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DocuSign Envelope ID: 2954802F-3DF9-4C1C-80A2-A507C762EF80 <br />4 <br />Form W-9 (Rev. 8-2013) <br />Page <br />If no name is circled when more than one name is listed,the number will be <br />What Name and Number To Give the Requester <br />Note. <br />considered to be that of the first name listed. <br />For this type of account:Give name and SSN of: <br />Secure Your Tax Records from Identity Theft <br />1. IndividualThe individual <br />Identity theft occurs when someone uses your personal informatio <br />2. Two or more individuals (joint The actual owner of the account or, <br />name, social security number (SSN), or other identifying informa <br />account)if combined funds, the first <br />permission, to commit fraud or other crimes. An identity thief m <br />1 <br />individual on the account <br />get a job or may file a tax return using your SSN to receive a r <br />3. Custodian account of a minor <br />2 <br />The minor <br />To reduce your risk: <br /> (Uniform Gift to Minors Act) <br />¥ Protect your SSN, <br />1 <br />The grantor-trustee <br />4. a. The usual revocable savings <br />¥ Ensure your employer is protecting your SSN, and <br />trust (grantor is also trustee) <br />b. So-called trust account that is <br />1 <br />¥ Be careful when choosing a tax preparer. <br />The actual owner <br />not a legal or valid trust under <br />If your tax records are affected by identity theft and you recei <br />state law <br />the IRS, respond right away to the name and phone number printed <br />3 <br />5. Sole proprietorship or disregarded <br />The owner <br />notice or letter. <br />entity owned by an individual <br />If your tax records are not currently affected by identity theft <br />The grantor* <br />6. Grantor trust filing under Optional <br />are at risk due to a lost or stolen purse or wallet, questionabl <br />Form 1099 Filing Method 1 (see <br />or credit report, contact the IRS Identity Theft Hotline at 1-80 <br />Regulation section 1.671-4(b)(2)(i)(A)) <br />Form 14039. <br />For this type of account:Give name and EIN of: <br />For more information, see Publication 4535, Identity Theft Preve <br />Assistance. <br />7. Disregarded entity not owned by an The owner <br />individual <br />Victims of identity theft who are experiencing economic harm or <br />4 <br />8. A valid trust, estate, or pension trustproblem, or are seeking help in resolving tax problems that have <br />Legal entity <br />through normal channels, may be eligible for Taxpayer Advocate S <br />9. Corporation or LLC electing The corporation <br />assistance. You can reach TAS by calling the TAS toll-free case <br />corporate status on Form 8832 or <br />1-877-777-4778 or TTY/TDD 1-800-829-4059. <br />Form 2553 <br />Phishing is the <br />Protect yourself from suspicious emails or phishing schemes. <br />10. Association, club, religious, The organization <br />creation and use of email andwebsites designed to mimic legitimate business <br /> <br />charitable, educational, or other <br />emails andwebsites. The most common act is sending an email to a userfalsely <br /> <br />tax-exempt organization <br />claiming to be an established legitimate enterprise in anattempt to scam the user <br /> <br />The partnership <br />11. Partnership or multi-member LLC <br />into surrendering private informationthat will be used for identity theft. <br /> <br />12. A broker or registered nomineeThe broker or nominee <br />The IRS does not initiate contacts with taxpayers via emails. Al <br />not request personal detailed information through email or ask t <br />13. Account with the Department of The public entity <br />PIN numbers, passwords, or similar secret access information for <br />Agriculture in the name of a public <br />bank, or other financial accounts. <br />entity (such as a state or local <br />government, school district, or <br />If you receive an unsolicited email claiming to be from the IRS, <br />prison) that receives agricultural <br />message to You may also report misuse of the IRS name, logo, <br />phishing@irs.gov. <br />program payments <br />or other IRS property to the Treasury Inspector General for Tax <br />1-800-366-4484. You can forward suspicious emails to the Federal <br />14. Grantor trust filing under the Form The trust <br />Commission at: or contact them at or 1-877- <br />spam@uce.govwww.ftc.gov/idtheft <br />1041 Filing Method or the Optional <br />IDTHEFT (1-877-438-4338). <br />Form 1099 Filing Method 2 (see <br />Regulation section 1.671-4(b)(2)(i)(B)) <br />Visit IRS.govto learn more about identity theft and how to reduce your risk. <br /> <br />1 <br />List first and circle the name of the person whose number you fuon a <br /> <br />joint account has an SSN, that personÈs number must be furnished <br />2 <br />Circle the minorÈs name and furnish the minorÈs SSN. <br /> <br />3 <br />You must show your individual name and you may also enter your bname on <br /> <br />the ÅBusiness name/disregarded entityÆ name line. You may use ei <br />have one),but the IRS encourages you to use your SSN. <br /> <br />4 <br />List first and circle the name of the trust, estate, or pension of the <br /> <br />personal representative or trustee unless the legal entity itselthe account <br /> <br />title.) Also see on page 1. <br />Special rules for partnerships <br /> <br /> Grantor also must provide a Form W-9 to trustee of trust. <br />*Note. <br />Privacy Act Notice <br />Section 6109 of the Internal Revenue Code requires you to provid <br />the IRS to report interest, dividends, or certain other income p <br />of debt; or contributions you made to an IRA, Archer MSA, or HSA <br />reporting the above information. Routine uses of this informatio <br />of Columbia, and U.S. commonwealths and possessions for use in a <br />federal and state agencies to enforce civil and criminal laws, o <br />whether or not you are required to file a tax return. Under sect <br />payments to a payee who does not give a TIN to the payer. Certai <br /> <br />