IDOA-TIN SIGNED.pdf

This is a W-9 Form, Request for Taxpayer Identification Number and Certification, completed by Deborah Epstein doing business as Fancy That. The document certifies the taxpayer identification information for an individual sole proprietor or sole member LLC. The entity has provided Employer Identification Number 36-748785 and confirms U.S. citizenship status. The legal status is marked as Sole Proprietor/Sole Member LLC, indicating the business structure under which the contractor will operate.

The document serves as a tax certification and withholding exemption declaration rather than a traditional contract award. Deborah Epstein certifies that she is not subject to backup withholding and confirms her taxpayer identification status as required by the Internal Revenue Service. The form was signed and dated 7/6/96, establishing the documentation necessary for payment processing and tax compliance purposes related to any contractual engagement with a government or private entity.