Request for Taxpayer 
Identification Number and Certification

Go to www.irs.gov/FormW9 for instructions and the latest information

 

1. Name (as shown on your income tax return).

2. Business name/disregarded entity name, if different from above

 

3. Check appropriate box for federal tax classification of the person whose name is entered on line 1.

4. Exemptions (codes apply only to certain entities, not individuals):

Exempt payee code (if any)  

Exemption from FATCA reporting code (if any)  

(Applies to accounts maintained outside the U.S.)

 

5. Address (number, street, and apt. or suite no.)

6. City, state, and ZIP code

7. List account number(s) here (optional)

8. Provide Your EIN or SSN

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Tax W-9 Form
lock iconUnique Document ID: 840d82764bc7f1d1de2895e75b31c70bb7ee3ef3
Timestamp Audit
January 4, 2022 4:29 pm ESTTax W-9 Form Uploaded by Mermaid Swim School - mermaidswimschool@hotmail.com IP 39.36.0.244
January 13, 2022 4:55 pm EST Document owner mermaidswimschool@hotmail.com has handed over this document to jaclyn.wagoner@gmail.com 2022-01-13 16:55:47 - 39.36.0.244