|
0
<br /> ® Fpn W'9 Request for Taxpayer Give form to the
<br /> (Rev.October 2007) Identification Number and Certification requester. Do not
<br /> ® Denaturise of the Treasuy send to the IRS.
<br /> Innen]Revenue Service
<br /> ® Name(as shown on your income tax retire)
<br /> m SAVING 8 MILLER DESIGN STUDIO,INC.
<br /> ® it Business name,if different from above
<br /> ® o
<br /> ® n c Check appropriate box: ElIndividual/Sole proprietor ZCorporation 111 Partnership Exempt
<br /> D'r ❑ tinted liability company.Enter the tax classification(D:disregarded entity,Corporation,P=partnerstlip)• ❑ payer
<br /> ® `o 2 ❑- Other(see instruca s) ►
<br /> c Address(number,street,and apt.or suite no.) Requester's name and address(optional)
<br /> ® a o 12345 NE 6th Avenue
<br /> .o C- ity,state,and ZIP code
<br /> ® to North Miami,FL 33161
<br /> ® m lot accountnumber(s)here(optional)
<br /> N
<br /> O Part I Taxpayer Identification Number (TIN)
<br /> 0 Enter your TIN in the appropriate box.The TIN provided must match the name given on Line 1 to avoid *nisi security number
<br /> backup withholding.For individuals,this is your social security number(SSW).However,for a resident
<br /> 0 alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3. For other entities,it is
<br /> your employer identification number(EIN). If you do not have a number,see How to get a TIN on page 3. or
<br /> O Note. If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identification number
<br /> number to enter. 65 ; 0412661
<br /> 0 Part II Certification
<br /> ® Under penalties of perjury,I certify that:
<br /> O 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
<br /> 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
<br /> ® 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
<br /> notified me that I am no longer subject to backup withholding, and
<br /> 0 3. I am a U.S.citizen or other U.S.person(defined below).
<br /> Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
<br /> ® withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.
<br /> For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement
<br /> ® arrangement(IRA),and generally, payments other than interest and dividends,you are not required to sign the Certification,but you must
<br /> provide your correct TIN. See the instructions on page 4.
<br /> 0 Sign Signature of
<br /> ® Here I u.s.person ► Date le
<br /> General Instructions Definition of a U.S. person. For federal tax purposes, you are
<br /> ® considered a U.S.person if you are:
<br /> Section references are to the Internal Revenue Code unless • An individual who is a U.S.citizen or U.S. resident alien,
<br /> ® otherwise noted.
<br /> • A partnership,corporation,company,or association created or
<br /> Purpose of Form organized in the United States or under the laws of the United
<br /> ®
<br /> A person who is required to file an information return with the States,
<br /> IRS must obtain your correct taxpayer identification number(TIN) • An estate(other than a foreign estate),or
<br /> eto report,for example,income paid to you, real estate • A domestic trust(as defined in Regulations section
<br /> ® transactions, mortgage interest you paid,acquisition or 301.7701-7).
<br /> abandonment of secured property,cancellation of debt, or
<br /> contributions you made to an IRA. Special rules for partnerships.Partnerships that conduct a
<br /> ED Use Form W-9 only if you are a U.S.person(including a trade or business in the United States are generally required to
<br /> pay a withholding tax on any foreign partners' share of income
<br /> resident alien),to provide your correct TIN to the person from such business. Further, in certain cases where a Form W-9
<br /> 4) requesting it(the requester)and,when applicable,to: has not been received,a partnership is required to presume that
<br /> ® 1. Certify that the TIN you are giving is correct(or you are a partner is a foreign person, and pay the withholding tax.
<br /> waiting for a number to be issued), Therefore, if you are a U.S. person that is a partner in a
<br /> 2. Certify that you are not subject to backup withholding,or partnership conducting a trade or business in the United States,
<br /> ® provide Form W-9 to the partnership to establish your U.S.
<br /> 3.Claim exemption from backup withholding if you are a U.S. status and avoid withholding on your share of partnership
<br /> e exempt payee. If applicable,you are also certifying that as a income.
<br /> U.S. person, your allocable share of any partnership income from The person who gives Form W-9 to the partnership for
<br /> ® a U.S.trade or business is not subject to the withholding tax on purposes of establishing its U.S. status and avoiding withholding
<br /> foreign partners' share of effectively connected income. on its allocable share of net income from the partnership
<br /> ® Note. If a requester gives you a form other than Form W-9 to conducting a trade or business in the United States is in the
<br /> request your TIN, you must use the requester's form if it is following cases:
<br /> ® substantially similar to this Form W-9. • The U.S.owner of a disregarded entity and not the entity,
<br /> ® Cat.No.10231% Form W-9 (Rev.10-2007)
<br /> O Savtno8C2M2PDesi.n Studio o(T,frR9 #12-04-02 6
<br />
|