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  IRS Form SS-4

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IRS Form SS-4
1.0  IRS Form SS-4 for obtaining an Employer Identification Number (EIN) v1.0
Public   Published   markoblad   markoblad  (owner)
Permalink: https://valcu.co/users/markoblad/doc_templates/irs-form-ss-4-v1_0
Created: July 17, 2015 7:10:31 EDT | Last modified: October 29, 2015 1:48:44 EDT
 

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Company's Employer Identification Number (EIN) as assigned by the IRS

1 - Legal name of entity (or individual) form whom the EIN is being requested

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

3a - Executor, administrator, trustee, "care of " name

4a - Applicant mailing address (room, apt., suite no. and street, or P.O. box)

4b - Applicant mailing city, state, and ZIP code (if foreign, see instructions)

5a - Applicant street address (if different) (Do not enter a P.O. Box.)

5b - Applicant city, state, and ZIP code (if different)

6 - Applicant county and state where principal business is located

7a - Name of Responsible Party

7b - SSN, ITIN, or EIN of Name of responsible party. To be manually entered into document.


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

State where company incorporated / organized


8a - Is this application for a limited liability company (LLC) (or a foreign equivalent) - Yes Box

8a - Is this application for a limited liability company (LLC) (or a foreign equivalent) - No Box

8b - Number of LLC members (if 8a is " Yes")


8c - Was the LLC organized in the United States (if 8a is "Yes")?

8c - Was the LLC organized in the United States (if 8a is "Yes") - Yes Box

8c - Was the LLC organized in the United States (if 8a is "Yes") - No Box

9a - Type of entity


9a - Entity type - sole proprietor

9a - SSN of Sole Proprietor. To be manually entered into document.

Sole Proprietor's SSN piece 0

Sole Proprietor's SSN piece 1

Sole Proprietor's SSN piece 2


9a - Entity type - partnership

9a - Entity type - corporation

9a - Entity type - corporation tax form number


9a - Entity Type - personal service corporation

9a - Entity type - church or church-controlled organization

9a - Entity type - other nonprofit organization

9a - Entity type - other nonprofit organization - specify type


9a - Entity type - other

9a - Entity type - other - specify type


9a - Entity type - estate

9a - SSN of Decedent (Estate). To be manually entered into document.

Decedent's SSN piece 0

Decedent's SSN piece 1

Decedent's SSN piece 2


9a - Entity type - plan administrator

9a - TIN of Plan Administrator. To be manually entered into document.


9a - Entity type - trust

9a - TIN of Trust Grantor. To be manually entered into document.


9a - Entity type - National Guard

9a - Entity type - state or local government

9a - Entity type - farmers cooperative

9a - Entity type - federal government or military

9a - Entity Type - REMIC

9a - Entity Type - Indian tribal governments or enterprises

9a - Entity type - group exemption number (GEN)

9b - corporation - U.S. state where incorporated (if applicable)

9b - corporation - incorporation country (if other than U.S.)

10 - Reason for applying


10 - reason for applying - started new business

10 - Reason for applying - started new business - specify type


10 - reason for applying - hired employees

10 - reason for applying - compliance with irs withholding regulations

10 - reason for applying - other

10 - Reason for applying - other - specify


10 - reason for applying - banking purpose

10 - Reason for applying - banking purpose - specify purpose


10 - reason for applying - changed type of organization

10 - Reason for applying - changed type of organization - specify new type


10 - reason for applying - purchased going business

10 - reason for applying - created a trust

10 - Reason for applying - created a trust - specify type


10 - reason for applying - created a pension plan

10 - Reason for applying - created pension plan - specify type

11 - dat business started or acquired. See instructions.

12 - Closing month of accounting year

13 - Highest number of Agricultural employees expected in the next 12 months

13 - Highest number of Household employees expected in the next 12 months

13 - Highest number of Other employees expected in the next 12 months


14 - Do you expect your employement 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?

15 - First date wages or annuities were paid. Note: If applicant is a withholding agent, enter date income will first be paid to nonresident alien.

16 - Best description of the principal activity of your business


16 - principal activity - health care social assistance

16 - principal activity - wholesale agent broker

16 - principal activity - construction

16 - principal activity - rental leasing

16 - principal activity - transportation warehousing

16 - principal activity - accommodation food service

16 - principal activity - wholesale other

16 - principal activity - retail

16 - principal activity - real estate

16 - principal activity - manufacturing

16 - principal activity - financing insurance

16 - principal activity - other

16 - Principal activity - other - specify

17 - Principal line of merchandise sold, specific construction work done, products produced, or servies provided


18 - Has the applicant previously applied for and received an EIN?

