)writtenorprintedonthelineforaFATCAexemptioncode.
A—Anorganization exempt from tax under section 501(a) orany individualretirementplanasdefinedinsection7701(a)(37)
B—The UnitedStatesoranyofitsagenciesorinstrumentalities
C—Astate,theDistrictofColumbia,aU.S.commonwealthorpossession,oranyoftheirpoliticalsubdivisionsorinstrumentalities
D—Acorporationthestockofwhichisregularlytradedononeormore establishedsecuritiesmarkets,asdescribedinRegulationssection1.1472-1(c)(1)(i)
E—AcorporationthatisamemberofthesameexpandedaffiliatedgroupasacorporationdescribedinRegulationssection1.1472-1(c)(1)(i)
F—Adealerinsecurities,commodities,orderivativefinancialinstruments(includingnotionalprincipalcontracts,futures,forwards,andoptions)thatis registeredassuchunderthelawsoftheUnitedStatesoranystate
G—A real estate investmenttrust
H—Aregulatedinvestmentcompanyasdefinedinsection851oranentityregisteredatalltimesduringthetaxyearundertheInvestmentCompanyActof1940
I—A commontrust fundasdefined insection584(a)J—Abankasdefinedinsection581
K—A broker
L—A trustexemptfromtaxundersection 664ordescribedinsection4947(a)(1)M—A tax exempt trust under a section403(b) plan or section 457(g) plan
Note.YoumaywishtoconsultwiththefinancialinstitutionrequestingthisformtodeterminewhethertheFATCAcodeand/orexemptpayeecodeshouldbecompleted.
Line5
Enteryouraddress (number,street, andapartmentor suitenumber). Thisis wheretherequesterofthisFormW-9willmailyourinformationreturns.
Line6
Enteryourcity,state,andZIPcode.
PartI.TaxpayerIdentificationNumber(TIN)
Enteryour TIN in theappropriate box. If you area resident alien andyou do nothaveandarenoteligibletogetanSSN,yourTINisyourIRSindividualtaxpayer identificationnumber(ITIN).Enteritinthesocialsecuritynumberbox.IfyoudonothaveanITIN,seeHowtogetaTINbelow.
IfyouareasoleproprietorandyouhaveanEIN,youmayentereitheryourSSNorEIN.However,theIRSprefersthatyouuseyourSSN.
Ifyouareasingle-memberLLCthatisdisregardedasanentityseparatefromitsowner(seeLimitedLiabilityCompany(LLC)onthispage),entertheowner’sSSN(orEIN,iftheownerhasone). Donotenterthedisregardedentity’s EIN.IftheLLC isclassifiedasacorporationorpartnership,entertheentity’sEIN.
Note.Seethechartonpage4forfurtherclarificationofnameandTINcombinations.
HowtogetaTIN.IfyoudonothaveaTIN,applyforoneimmediately.ToapplyforanSSN,getFormSS-5,ApplicationforaSocialSecurityCard,fromyourlocalSSAofficeorgetthisformonlineat.Youmayalsogetthisformbycalling1-800-772-1213.UseFormW-7,ApplicationforIRSIndividualTaxpayerIdentificationNumber,toapplyforanITIN,orFormSS-4,ApplicationforEmployer IdentificationNumber,toapplyforanEIN.YoucanapplyforanEINonlinebyaccessingtheIRSwebsiteatandclickingonEmployer IdentificationNumber (EIN)under Startinga Business.You can getForms W-7andSS-4 fromthe IRSby visitingIRS.gov orby calling1-800-TAX-FORM
(1-800-829-3676).
IfyouareaskedtocompleteFormW-9butdonothaveaTIN,applyforaTINandwrite“AppliedFor”inthespacefortheTIN,signanddatetheform,andgiveittotherequester.Forinterestanddividendpayments,andcertainpaymentsmade withrespecttoreadilytradableinstruments,generallyyouwillhave60daystogetaTINandgiveittotherequesterbeforeyouaresubjecttobackupwithholdingonpayments.The60-dayruledoesnotapplytoothertypesofpayments.YouwillbesubjecttobackupwithholdingonallsuchpaymentsuntilyouprovideyourTINtotherequester.
