Blank TIN Form~28.docx

This is a Taxpayer Identification Number (TIN) certification form issued by the State of Illinois for use in state and local contract opportunities. The form is a blank template designed to collect taxpayer identification information from bidders and contractors seeking to participate in Illinois procurement opportunities, including the Pest Control services contract at site J0110 located at 4500 South 6th Street, Springfield, Illinois 62703. The form requires respondents to provide their legal name, business name, and appropriate taxpayer identification number (either Social Security Number or Employer Identification Number) and to certify their correct tax identification status and compliance with IRS backup withholding requirements. Respondents must also indicate their legal status, selecting from options including individual, sole proprietor, partnership, corporation, limited liability company, and various other entity types such as tax-exempt organizations, governmental entities, and entities providing medical or health care services.

The form serves as a prerequisite documentation requirement for state and local contract opportunities in Illinois and does not itself contain pricing terms, set-asides, funding information, or contract-specific details. Completion and submission of the TIN form is mandatory for all prospective contractors and bidders, regardless of entity type, to establish their eligibility to participate in Illinois procurement processes. The form includes certification language whereby authorized representatives attest to the accuracy of their taxpayer identification information and their non-subject status to IRS backup withholding, ensuring compliance with federal tax reporting requirements.