TAX ID PAGE~2.docx

DOCX document 43 KB Posted

Attached to
DOP-SEU-Box Trailers - SM
Solicitation number
23-493ISP-OPERA-B-32472
Issued by
Illinois

About this file

This document is a Taxpayer Identification Number certification form related to a state and local contract opportunity issued by the Illinois State Police to purchase newly manufactured box trailers. The form requires the vendor to provide their name, business name, Social Security Number or Employer Identification Number, and legal status. The contract opportunity has an ID of DOP-SEU-Box Trailers - SM and is seeking specifications for the box trailers, but no further details on quantities, response dates, or contract term are provided.

The pricing terms, set asides, incumbent, funding requirements, and other salient details for this contract opportunity are not included in this document. The document solely focuses on the taxpayer identification requirements for vendors responding to this state and local contract opportunity.

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Text version

STATE OF ILLINOIS

TAXPAYER IDENTIFICATION NUMBER

I certify that:

The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and I am a U.S. person (including a U.S. resident alien).

· If you are an individual, enter your name and SSN as it appears on your Social Security Card.

· If you are a sole proprietor, enter the owner’s name on the name line followed by the name of the business and the owner’s SSN or EIN.

· If you are a single-member LLC that is disregarded as an entity separate from its owner, enter the owner’s name on the name line and the D/B/A on the business name line and enter the owner’s SSN or EIN.

· If the LLC is a corporation or partnership, enter the entity’s business name and EIN and for corporations, attach IRS acceptance letter (CP261 or CP277).

· For all other entities, enter the name of the entity as used to apply for the entity’s EIN and the EIN.

Name: Click here to enter text.

Business Name: Click here to enter text.

Taxpayer Identification Number:

Social Security Number: Click here to enter text.

or Employer Identification Number: Click here to enter text.

Legal Status (check one):

|_| Individual|_| Governmental
|_| Sole Proprietor|_| Nonresident alien
|_| Partnership|_| Estate or trust
|_| Legal Services Corporation|_| Pharmacy (Non-Corp.)
|_| Tax-exempt|_| Pharmacy/Funeral Home/Cemetery (Corp.)
|_| Corporation providing or billing|_| Limited Liability Company
medical and/or health care services(select applicable tax classification)
|_| Corporation NOT providing or billing|_| C = corporation
medical and/or health care services|_| P = partnership

Signature of Authorized Representative:

Date: Click here to enter a date.

State of Illinois Chief Procurement Office General Services 21 IFB or RFP Solicitation: Forms A: Taxpayer Identification Number V.23.1

File details come from the government source that posted it. Updated .