Form Application for Employer Identification Number (United States)
This is an employer identification number application. The form provided here is simply a sample of what the actual Form SS-4 EIN looks like.
Application for Employer Identification Number
Form SS-4 EIN
(For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others.)
OMB No. 1545-0003
Department of the Treasury
Internal Revenue Service
1 Legal name of entity (or individual) for whom the EIN is being requested
____________________________
2 Trade name of business (if different from name on line 1)
____________________________
3 Executor, administrator, trustee, "care of" name
____________________________
4a Mailing address (room, apt., suite no. and street, or P.O. box)
____________________________
4b City, state, and ZIP code (if foreign, see instructions)
____________________________
5a Street address (if different) (Do not enter a P.O. box.)
____________________________
5b City, state, and ZIP code (if foreign, see instructions)
____________________________
6 County and state where principal business is located
____________________________
7a Name of principal officer, general partner, grantor, owner, or trustor
____________________________
7b SSN, ITIN, or EIN ____________________________
8a Is this application for a limited liability company (LLC) (or a foreign equivalent)?
____ Yes ____ No
8b If 8a is "Yes," enter the number of LLC members ____________________________
8c If 8a is "Yes," was the LLC organized in the United States?
____ Yes ____ No
9a Type of entity (check only one box). Caution. If 8a is "Yes," see the instructions for the correct box to check.
____ Sole proprietor (SSN) ____________________________
____ Partnership
____ Corporation (enter form number to be filed)
____________________________
____ Personal service corporation
____ Church or church-controlled organization
____ Other nonprofit organization (specify)
____________________________
____ Other (specify) ____________________________
____ Estate (SSN of decedent) ____________________________
____ Plan administrator (TIN) ____________________________
____ Trust (TIN of grantor) ____________________________
____ National Guard
____ Farmers' cooperative
____ REMIC
____ State/local government
____ Federal government/military
____ Indian tribal governments/enterprises
____ Group Exemption Number (GEN) if any
____________________________
9b If a corporation, name the state or foreign country (if applicable) where incorporated
State ____________________________
Foreign country ____________________________
10 Reason for applying (check only one box)
____ Started new business (specify type) ____________________________
____ Hired employees (Check the box and see line 13.)
____ Compliance with IRS withholding regulations
____ Other (specify) ____________________________
____ Banking purpose (specify purpose) ____________________________
____ Changed type of organization (specify new type)
____________________________
____ Purchased going business
____ Created a trust (specify type) ____________________________
____ Created a pension plan (specify type) ____________________________
11 Date business started or acquired (month, day, year). See instructions.
____________________________
12 Closing month of accounting year ____________________________
13 Highest number of employees expected in the next 12 months (enter -0- if none).
Agricultural ____________________________
Household ____________________________
Other ____________________________
14 Do you expect your employment tax liability to be $1,000 or less in a full calendar year?
____ Yes ____ No (If you expect to pay $4,000 or less in total wages in a full calendar year, you can mark "Yes.")
15 First date wages or annuities were paid (month, day, year). Note. If applicant is a withholding agent, enter date income will first be paid to nonresident alien (month, day, year)
____________________________
16 Check one box that best describes the principal activity of your business.
____ Construction
____ Real estate
____ Rental & leasing
____ Manufacturing
____ Transportation & warehousing
____ Finance & insurance
____ Health care & social assistance
____ Accommodation & food service
____ Other (specify) ____________________________
____ Wholesale-agent/broker
____ Wholesale-other
____ Retail
17 Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.
____________________________
18 Has the applicant entity shown on line 1 ever applied for and received an EIN?
____ Yes ____ No
If "Yes," write previous EIN here ____________________________
Third Party Designee
Complete this section only i f you want to authorize the named individual to receive the entity's EIN and answer questions about the completion of this form.
Designee's name ____________________________
Designee's telephone number (include area code)
____________________________
Address and ZIP code ____________________________
Designee's fax number (include area code)
____________________________
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.
Name and title (type or print clearly) ____________________________
Applicant's telephone number (include area code)
____________________________
Applicant's fax number (include area code)
____________________________
Signature ____________________________
Date ____________________________
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INSTRUCTIONS FOR FILLING IN FORM
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Do I Need an EIN?
File Form SS-4 if the applicant entity does not already have an EIN but is required to show an EIN on any return, statement, or other document.1 See also the separate instructions for each line on Form SS-4.
IF the applicant...Started a new business AND Does not currently have (nor expect to have) employees Complete lines 1, 2, 4a-8a, 8b-c (if applicable), 9a, 9b (if applicable), and 10-14 and 16-18.
