ESBD_441946_1753993248845_04-Attachment C – Sample W-9.pdf

This document is a Sample W-9 Request for Taxpayer Identification Number and Certification form from the Internal Revenue Service (IRS), dated March 2024. The form is typically used for tax reporting purposes when an entity is engaging in a business transaction that requires reporting income to the IRS. While this specific document is marked as a "Sample", it provides a template for businesses and individuals to provide their taxpayer identification information.

The W-9 form includes sections for entering business/individual name, federal tax classification (such as individual, corporation, partnership, trust/estate), exemption codes, and taxpayer identification number (TIN). The form also contains certification statements where the taxpayer affirms the accuracy of their provided information, declares their backup withholding status, and confirms whether they are subject to FATCA reporting requirements. The document includes instructions for completing the form and directs users to the IRS website (www.irs.gov/FormW-9) for the most current version and additional guidance.