signature on this form indicates that Contractor is deemed to have provided the certification Contractor’s described herein. Signature Contractor’s Printed Name Title Company Business Address Date TAXPAYER ID NUMBER AND CERTIFICATION W9 FORM – Pursuant to Section 6109 of the Internal Revenue Code, you must furnish your Taxpayer Identification Number (TIN) to Isle of Wight County Schools. If this number is not provided, you may be subject to a 28 percent tax on each payment. You must provide your TIN whether or not you are required to file a tax return. To avoid the 28 percent withholding and to ensure that accurate tax information is reported to the Internal Revenue Service, please use this form to provide the requested information. OWNER’S NAME Note: If you are a sole proprietor the above line must be completed with your name, as shown on your SOCIAL SECURITY CARD. LEGAL BUSINESS NAME Note: If you are a sole proprietor your legal business name should be your business or name. “doing as” “trading as” STREET ADDRESS CITY STATE ZIP PHONE Business Type: Business Activity: Business Category: (Check one) (Check one) (Check all that apply) African-American Corporation Government Agency Services Only Legal Services Eskimo Owned Owned Merchandise (goods Medical/Health Asian-American Hispanic Partnership Trust or Estate only) Care Owned Owned American Indian Sole Proprietorship/ Individual Merchandise & Services Small Business Owned Woman Tax Exempt or Non-Profit Organization Aleut Owned Owned Check if applicable: A Division of A Wholly-Owned Subsidiary of Non-U.S. Supplier (Same Federal Tax ID as Parent) (Different Federal Tax ID than Parent) (Primarily of Foreign Origin) (Parent Company) (Parent Company) (Country)
Contractor’s signature on this form indicates that Contractor is deemed to have provided the certification described herein. Contractor’s Signature Printed Name Title Company Business Address Date TAXPAYER ID NUMBER AND CERTIFICATION – W9 FORM Pursuant to Section 6109 of the Internal Revenue Code, you must furnish your Taxpayer Identification Number (TIN) to Isle of Wight County Schools. If this number is not provided, you may be subject to a 28 percent tax on each payment. You must provide your TIN whether or not you are required to file a tax return. To avoid the 28 percent withholding and to ensure that accurate tax information is reported to the Internal Revenue Service, please use this form to provide the requested information. OWNER’S NAME Note: If you are a sole proprietor the above line must be completed with your name, as shown on your SOCIAL SECURITY CARD. LEGAL BUSINESS NAME Note: If you are a sole proprietor your legal business name should be your “doing business as” or “trading as” name. STREET ADDRESS CITY STATE ZIP PHONE Business Type: (Check one) Business Activity: (Check one) Business Category: (Check all that apply) Corporation Government Agency Services Only Legal Services African-American Owned Eskimo Owned Partnership Trust or Estate Merchandise (goods only) Medical/Health Care Asian-American Owned Hispanic Owned Sole Proprietorship/ Individual Merchandise & Services American Indian Owned Small Business Tax Exempt or Non-Profit Organization Aleut Owned Woman Owned Check if applicable: A Division of (Same Federal Tax ID as Parent) A Wholly-Owned Subsidiary of (Different Federal Tax ID than Parent) Non-U.S. Supplier (Primarily of Foreign Origin) (Parent Company) (Parent Company) (Country)
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