TIN form blank~39.docx

This is a Taxpayer Identification Number (TIN) form blank issued by the State of Illinois, required for vendors and contractors seeking to conduct business with Illinois government agencies. The form is a standard certification document used to collect taxpayer identification information from prospective contractors, including individuals, sole proprietors, partnerships, corporations, limited liability companies, and other business entities. The form requires the applicant to certify their correct taxpayer identification number, confirm they are not subject to backup withholding by the Internal Revenue Service, and verify their status as a U.S. person or resident alien. The form includes fields for the applicant's name, business name, Social Security Number or Employer Identification Number, and legal status classification, with an authorized representative signature and date required for completion.

This blank form serves as a pre-qualification document for the State of Illinois UPS Battery Maintenance Multi Locations contract opportunity, which involves establishing a five-year contract for uninterrupted power supply (UPS) inspection, repair, and maintenance services across multiple locations throughout Illinois. Prospective bidders on this contract are required to complete and submit the TIN form as part of their proposal package. The form ensures compliance with state and federal tax reporting requirements and provides the procuring agency with verified identification information necessary for contract administration and payment processing.