IF the applicant...Hired (or will hire) employees, including household employees AND Does not already have an EIN THEN Complete lines 1, 2, 4a-6, 7a-b (if applicable), 8a, 8b-c (if applicable), 9a, 9b (if applicable), 10-18.
IF the applicant...Opened a bank account AND Needs an EIN for banking purposes only THEN Complete lines 1-5b, 7a-b (if applicable), 8a, 8b-c (if applicable), 9a, 9b (if applicable), 10, and 18.
IF the applicant...Changed type of organization AND Either the legal character of the organization or its ownership changed (for example, you incorporate a sole proprietorship or form a partnership)(2) THEN Complete lines 1-18 (as applicable).
IF the applicant...Purchased a going business(3) AND Does not already have an EIN THEN Complete lines 1-18 (as applicable).
IF the applicant...Created a trust AND The trust is other than a grantor trust or an IRA Trust(4) THEN Complete lines 1-18 (as applicable).
IF the applicant...Created a pension plan as a plan administrator(5) AND Needs an EIN for reporting purposes THEN Complete lines 1-6, 9a, 10-12, 13-17 (if applicable), and 18.
IF the applicant...Is a foreign person needing an EIN to comply with IRS withholding regulations AND Needs an EIN to complete a Form W-8 (other than Form W-8ECI), avoid withholding on portfolio assets, or claim tax treaty benefits(6) THEN Complete lines 1-5b, 7a-b (SSN or ITIN optional), 8a, 8b-c (if applicable), 9a, 9b (if applicable), 10, and 18.
IF the applicant...Is administering an estate AND Needs an EIN to report estate income on Form 1041 THEN Complete lines 1, 3, 4a-5b, 9a, 10, and 18.
IF the applicant...Is a withholding agent for taxes on non-wage income paid to an alien (i.e., individual, corporation, or partnership, etc.) AND Is an agent, broker, fiduciary, manager, tenant, or spouse who is required to file Form 1042, Annual Withholding Tax Return for U.S. Source Income of Foreign Persons THEN Complete lines 1, 2, 3 (if applicable), 4a-5b, 7a-b (if applicable), 8a, 8b-c (if applicable), 9a, 9b (if applicable), 10 and 18.
IF the applicant...Is a state or local agency AND Serves as a tax reporting agent for public assistance recipients under Rev. Proc. 80-4, 1980-1 C.B. 5817 THEN Complete lines 1, 2, 4a-5b, 9a, 10 and 18.
IF the applicant...Is a single-member LLC AND Needs an EIN to file Form 8832, Classification Election, for filing employment tax returns, or for state reporting purposes(8) THEN Complete lines 1-18 (as applicable).
IF the applicant...Is an S corporation AND Needs an EIN to file Form 2553, Election by a Small Business Corporation(9) THEN Complete lines 1-18 (as applicable).
1 For example, a sole proprietorship or self-employed farmer who establishes a qualified retirement plan, or is required to file excise, employment, alcohol, tobacco, or firearms returns, must have an EIN. A partnership, corporation, REMIC (real estate mortgage investment conduit), nonprofit organization (church, club, etc.), or farmers' cooperative must use an EIN for any tax-related purpose even if the entity does not have employees.
2 However, do not apply for a new EIN if the existing entity only (a) changed its business name, (b) elected on Form 8832 to change the way it is taxed (or is covered by the default rules), or (c) terminated its partnership status because at least 50% of the total interests in partnership capital and profits were sold or exchanged within a 12-month period. The EIN of the terminated partnership should continue to be used. See Regulations section 301.6109-1(d)(2)(iii).
3 Do not use the EIN of the prior business unless you became the "owner" of a corporation by acquiring its stock.
4 However, grantor trusts that do not file using Optional Method 1 and IRA trusts that are required to file Form 990-T, Exempt Organization Business Income Tax Return, must have an EIN. For more information on grantor trusts, see the Instructions for Form 1041.
5 A plan administrator is the person or group of persons specified as the administrator by the instrument under which the plan is operated.
6 Entities applying to be a Qualified Intermediary (QI) need a QI-EIN even if they already have an EIN. See Rev. Proc. 2000-12.
7 See also Household employer on page 4 of the instructions. Note. State or local agencies may need an EIN for other reasons, for example, hired employees.
8 Most LLCs do not need to file Form 8832. See Limited liability company (LLC) on page 4 of the instructions for details on completing Form SS-4 for an LLC.
9 An existing corporation that is electing or revoking S corporation status should use its previously-assigned EIN.