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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 ____________________________


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.

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