1. Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
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. Checkonly one of the following seven boxes.
Federal Tax Classification
Note: Check the appropriate box in the line above for the tax classification of the single-member owner.Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the ownerunless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal taxpurposes. Otherwise, a single-member LLC that is disregarded from the owner should check theappropriate box for the tax classification of its owner.
4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):
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.) See instructions.
7 List account number(s) here (optional)
8 Requester's name and address (optional)
1040TaxBiz, LLC11723 Pendleton Pike Indianapolis, IN 46236
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backupwithholding. For individuals, this is generally your social security number (SSN). However, for a resident alien,sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is youremployer identification number (EIN). If you do not have a number, see How to get a TIN, later.Note: If the account is in more than one name, see the instructions for line 1. Also see What Name andNumber To Give the Requester for guidelines on whose number to enter.
Social Security Number or EIN
Part II Certification
Under penalties of perjury, I certify that:1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a numberto be issued to me); and2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have notbeen notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of afailure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backupwithholding; and3. I am a U.S. citizen or other U.S. person (defined below); and4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting iscorrect.Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you arecurrently subject to backup withholding because you have failed to report all interest and dividends on yourtax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition orabandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement(IRA), and generally, payments other than interest and dividends, you are not required to sign thecertification, but you must provide your correct TIN. See the instructions for Part II, later.
Leave this empty:
Your legal name
Your email address
Signed by Antonio Alford
Signed On: May 26, 2023
If you have questions about the contents of this document, you can email the document owner.
Document Name: W9
Agree & Sign