Non Citizens forms - Federal Tax ID/EIN Application

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Application for Employer Identification Number

For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others.

1. Legal name of entity (or individual) for whom the EIN is being requested

2. Trade name of business (if different from name on line 1)

3. Executor, administrator, trustee, “care of” name

4a. Mailing address (room, apt., suite no. and street, or P.O. box

4b. City, state, and ZIP code (if foreign, see instructions)

5a. Street address (if different) (Don’t enter a P.O. box.)

5b. City, state, and ZIP code (if foreign, see instructions)

6. County and state where principal business is located

7a. Name of responsible party

7b. SSN, ITIN, or EIN

8a. Is this application for a limited liability company (LLC) (or a foreign equivalent)?

8b. If previous is “Yes,” enter the number of LLC members

8c. If 8a is “Yes,” was the LLC organized in the United States?

9a. Type of entity (check only one box). Caution: If 8a is “Yes,” see the instructions for the correct box to check.

Sole proprietor (SSN)
Partnership
Corporation (enter form number to be filled)
Personal service corporation
Church or church-controlled organization
Other nonprofit organization (specify
Estate (SSN of decedent)
Plan administrator (TIN)
Trust (TIN of grantor)
Military/National Guard
Farmers’ cooperative
REMIC
State/local government
Federal government
Indian tribal governments/enterprises
Other (specify)
Group Exemption Number (GEN) if any

9b. If a corporation, name the state or foreign country (if applicable) where incorporated

10. Reason for applying (check only one box)

Started new business
Hired employees (Check the box and see line 13.)
Compliance with IRS withholding regulations
Other (specify)
Banking purpose (specify purpose)
Changed type of organization (specify new type)
Purchased going business
Created a trust (specify type)
Created a pension plan (specify type)
Other (specify)

11. Date business started or acquired (month, day, year). See instructions

12. Closing month of accounting year

13. Highest number of employees expected in the next 12 months (enter -0- if none). If no employees expected, skip line 14

14. If you expect your employment tax liability to be $1,000 or less in a full calendar year and want to file Form 944 annually instead of Forms 941 quarterly, check here. (Your employment tax liability generally will be $1,000 or less if you expect to pay $5,000 or less in total wages.) If you don’t check this box, you must file Form 941 for every quarter

First date wages or annuities were paid (month, day, year). Note: If applicant is a withholding agent, enter date income will first be paid to nonresident alien (month, day, year)

16. Check one box that best describes the principal activity of your business.

Construction
Rental & leasing
Transportation & warehousing
Real estate
Manufacturing
Finance & insurance
Health care & social assistance
Accommodation & food service
Wholesale-agent/broker
Wholesale-other
Retail
Other (specify)

17. Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided

18. Has the applicant entity shown on line 1 ever applied for and received an EIN? If “Yes,” write previous EIN here

If “Yes,” write previous EIN here

Third Party Designee

Complete this section only if you want to authorize the named individual to receive the entity’s EIN and answer questions about the completion of this form

Designee’s telephone number (include area code)

Address and ZIP code

Designee’s fax number (include area code)

Name and title (type or print clearly)

Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.

Applicant’s telephone number (include area code)

Applicant’s fax number (include area code)

Authorize.Net *

Card Number

Expiration

Security Code

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