Form W-4
Department of the Treasury — Internal Revenue Service | Employee's Withholding Certificate
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(a) First name and middle initial — |
Last name — |
(b) Social security number ***-**-**** |
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Address — |
Filing Status Single |
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Step 2: Multiple Jobs or Spouse Works
[ ] (c) Two jobs total option selected.
Step 3: Claim Dependent and Other Credits
| Line 3: Total dependent credit amount entered | $0.00 |
Step 4 (optional): Other Adjustments
| 4(a) Other income (not from jobs) | $0.00 |
| 4(b) Deductions | $0.00 |
| 4(c) Extra withholding per pay period | $0.00 |
Step 5: Sign Here
Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.
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Employee's signature — |
Date — |
Form I-9
U.S. Citizenship and Immigration Services | Section 1. Employee Information and Attestation
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Last Name (Family Name) — |
First Name (Given Name) — |
Middle Initial — |
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Address (Street Number and Name) — |
Date of Birth (mm/dd/yyyy) — |
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U.S. Social Security Number ***-**-**** |
Employee's Email Address — |
Employee's Telephone Number — |
Attestation of Citizenship or Immigration Status
☑ 1. A citizen of the United States
Alien / USCIS #: — | Expiration: —
Employee Signature & Date
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Signature of Employee — |
Today's Date (mm/dd/yyyy) — |
Form W-9
(Rev. March 2024)
Department of the Treasury
Internal Revenue Service
(Rev. March 2024)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
requester. Do not
send to the IRS.
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1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2.) — |
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2 Business name/disregarded entity name, if different from above. — |
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3a Check appropriate box for federal tax classification of the entity/individual:
[ ] Individual/sole proprietor
[ ] C Corporation [ ] S Corporation [ ] Partnership [ ] Trust/estate
[ ] LLC. Enter the tax classification (C=C corp, S=S corp, P=Partnership): —
[ ] Other
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| 4 Exemptions (codes apply only to certain entities): Exempt payee code: — | Exemption from FATCA code: — |
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5 Address (number, street, and apt. or suite no.) — |
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6 City, state, and ZIP code — |
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). For other entities, it is your employer identification number (EIN).
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Social security number ***-**-**** |
Employer identification number (EIN) **-******* |
Part II Certification
Under penalties of perjury, I certify that: (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 (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 IRS that I am subject to backup withholding; and (3) I am a U.S. citizen or other U.S. person; and (4) The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
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Sign Here — Signature of U.S. person — |
Date — |