Orange County NC Website
23 <br /> Form W-9(Rev.10-2018) Page 3 <br /> Criminal penalty for falsifying information.Willfully falsifying IF the entity/person on line 1 is THEN check the box for... <br /> certifications or affirmations may subject you to criminal penalties a(n)... <br /> including fines and/or imprisonment. <br /> Misuse of TINs.If the requester discloses or uses TINs in violation of • Corporation Corporation <br /> federal law,the requester may be subject to civil and criminal penalties. • Individual Individual/sole proprietor or single- <br /> * Sole proprietorship,or member LLC <br /> Specific Instructions • Single-member limited liability <br /> company(LLC)owned by an <br /> Line 1 individual and disregarded for U.S. <br /> You must enter one of the following on this line;do not leave this line federal tax purposes. <br /> blank.The name should match the name on your tax return. LLC treated as a partnership for Limited liability company and enter <br /> If this Form W-9 is for a joint account(other than an account U.S,federal tax purposes, the appropriate tax classification. <br /> maintained by a foreign financial institution(FFI)), list first,and then LLC that has filed Form 8832 or (P=Partnership;C=C corporation; <br /> circle,the name of the person or entity whose number you entered in 2553 to be taxed as a corporation, or S=S corporation) <br /> Part I of Form W-9.If you are providing Form W-9 to an FFI to document or <br /> a joint account,each holder of the account that is a U.S.person must <br /> • LLC that is disregarded as an <br /> provide a Form W-9. <br /> entity separate from its owner but <br /> a. Individual.Generally,enter the name shown on your tax return.If the owner is another LLC that is <br /> you have changed your last name without informing the Social Security not disregarded for U.S.federal tax <br /> Administration(SSA)of the name change,enter your first name,the last purposes. <br /> name as shown on your social security card,and your new last name. <br /> Note:ITIN applicant:Enter your individual name as it was entered on Partnership Partnership <br /> your Form W-7 application, line 1 a.This should also be the same as the Trust/estate Trust/estate <br /> name you entered on the Form 1040/1040A/1040EZ you filed with your Line 4, Exemptions <br /> application. <br /> b. Sole proprietor or single-member LLC.Enter your individual If you are exempt from backup withholding and/or FATCA reporting, <br /> name as shown on your 1040/1040A/1040EZ on line 1.You may enter enter in the appropriate space on line 4 any code(s)that may apply to <br /> your business,trade,or"doing business as"(DBA)name on line 2. you. <br /> c. Partnership,LLC that is not a single-member LLC,C Exempt payee code. <br /> corporation,or S corporation.Enter the entity's name as shown on the Generally,individuals(including sole proprietors)are not exempt from <br /> entity's tax return on line 1 and any business,trade,or DBA name on backup withholding. <br /> line 2. Except as provided below,corporations are exempt from backup <br /> d. Other entities.Enter your name as shown on required U.S,federal withholding for certain payments,including interest and dividends. <br /> tax documents on line 1.This name should match the name shown on the Corporations are not exempt from backup withholding for payments <br /> charter or other legal document creating the entity.You may enter any made in settlement of payment card or third party network transactions. <br /> business,trade,or DBA name on line 2. <br /> • Corporations are not exempt from backup withholding with respect to <br /> e. Disregarded entity.For U.S.federal tax purposes,an entity that is attorneys'fees or gross proceeds paid to attorneys,and corporations <br /> disregarded as an entity separate from its owner is treated as a that provide medical or health care services are not exempt with respect <br /> "disregarded entity." See Regulations section 301.7701-2(c)(2)(iii).Enter to payments reportable on Form 1099-MISC. <br /> the owner's name on line 1.The name of the entity entered on line 1 <br /> should never be a disregarded entity.The name on line 1 should be the The following codes identify payees that are exempt from backup <br /> name shown on the income tax return on which the income should be withholding.Enter the appropriate code in the space in line 4. <br /> reported.For example,if a foreign LLC that is treated as a disregarded 1—An organization exempt from tax under section 501(a),any IRA,or <br /> entity for U.S,federal tax purposes has a single owner that is a U.S. a custodial account under section 403(b)(7)if the account satisfies the <br /> person,the U.S.owner's name is required to be provided on line 1.If requirements of section 401(f)(2) <br /> the direct owner of the entity is also a disregarded entity,enter the first 2—The United States or any of its agencies or instrumentalities <br /> owner that is not disregarded for federal tax purposes.Enter the <br /> disregarded entity's name on line 2,"Business name/disregarded entity 3—A state,the District of Columbia,a U.S.commonwealth or <br /> name."If the owner of the disregarded entity is a foreign person,the possession,or any of their political subdivisions or instrumentalities <br /> owner must complete an appropriate Form W-8 instead of a Form W-9. 4—A foreign government or any of its political subdivisions,agencies, <br /> This is the case even if the foreign person has a U.S.TIN. or instrumentalities <br /> Line 2 5—A corporation <br /> If you have a business name,trade name,DBA name,or disregarded 6—A dealer in securities or commodities required to register in the <br /> entity name,you may enter it on line 2. United States,the District of Columbia,or a U.S.commonwealth or <br /> possession <br /> Line 3 7—A futures commission merchant registered with the Commodity <br /> Check the appropriate box on line 3 for the U.S.federal tax Futures Trading Commission <br /> classification of the person whose name is entered on line 1.Check only 8—A real estate investment trust <br /> one box on line 3. 9—An entity registered at all times during the tax year under the <br /> Investment Company Act of 1940 <br /> 10—A common trust fund operated by a bank under section 584(a) <br /> 11—A financial institution <br /> I <br /> 12—A middleman known in the investment community as a nominee or <br /> custodian <br /> 13—A trust exempt from tax under section 664 or described in section <br /> 4947 <br /> i <br /> i <br />