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- Application for Employer Identification Number Form 55-4 (For use by omployors, corporations, partnorships, trusts, ostatos, churchos, (REV. D~c~mb~r 2001) govornmont agencios, Indian tribal ontitios,cortain individuals, and othors) D~parlm~~l of tho Ttusuty'" ... K f d Intornal Rovonuo Sorvice ,. See separate Instructions for each line. ,. eep a copy or your recor s. Legal name 01 entity (or individual) for whom the EIN is baing requested. r ,; EIN 20-8715972 03903 03/27/2007 i:- '- ~ ~ u - C 'C c. '- o G> C. ~ 2 Sa Street address (if different) (Do not enter a P.O. box) 4b City, state, and ZIP code POMPANO BEACH, FL 33069 6 County and state where principal business is located, 5b City, state, and ZIP code BROWARD FL 70 Name 01 principal officer, general partner, grantor, owner, or trustor 7b SSN, ITIN, or EIN " 6a Type of entity (check only one box) 00 Sole proprietor (SSN) 5921 03 17473 o Partnership o Corporation (enter lorm number to be filed)~ o Personal service corp. o Church or church-controlled organization o Other nonprofit organization (specify) ~ o Other (specily) 8b II a corporation, name 01 state or loreign country (if applicable) where incorporated 9 Reason for applying (check only one box) I!l Started new business (specify type) ~ CLEANING o Hired employees (Check the box and see line 12.) o Compliance with IRS withholding regulations o Other (specily)~ .10 Date business started or acquired (month, day, year) 10/01/2006 11 Closing month 01 accounting year 12 First date wages or annuities were paid or will be paid (month, day, year) Noto:lf appliC:3nt Is a withholding agent, enter date income will first be paid 10 nonresident alien, (month, day, year)........................................................ ~ 13 Enter highest number of employees expected In the next 12 months. Noto: If the applicant ... Agricultural Household Other does not expect to have any employees during the period, enter "-0.". ....................................,. 0 0 0 14 Check one box that best describes the principal activity of your business. 0 Health care & social assistance 0 Wholesale.agenllbrok€lr o Construction 0 Rental & leasing 0 Transportation & warehousing 0 Accommodation & food service 0 Wholesale.other 0 Retail o Real estate 0 Manufacturing 0 Finance & insurance 00 Other (specify)CLEANING 15 Incicata principnl line 01 tnl'lrchandis.. sold; specific construction work done; products produced; or services provided. JANITORIAL SERVICE 6461 160 Has the applicant ever applied for an employee identification number lor this or any other business .-----------.0 Yes Note: If "Yes. please 'complete lines 16b and 160. 16b II you checked "Yes" on line 16a, give applicant's legal name and trade name shown on prior application il different from line 1 or 2 above. Lagi'll name ~ Trada nama ~ 16c Approximata date when, and city and state where, the application was flied. Enter previous employer identification number if known. Approximate date when filed (mo., day, year) City & state where flied Previous EIN o B o National Guard 0 Statel10cal government o Farmers' cooperative 0 Federal government/military o REMIC 0 Indian tribal governments/enterprises Group Exemption Number (GEN) ~ Estate (SSN of decedent) Plan administrator (SSN) rflJst (SSN of grantor) State Foreign country o Banking purpose (specify purpose) ~ o Changed type 01 organization (specify new type) ~ o Purchased going business o Created a trust (spacify type) ~ o Created a pension plan (specily type) ~ ~NO Com liMe this section onl Dasignae's name 's EIN and answer uestlons about the com letlon of this lotm. oulg~oe'slol~phono ~umber (Incl. aroa codo) ( ) DOIIg~oo's fall ~umber (Include aroa codo) ( ) Third Party Dosignoo Addrass and Zip Code Under pon~iijn of perjury. I dO(:I~r. lh~ll h~ve ..~minod this applleallo~. and 10 tho besl 01 my knowlodQo and bellol. Ills llUO. corroel. and complolo. Name and title (Please type or print clearly.) ~ Si nature 03/27/2007 For Prlvaby Act and Paperwork Reduction Act Notice, see separate Instructions. Cat. No, 16055N (Rev, 12.2001)