taxpayer identification number.docx
DOCX document 18 KB Posted
- Attached to
- Fire Alarm System Service Contract
- Solicitation number
- 27-426DOC-SWICC-B-53759
- Issued by
- Illinois
About this file
This is a Taxpayer Identification Number (TIN) certification form issued by the State of Illinois for use in connection with a Fire Alarm System Service Contract opportunity at Southwestern Illinois Community College. The form requires vendors to provide their correct taxpayer identification information and certify their tax compliance status, including confirmation that they are not subject to backup withholding by the Internal Revenue Service. The document accommodates various business entity types, including individuals, sole proprietors, partnerships, corporations, limited liability companies, and tax-exempt organizations, each with specific documentation requirements such as Social Security Numbers or Employer Identification Numbers.
Completion of this form is mandatory for all prospective bidders and must be signed by an authorized representative with an accompanying date. For corporate entities, vendors must attach IRS acceptance letters (Form CP261 or CP277), and for single-member LLCs disregarded as separate entities, the owner's identification number is required. The form serves as a prerequisite documentation requirement in the procurement process and does not itself contain pricing terms, contract duration, scope specifications, or award details, which would be contained in the associated solicitation documents.
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Other files
| File | Type | Posted |
|---|---|---|
| standard-terms-and-conditions FY25 a14~1.pdf | ||
| Fire Alarm System Contract.docx | DOCX document | |
| prevailing wage certification.docx | DOCX document |
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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.
File details come from the government source that posted it. Updated .