EIN Thank You

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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 8a is “Yes,” enter the number of LLC members

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

9. Type of entity (check only one box).

Caution: If 8a is “Yes,” see the instructions for the correct box to check.

Details of Sole proprietor (SSN)

Details of Corporation (enter form number to be filed)

Specify the details of 'Other nonprofit organization'

Details of Estate (SSN of decedent)

Details of Plan administrator (TIN)

Details of Trust (TIN of grantor)

Specify the detailed reason for choosing the other option

Group Exemption Number (GEN) if any

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

State

Foreign country

10. Reason for applying

Started new business (specify type)

Banking purpose (specify purpose)

Changed type of organization (specify new type)

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.

Agricultural

Household

Other

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 will generally be $1,000 or less if you expect to pay $5,000 or less (or $6,536 or less if you’re in a U.S. territory) in total wages.

If you don’t check this box, you must file Form 941 every quarter.

I want to file Form 944 annually instead of Forms 941 quarterly

15. 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.

Wholesale—other (Please specify)

Other (Please 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?

Yes

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 name

Designee’s telephone number (include area code)

Address and ZIP code

Designee’s fax number (include area code)

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.

Name and title

Applicant’s telephone number (include area code)

Applicant’s fax number (include area code)

[thankyou_data]

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