TIN form blank~67.docx

This is a Taxpayer Identification Number (TIN) form blank template issued by the State of Illinois for use in conjunction with state and local contract opportunities. The form is designed to collect taxpayer identification information from bidders and contractors seeking to contract with the State of Illinois, specifically for the Elevator Inspections Bureau of Property Management Locations contract, which establishes a 3-year contract for inspections of elevators, escalators, chairlifts, and dumbwaiters throughout Illinois. The form requires submission of either a Social Security Number for individuals and sole proprietors or an Employer Identification Number for business entities, along with certification that the taxpayer identification number provided is correct and that the respondent is not subject to backup withholding by the Internal Revenue Service.

The form accommodates multiple entity types including individuals, sole proprietors, partnerships, corporations, limited liability companies, governmental entities, estates or trusts, tax-exempt organizations, and specialized entities such as legal services corporations and pharmacies. Respondents must certify their U.S. person status and provide an authorized representative signature with date. For corporations providing medical and/or health care services, an IRS acceptance letter (CP261 or CP277) must be attached. This form serves as a prerequisite documentation requirement for bidders on Illinois state and local contract opportunities and does not contain pricing information, set-asides, or other substantive contract terms.