FORM W9.pdf

This is IRS Form W-9 (Rev. March 2024), "Request for Taxpayer Identification Number and Certification," which is required for vendors to provide their taxpayer identification information to the requester. The form is used to obtain the correct taxpayer identification number (TIN) from vendors doing business with the federal government, in this case related to a VA solicitation for Non-Emergent Ground Ambulance Services at the Long Beach Healthcare System.

The form requires entities to provide their legal business name, tax classification (individual/sole proprietor, C corporation, S corporation, partnership, trust/estate, or LLC), address, and TIN (either SSN or EIN). It includes certifications regarding backup withholding status and FATCA reporting requirements. The form contains detailed instructions for completion, information about backup withholding rules, and privacy act notices. This is a standard required federal form that must be completed by vendors to facilitate proper tax reporting of payments made under federal contracts.