18 - Has the applicant previously applied for and received an EIN? - Yes Box

18 - Has the applicant previously applied for and received an EIN? - No Box

Applicant's previous Employer Identification Number (EIN) as assigned by the IRS

Applicant's previous Employer Identification Number (EIN) as assigned by the IRS (First Part)

Applicant's previous Employer Identification Number (EIN) as assigned by the IRS (Last Part)

Third party designee name (if any)

Full address of the third party designee

Third Party Designee Phone number (or country) code

Third Party Designee Phone number without (or country) code

Third Party Designee Fax number (or country) code

Third Party Designee Fax number without (or country) code

Title of person who will sign this document

Applicant Phone number (or country) code

Applicant phone number without (or country) code

Applicant Fax number (or country) code

Applicant Fax number without (or country) code



Note: Form SS-4 begins on the next page of this document.

Change to Domestic Employer Identification Number (EIN)
Assignment by Toll-Free Phones
Beginning January 6, 2014, the IRS will refer all domestic EIN requests
received by toll-free phones to the EIN Online Assistant. You can access
the Assistant by going to www.irs.gov, entering “EIN” in the “Search”
feature and following instructions for applying for an EIN online.

Attention
Limit of one (1) Employer Identification Number (EIN)

Issuance per Business Day
Effective May 21, 2012, to ensure fair and equitable treatment for all
taxpayers, the Internal Revenue Service (IRS) will limit Employer
Identification Number (EIN) issuance to one per responsible party per day.
For trusts, the limitation is applied to the grantor, owner, or trustor. For
estates, the limitation is applied to the decedent (decedent estate) or the
debtor (bankruptcy estate). This limitation is applicable to all requests for
EINs whether online or by phone, fax or mail. We apologize for any
inconvenience this may cause.

Change to Where to File Address and Fax-TIN Number
There is a change to the Instructions for Form SS-4 (Rev. January 2011).
On page 2, under the "Where to File or Fax" table, the address and Fax-
TIN number have changed. If you are applying for an Employer
Identification Number (EIN), and you have no legal residence, principal
place of business, or principal office or agency in any state or the District of
Columbia, file or fax your application to:

Internal Revenue Service Center
Attn: EIN International Operation
Cincinnati, OH 45999
Fax-TIN: 859-669-5987

This change will be included in the next revision of the Instructions for Form
SS-4.



Application for Employer Identification Number Form SS-4
EIN (Rev. January 2010) (For use by employers, corporations, partnerships, trusts, estates, churches,government agencies, Indian tribal entities, certain individuals, and others.)



OMB No. 1545-0003


Department of the Treasury
Internal Revenue Service


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


1


Executor, administrator, trustee, “care of” name


3


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


2


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


4a


Street address (if different) (Do not enter a P.O. box.)


5a


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


4b


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


5b


County and state where principal business is located


6


Name of responsible party


7a


Estate (SSN of decedent)


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


9a


Partnership


Plan administrator (TIN)


Sole proprietor (SSN)


Farmers’ cooperative


Corporation (enter form number to be filed) ©


Personal service corporation


REMIC


Church or church-controlled organization


National Guard


Trust (TIN of grantor)


Group Exemption Number (GEN) if any ©


Other nonprofit organization (specify) ©
Other (specify) ©

9b


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


Changed type of organization (specify new type) ©


Reason for applying (check only one box)


10


Purchased going business


Started new business (specify type) ©


Hired employees (Check the box and see line 13.)


Created a trust (specify type) ©
Created a pension plan (specify type) ©



Banking purpose (specify purpose) ©


Other (specify) ©
12


11


Closing month of accounting year


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


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) ©



Household


Agricultural


13 Highest number of employees expected in the next 12 months (enter -0- if none).


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 No


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)

Date ©


Signature ©


For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Form SS-4 (Rev. 1-2010)


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Cat. No. 16055N


Foreign country


State


Designee’s fax number (include area code)

© See separate instructions for each line.


( )


( )


© Keep a copy for your records.


Compliance with IRS withholding regulations


SSN, ITIN, or EIN


7b


Other


Applicant’s telephone number (include area code)

Applicant’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 (type or print clearly) ©

Third
Party
Designee


Designee’s name



Address and ZIP code



Federal government/military
Indian tribal governments/enterprises


State/local government


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 $4,000 or less in total
wages.) If you do not check this box, you must file
Form 941 for every quarter.


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



No


Yes


8a


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



8b


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


8c


No


Yes


14


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


16
Construction
Real estate


Rental & leasing
Manufacturing


Transportation & warehousing
Finance & insurance


Health care & social assistance
Accommodation & food service
Other (specify)


Wholesale-agent/broker
Wholesale-other


Retail


If “Yes,” write previous EIN here ©


If no employees expected, skip line 14.




Do I Need an EIN?
File Form SS-4 if the applicant entity does not already have an EIN but is required to show an EIN on any return, statement,
or other document.1 See also the separate instructions for each line on Form SS-4.

IF the applicant... AND... THEN...