Note.Entering“AppliedFor”meansthatyouhavealreadyappliedforaTINorthatyouintendtoapplyforonesoon.
Caution:AdisregardedU.S.entitythathasaforeignownermustusetheappropriateFormW-8.
PartII.Certification
ToestablishtothewithholdingagentthatyouareaU.S.person,orresidentalien,signFormW-9.Youmayberequestedtosignbythewithholdingagentevenifitems1,4,or5belowindicateotherwise.
For ajointaccount,onlytheperson whoseTINisshowninPart Ishouldsign (when required).In thecaseof adisregardedentity, thepersonidentified online1 mustsign.Exemptpayees,seeExemptpayeecodeearlier.
Signaturerequirements.Completethecertificationasindicatedinitems1 through5below.
1.Interest, dividend, and barter exchange accountsopened before 1984 andbrokeraccountsconsideredactiveduring1983.Youmustgiveyour correctTIN,butyoudonothavetosignthecertification.
2.Interest,dividend,broker, andbarterexchangeaccountsopenedafter1983andbrokeraccountsconsideredinactiveduring1983.Youmustsignthecertificationorbackupwithholdingwillapply.IfyouaresubjecttobackupwithholdingandyouaremerelyprovidingyourcorrectTINtotherequester,youmustcrossoutitem2inthecertificationbeforesigningtheform.
3.Realestatetransactions.Youmustsignthecertification.Youmaycrossoutitem2ofthecertification.
4.Otherpayments.YoumustgiveyourcorrectTIN,butyoudonothavetosign the certificationunlessyouhavebeennotifiedthatyouhavepreviouslygiven anincorrectTIN.“Otherpayments”includepaymentsmadeinthecourseoftherequester’stradeorbusinessforrents,royalties,goods(otherthanbillsformerchandise),medical and health care services (including payments tocorporations),paymentstoanonemployeeforservices,paymentsmadein settlementofpaymentcardandthirdpartynetworktransactions,paymentstocertainfishingboatcrewmembersandfishermen,andgrossproceedspaidtoattorneys(includingpaymentstocorporations).
5.Mortgageinterestpaidbyyou,acquisitionorabandonmentofsecured property,cancellationofdebt,qualifiedtuitionprogrampayments(undersection529),IRA,CoverdellESA,ArcherMSAorHSAcontributionsor distributions,andpensiondistributions.YoumustgiveyourcorrectTIN,butyoudonothavetosignthecertification.
What Name and Number To Give the Requester
3
You mustshow your individualname andyou mayalso enteryour businessor DBAname on
the “Business name/disregarded entity”name line. You mayuse either your SSNor EIN (if youhaveone),buttheIRSencouragesyoutouseyourSSN.
4
Listfirstandcirclethenameofthetrust,estate,orpensiontrust.(DonotfurnishtheTINofthe
personalrepresentativeortrusteeunlessthelegalentityitselfisnotdesignatedintheaccounttitle.)AlsoseeSpecialrulesforpartnershipsonpage2.
*Note.GrantoralsomustprovideaFormW-9totrusteeoftrust.
Note.Ifnonameiscircledwhenmorethanonenameislisted,thenumberwillbeconsideredtobethatofthefirstnamelisted.
SecureYourTaxRecordsfromIdentityTheft
Identitytheftoccurswhensomeoneusesyourpersonalinformationsuchasyour name,SSN,orotheridentifyinginformation,withoutyourpermission,tocommitfraudorothercrimes.AnidentitythiefmayuseyourSSNtogetajobormayfileatax return using your SSNto receive a refund.
