COG_Sub_W9_.pdf
PDF 170 KB Posted
- Solicitation number
- RFP #26044
- Issued by
- Greenville County, South Carolina
About this file
The document is a Substitute Form W-9 from the County of Greenville, revised in October 2022, designed to collect taxpayer and vendor information for payment processing. The form requires vendors to provide their legal name, taxpayer identification number, legal address, entity tax classification, and details about the services they will provide. Vendors must select their entity type (such as individual/sole proprietorship, partnership, corporation) and specify the type of service they offer, which can include medical, legal, rental, or other professional services.
The form includes a payment remittance section for contact information and requires the vendor to certify their tax status under penalties of perjury. Specific certifications include confirming the accuracy of the taxpayer identification number, stating they are not subject to backup withholding, and affirming they are a U.S. citizen or U.S. person. The document emphasizes that failure to provide the requested information in a timely manner could prevent or delay payment, and the form must be used instead of the standard IRS Form W-9.
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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 .