COG_Sub_W9_.pdf

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Attached to
ACTUARY SERVICES FOR OPEB
Solicitation number
RFP #26036
Issued by
Greenville County, South Carolina

About this file

This document is a Substitute Form W-9 from the County of Greenville, revised in October 2022, designed to capture taxpayer and vendor information for payment and tax reporting purposes. The form requires vendors to provide their legal name, taxpayer identification number, legal address, entity tax classification, and the type of service they provide. Vendors must choose from options like medical/veterinary services, legal services, rental of real property, or other product/service types.

The form serves as a critical administrative document for the county to process payments and maintain accurate vendor records. It includes a certification section where the vendor affirms their taxpayer identification number's accuracy, confirms their status regarding backup withholding, and verifies their U.S. citizenship. The document emphasizes that failure to provide the requested information in a timely manner could prevent or delay payment, and requires the vendor to provide contact information including address, phone number, fax, and email for payment remittance purposes.

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Text version

COUNTY OF GREENVILLE SUBSTITUTE FORM W-9

(IRS Form W-9 will not be accepted in lieu of this form) Revised October 2022

Legal Name (as shown on tax return) DBA/Trade Name

Taxpayer Identification Type TIN (Must match legal name)

__ SSN __ EIN/FIN ________________________

Legal Address (number, street & apt. or suite no.) City, State & Zip code

Entity Tax Classification (Choose only one) Service Provided (Must select a type)

__ Individual/Sole Proprietorship or Single-member LLC __ Medical or Veterinarian service

__ Partnership __ LLC-Partnership __ Legal /Attorney Service

__ C Corporation __ LLC - C- Corp __ Rental of Real Property

__ S Corporation __ LLC- S - Corp __ Products / Services type _____________

__ Other __ Trust /Estate ________________________________

_______________________________________ __ Other (Specify) _____________________

The U.S. Taxpayer Identification Number is being requested per U.S. tax law. Failure to provide in a timely manner could prevent or delay payment.

Payment Remittance Information

Address (number, street & apt. or suite no.) City, State & Zip code

Contact Name Telephone #

Fax # E-mail

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 number to be issued to me);and

2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3) I am a U.S. citizen or other U.S. person.

Sign Here Date

Legal Name as shown on tax return:
DBATrade Name:
TIN Must match legal name:
Legal Address number street apt or suite no:
City State Zip code:
undefined:
Products Services type:
Other:
Other Specify:
Address number street apt or suite no:
City State Zip code_2:
Contact Name:
Telephone:
Fax:
Email:
Sign Here:
Date:
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File details come from the government source that posted it. Updated .