Started a new business

Hired (or will hire) employees,
including household employees

Opened a bank account

Changed type of organization

Purchased a going business 3

Created a trust

Created a pension plan as a
plan administrator 5

Is a foreign person needing an
EIN to comply with IRS
withholding regulations

Is administering an estate

Is a withholding agent for
taxes on non-wage income
paid to an alien (i.e.,
individual, corporation, or
partnership, etc.)
Is a state or local agency

Is a single-member LLC

Is an S corporation

Does not currently have (nor expect to have)
employees

Does not already have an EIN

Needs an EIN for banking purposes only

Either the legal character of the organization or its
ownership changed (for example, you incorporate a
sole proprietorship or form a partnership) 2

Does not already have an EIN

The trust is other than a grantor trust or an IRA
trust 4

Needs an EIN for reporting purposes

Needs an EIN to complete a Form W-8 (other than
Form W-8ECI), avoid withholding on portfolio assets,
or claim tax treaty benefits 6

Needs an EIN to report estate income on Form 1041

Is an agent, broker, fiduciary, manager, tenant, or
spouse who is required to file Form 1042, Annual
Withholding Tax Return for U.S. Source Income of
Foreign Persons

Serves as a tax reporting agent for public assistance
recipients under Rev. Proc. 80-4, 1980-1 C.B. 581 7

Needs an EIN to file Form 8832, Classification
Election, for filing employment tax returns and
excise tax returns, or for state reporting purposes 8

Needs an EIN to file Form 2553, Election by a Small
Business Corporation 9

Complete lines 1, 2, 4a–8a, 8b–c (if applicable), 9a,
9b (if applicable), and 10–14 and 16–18.

Complete lines 1, 2, 4a–6, 7a–b (if applicable), 8a,
8b–c (if applicable), 9a, 9b (if applicable), 10–18.

Complete lines 1–5b, 7a–b (if applicable), 8a, 8b–c
(if applicable), 9a, 9b (if applicable), 10, and 18.

Complete lines 1–18 (as applicable).

Complete lines 1–18 (as applicable).

Complete lines 1–6, 9a, 10–12, 13–17 (if applicable),
and 18.

Complete lines 1–5b, 7a–b (SSN or ITIN optional),
8a, 8b–c (if applicable), 9a, 9b (if applicable), 10,
and 18.

Complete lines 1, 3, 4a–5b, 9a, 10, and 18.

Complete lines 1, 2, 3 (if applicable), 4a–5b, 7a–b (if
applicable), 8a, 8b–c (if applicable), 9a, 9b (if
applicable), 10, and 18.

Complete lines 1, 2, 4a–5b, 9a, 10, and 18.

Complete lines 1–18 (as applicable).

Complete lines 1–18 (as applicable).

3 Do not use the EIN of the prior business unless you became the “owner” of a corporation by acquiring its stock.
4 However, grantor trusts that do not file using Optional Method 1 and IRA trusts that are required to file Form 990-T, Exempt Organization Business Income Tax

Return, must have an EIN. For more information on grantor trusts, see the Instructions for Form 1041.
5 A plan administrator is the person or group of persons specified as the administrator by the instrument under which the plan is operated.
6 Entities applying to be a Qualified Intermediary (QI) need a QI-EIN even if they already have an EIN. See Rev. Proc. 2000-12.
7 See also Household employer on page 4 of the instructions. Note. State or local agencies may need an EIN for other reasons, for example, hired employees.
8 See Disregarded entities on page 4 of the instructions for details on completing Form SS-4 for an LLC.
9 An existing corporation that is electing or revoking S corporation status should use its previously-assigned EIN.

Complete lines 1–18 (as applicable).

Form SS-4 (Rev. 1-2010) Page 2

1 For example, a sole proprietorship or self-employed farmer who establishes a qualified retirement plan, or is required to file excise, employment, alcohol,
tobacco, or firearms returns, must have an EIN. A partnership, corporation, REMIC (real estate mortgage investment conduit), nonprofit organization
(church, club, etc.), or farmers’ cooperative must use an EIN for any tax-related purpose even if the entity does not have employees.

2 However, do not apply for a new EIN if the existing entity only (a) changed its business name, (b) elected on Form 8832 to change the way it is taxed (or is
covered by the default rules), or (c) terminated its partnership status because at least 50% of the total interests in partnership capital and profits were sold or
exchanged within a 12-month period. The EIN of the terminated partnership should continue to be used. See Regulations section 301.6109-1(d)(2)(iii).


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Access
Public
Description
IRS Form SS-4 for obtaining an Employer Identification Number (EIN) v1.0
Notes
None.
License
Not specified
License Detail
Not specified
Disclaimer
Not specified

INSTRUCTIONS:

1. Available here: http://www.irs.gov/uac/Form-SS-4,-Application-for-Employer-Identification-Number-(EIN) and http://www.irs.gov/pub/irs-pdf/iss4.pdf.

2. Please consult your attorney and/or tax accountants.