20-Form 6-Substitute W-9 Direct Deposit Form.docx
DOCX document 31 KB Posted
- Attached to
- 3202600107 Mopac Print Shop Upgrades Services
- Solicitation number
- 3202600107
- Issued by
- Travis County, Austin City, Texas
About this file
This is a TWC Substitute W-9 and Direct Deposit Form used by the Texas Workforce Commission (TWC) to collect taxpayer identification and payment information from vendors and contractors. The form serves as a substitute W-9 for tax identification purposes and requires vendors to provide their legal name, business name if applicable, tax mailing address, and taxpayer identification number (either Social Security Number or Employer Identification Number). Vendors must also designate their federal tax classification and business designation, including options for Texas corporations, professional corporations, limited liability companies, individuals, partnerships, sole proprietorships, state agencies, and government entities. Additional sections require vendors to provide profit status, corporation information including state of jurisdiction and file/charter number, sole ownership information, or general partnership details as applicable to their business structure.
The form mandates completion of direct deposit information as a required response, with options for vendors to establish new direct deposit accounts, continue existing arrangements, change account information, or cancel direct deposit services. Vendors must provide their financial institution name, address, routing number, account type (checking or savings), and account number. The form includes a certification section requiring an authorized signature, printed name, and date, wherein the vendor certifies under penalties of perjury that they have provided correct taxpayer identification information, are not subject to backup withholding, and are a U.S. citizen or other U.S. person. Vendors must also authorize the Texas Comptroller of Public Accounts to process electronic deposits in accordance with National Automated Clearing House Association rules.
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Text version
TWC Substitute W-9 and Direct Deposit Form
Box 1 Box 2 Box 3 Legal Name (as shown on your tax return):
Business Name (if different from Box 1):
Tax Information Mailing Address:
| City: |
| State: |
| Zip: |
| Phone: |
| Fax: |
| Email: |
| Box 4 |
| Payment Address (if different from Tax Address): |
| City: |
| State: |
| Zip: |
| Phone: |
| Fax: |
| Email: |
| Box 5 |
| Taxpayer Identification Number: |
| Note: Enter the same number used filing your tax return Social Security Number (SSN) |
Employer Identification Number (EIN)
| Box 6 | |||
| Federal Tax Classification/ Business Designation: | |||
| T=Texas Corporation; C=Professional Corporation; or T/O= Limited Liability Company | |||
| A=Professional Assoc. | I=Individual Recipient | ||
| L=Limited Partnership | F=Financial Institution | ||
| P=General Partnership | R=Foreign Corporation O=Out-of-State Corporation | U=State Agency/University S=Sole Owner | E=State Employee |
| G=Government Entity | N= Other |
If Other, please explain:
| Box 7 |
| Profit Status: |
| Profit |
| Non-Profit |
| Box 8 |
| Corporation Info: |
| State of Jurisdiction: |
| File or Charter Number: |
| Box 9 |
| Sole Ownership Info: |
| Sole Owner Name: Sole Owner SSN: |
| Box 10 |
| General Partnership Information: |
| Partner 1 Name: |
Partner 1 SSN/EIN:
Partner 2 Name:
Partner 2 SSN/EIN:
| Box 11 |
| Backup Withholding: |
Please see IRS Website Exempt from Backup Withholding
TWC1020
(06/18) Page of
Direct Deposit Information (Response Required)
| Box 12 |
| New Account Information (Setups and Changes) |
| I am currently on Direct Deposit and wish to continue. |
| I decline Direct Deposit at this time. |
| New Set-up |
| Change in Direct Deposit Information |
| Cancel My Direct Deposit |
Financial Institution Name:
Financial Institution Address: City: State: Zip:
| Financial Institution Routing Number: |
| Type of Account: |
| Account Number: | |
| Checking | Savings |
| Box 13 |
| Existing Account Information (Complete only for direct deposit information change) |
| Financial Institution Routing Number: |
| Type of Account: |
| Account Number: | |
| Checking | Savings |
Box 14 Box 15 Will payments be forwarded to a financial institution outside the United States? Yes No
Certification of TWC Substitute W-9 and Direct Deposit Form
Under penalties of perjury, I certify that:
1) I have provided my correct taxpayer identification number and that;
2) I am not subject to backup withholding as specified on the instruction page for this form and that;
3) I am a US citizen or other US person and that;
4) For Direct Deposit Authorization Setup, Changes or Cancellation I authorize the Texas Comptroller of Public Accounts to deposit my payments from the State of Texas to my financial institution electronically. I understand that the Texas Comptroller of Public Accounts will reverse any payments to my account in error.
I further understand that the Texas Comptroller of Public Accounts will comply at all times with the National Automated Clearing House Association’s rules. For further information on these rules, please contact your financial institution.
Authorized Signature Required:
Printed Name Required: Date Required:
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