Toreduceyourrisk:
•ProtectyourSSN,
•Ensure your employer is protecting your SSN, and
•Becarefulwhenchoosingataxpreparer.
IfyourtaxrecordsareaffectedbyidentitytheftandyoureceiveanoticefromtheIRS,respondrightawaytothenameandphonenumberprintedontheIRSnoticeorletter.
Ifyourtaxrecordsarenotcurrentlyaffectedbyidentitytheftbutyouthinkyouareatriskduetoalostorstolenpurseorwallet,questionablecreditcardactivityorcreditreport,contacttheIRSIdentityTheftHotlineat1-800-908-4490orsubmitForm 14039.
For moreinformation,seePublication4535,Identity TheftPreventionandVictimAssistance.
Victimsofidentitytheftwhoareexperiencingeconomicharmorasystemproblem,orareseekinghelpinresolvingtaxproblemsthathavenotbeenresolved throughnormalchannels,maybeeligibleforTaxpayerAdvocateService(TAS)assistance.YoucanreachTASby callingtheTAStoll-freecaseintake lineat
1-877-777-4778orTTY/TDD1-800-829-4059.
Protectyourselffromsuspiciousemailsorphishingschemes.Phishingisthecreationanduseofemailandwebsitesdesignedtomimiclegitimatebusiness emailsandwebsites.Themostcommonactissendinganemailtoauserfalselyclaimingtobeanestablishedlegitimateenterpriseinanattempttoscamtheuserintosurrenderingprivateinformationthatwillbeusedforidentitytheft.
TheIRS does not initiate contacts with taxpayers via emails. Also, the IRS doesnotrequestpersonaldetailedinformationthroughemailorasktaxpayersforthePINnumbers,passwords,orsimilarsecretaccessinformationfortheircreditcard,bank,orotherfinancialaccounts.
IfyoureceiveanunsolicitedemailclaimingtobefromtheIRS,forwardthismessageto.YoumayalsoreportmisuseoftheIRSname,logo,or otherIRS propertyto theTreasury InspectorGeneral forTax Administration(TIGTA)at1-800-366-4484. Youcanforward suspiciousemailsto theFederalTradeCommissionat:orcontactthemator1-877-IDTHEFT(1-877-438-4338).
VisitIRS.govtolearnmoreaboutidentitytheftandhowtoreduceyourrisk.
PrivacyActNotice
Section6109oftheInternalRevenueCoderequiresyoutoprovideyourcorrectTINto persons (including federalagencies) who are required tofile informationreturnswiththeIRStoreportinterest,dividends,orcertainotherincomepaidtoyou;mortgageinterestyoupaid;theacquisitionorabandonmentofsecuredproperty;thecancellationofdebt;orcontributionsyoumadetoanIRA,ArcherMSA,orHSA.ThepersoncollectingthisformusestheinformationontheformtofileinformationreturnswiththeIRS,reportingtheaboveinformation.RoutineusesofthisinformationincludegivingittotheDepartmentofJusticeforcivilandcriminallitigationandtocities,states,theDistrictofColumbia,andU.S.commonwealthsandpossessionsforuseinadministeringtheirlaws.Theinformationalsomaybedisclosedtoothercountriesunderatreaty,tofederalandstateagenciestoenforcecivilandcriminallaws,ortofederallawenforcementandintelligenceagenciestocombatterrorism.YoumustprovideyourTINwhetherornot youarerequiredtofileataxreturn.Undersection3406,payersmust generallywithholdapercentageoftaxableinterest,dividend,andcertainotherpaymentstoa payee who does not give a TIN tothe payer. Certain penalties may also apply forprovidingfalseorfraudulentinformation.
1
Listfirstandcirclethenameofthepersonwhosenumberyoufurnish.Ifonlyonepersonona
jointaccounthasanSSN,thatperson’snumbermustbefurnished.
2
Circletheminor’snameandfurnishtheminor’sSSN.