Massachusetts W-9 Form.pdf

This is a W-9 Form (Request for Taxpayer Identification Number and Certification) issued by the Massachusetts Executive Office of Health and Human Services (EOHHS) in connection with the Safe and Successful Youth Initiative (SSYI) Human Trafficking Intervention Program grant application. The W-9 form is a standard federal tax document required from respondents and bidders seeking to receive grant funding or enter into contracts with the state. This form collects taxpayer identification information, business structure details, and certifications regarding the respondent's tax status and eligibility to conduct business with the Commonwealth of Massachusetts.

The W-9 form serves as a prerequisite document for entities responding to the SSYI Human Trafficking Intervention Program grant application. Respondents must complete and submit this form as part of their application package to establish their legal identity, tax classification, and federal employer identification number (EIN) or social security number (SSN) for payment and reporting purposes. The form includes certifications that the respondent is not subject to backup withholding and that the information provided is accurate. Submission of the executed W-9 form is mandatory for all qualified entities seeking to implement aspects of the Human Trafficking Intervention Program under the EOHHS grant opportunity.