ESBD_512616_1778614000918_Form 6 - Substitute W9 and Direct Deposit Form with Instructions.docx

Texas Workforce Commission Instructions for TWC Substitute W-9 and Direct Deposit Form

Sole Owner, enter the name of the owner.

(i.e., 1099 form, etc.).

Box 3.

type must be selected). (see Note 4 below for additional guidance)

· Then the File or Charter Number must be completed.

· (see Note 1 below)

· Then the partner’s name and SSN/EIN must be completed. The information must be provided for two of the entity’s partners. Cannot be a duplicate of the EIN in Box 5.

· (see Note 2 below)

below for listing of IRS Exempt Payee Codes)

routing number (9 digits), bank account number, and type of account.

statements were checked in Box 12:

“I am currently on Direct Deposit and wish to continue.” “New Set-up” “Change in Direct Deposit Information”

- (see Note 3 below)

Note 1: Texas based entities doing business as a:

· Texas Corporation (T)

· Professional Association (A)

· Texas Limited Partnership (L) - (this is a specific entity type, and is different from a general partnership)

· Professional Corporation (C)

Must have a Texas File Number/Texas Charter Number that is assigned by the Texas Secretary of State. Questions related to this number should be directed to the Secretary of State’s office at (512)463-5555.

Note 2: A partnership must have a minimum of two partners but may have more. The name and SSN/EIN must be provided for two partners. The information related to the remaining partners is not required to be submitted.

Note 3: Federal requirement of the Office of Foreign Assets Control (OFAC), and per rules adopted by the National Automated Clearing House Association (NACHA).

Note 4: Ownership Types

P Partnership Includes:

· Business General Partnership

· Individual General Partnership

Legal relationship that exists between two or more persons or other legal entities contractually associated as joint principals in a business.

L

Texas Limited Partnership Partnership formed by two or more persons and having one or more general partners and one or more limited partners registered with the Texas Secretary of State.

T Texas Corporation Includes:

· Limited Liability Corporation - Texas

· Texas Domestic Non-Profit Corporation

· Texas Domestic Profit Corporation

Corporation registered with the Texas Secretary of State - - either profit or non-profit.

O Out-of-State Corporation (Not Texas) Includes:

- Limited Liability Corporation - Out-of-State

Corporation legally chartered by a governmental entity outside the state of Texas.

G

Governmental Entity Any legal government agency not created by the Texas Legislature, such as a city, county, or federal agency.

A

Professional Association Entity is registered with the Texas Secretary of State as a Professional Association.

C

Professional Corporation Corporation is registered with the Texas Secretary of State as a Professional Corporation.

I

Individual Recipient

An individual entitled to receive state payments such as a grant or state refund, who is not a sole proprietor (sole ownership).

F

Financial Institution Any state bank, federal bank, savings and loan or credit union within the state of Texas or the United States.

U

State Agency/University Any Texas state agency or institution of higher education created by the Texas Legislature.

E

State Employee Employee of a Texas state agency or institution of higher education.

N

Other Organizations not defined within one of the other ownership types.

Note 5: IRS Exempt Payee Codes IRS Payee Exempt Code

IRS Description

An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2)

A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions, agencies, or instrumentalities

A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U. S. commonwealth or possession

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:

Box 5

Box 6

Box 7 Box 8 Box 9

Box 10

Box 11

Employer Identification Number (EIN)

If Other, please explain:

Partner 1 SSN/EIN:

Partner 2 Name:

Partner 2 SSN/EIN:

Backup Withholding:

Please see IRS Website Exempt from Backup Withholding

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Direct Deposit Information (Response Required)

Financial Institution Name:

Financial Institution Address: City: State: Zip:

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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