W-96 (3).pdf

This document is an IRS Form W-9 (Request for Taxpayer Identification Number and Certification) dated December 2014. The form is a standard tax document used to collect a taxpayer's identifying information for income reporting purposes. It requires the taxpayer to provide their name, business name, federal tax classification, and either a Social Security Number or Employer Identification Number.

The form contains two primary sections: Part I for entering the Taxpayer Identification Number (TIN) and Part II for Certification. In the Certification section, the taxpayer affirms under penalties of perjury that the provided information is correct, they are a U.S. citizen or U.S. person, and they are not subject to backup withholding. The form includes general instructions about its purpose, which is to provide the IRS with correct identifying information for tax reporting across various types of income and transactions such as interest, dividends, real estate transactions, and merchant card payments.