Tax Preparation Documents

Name (as shown on your income tax return):*

Business name/disregarded entity name, if different from above:

Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the following seven boxes.:*

Individual/sole proprietor or single-member LLC

C Corporation

S Corporation

Partnership

Trust/estate single-member LLC

Exempt payee code (if any):

Exemption from FATCA reporting code (if any):

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

City, state, and ZIP code:

List account number(s) here (optional):

Requester’s name and address (optional)

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)

Other (see instructions)

Social security number:

Employee identification number: