5

TLS, have you I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING

transmitted all R Action Date Signature
text files for this INSTRUCTIONS TO PRINTERS
cycle update? FORM SS-4, PAGE 1 of 2
MARGINS: 25mm (1") HEAD, CENTER SIDES. PRINTS: HEAD to FOOT O.K. to print
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216mm (81⁄2 ") X 559mm (22"), FOLD TO 216mm (81⁄2 ") X 279mm (11")
Date PERFORATE: NONE Revised proofs
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT requested

Form SS-4 Application for Employer Identification Number OMB No. 1545-0003
(For use by employers, corporations, partnerships, trusts, estates, churches, EIN
(Rev. February 2006) government agencies, Indian tribal entities, certain individuals, and others.)
Department of the Treasury
Internal Revenue Service 䊳 See separate instructions for each line. 䊳 Keep a copy for your records.
1 Legal name of entity (or individual) for whom the EIN is being requested
Type or print clearly.

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) 5a Street address (if different) (Do not enter a P.O. box.)

4b City, state, and ZIP code 5b City, state, and ZIP code

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 Type of entity (check only one box) Estate (SSN of decedent)

Sole proprietor (SSN) Plan administrator (SSN)
Partnership Trust (SSN of grantor)
Corporation (enter form number to be filed) 䊳 National Guard State/local government
Personal service corporation Farmers’ cooperative Federal government/military
Church or church-controlled organization REMIC Indian tribal governments/enterprises
Other nonprofit organization (specify) 䊳 Group Exemption Number (GEN) 䊳
Other (specify) 䊳
8b If a corporation, name the state or foreign country State Foreign country
(if applicable) where incorporated

9 Reason for applying (check only one box) Banking purpose (specify purpose) 䊳

Started new business (specify type) 䊳 Changed type of organization (specify new type) 䊳

Purchased going business

Hired employees (Check the box and see line 12.) Created a trust (specify type) 䊳
Compliance with IRS withholding regulations Created a pension plan (specify type) 䊳
Other (specify) 䊳
10 Date business started or acquired (month, day, year). See instructions. 11 Closing month of accounting year

12 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) 䊳

13 Highest number of employees expected in the next 12 months (enter -0- if none). Agricultural Household Other
Do you expect to have $1,000 or less in employment tax liability for the calendar
year? Yes No. (If you expect to pay $4,000 or less in wages, you can mark yes.)
14 Check one box that best describes the principal activity of your business. Health care & social assistance Wholesale–agent/broker
Construction Rental & leasing Transportation & warehousing Accommodation & food service Wholesale–other Retail
Real estate Manufacturing Finance & insurance Other (specify)
15 Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.

16a Has the applicant ever applied for an employer identification number for this or any other business? Yes No
Note. If “Yes,” please complete lines 16b and 16c.
16b If you checked “Yes” on line 16a, give applicant’s legal name and trade name shown on prior application if different from line 1 or 2 above.
Legal name 䊳 Trade name 䊳
16c Approximate date when, and city and state where, the application was filed. Enter previous employer identification number if known.
Approximate date when filed (mo., day, year) City and state where filed Previous EIN
..
..
Complete this section only if you want to authorize the named individual to receive the entity’s EIN and answer questions about the completion of this form.

Third Designee’s name Designee’s telephone number (include area code)

Party ( )
Designee 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. Applicant’s telephone number (include area code)
Name and title (type or print clearly) 䊳 ( )
Applicant’s fax number (include area code)
Signature 䊳 Date 䊳 ( )
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 16055N Form SS-4 (Rev. 2-2006)
 5
I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM SS-4, PAGE 2 of 2
MARGINS: TOP 13mm (1⁄2 "), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216mm (81⁄2 ") x 279mm (11")
PERFORATE: NONE
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form SS-4 (Rev. 2-2006) Page 2

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... AND... THEN...

Started a new business Does not currently have (nor expect to have) Complete lines 1, 2, 4a–8a, 8b (if applicable),
employees and 9–16c.

Hired (or will hire) Does not already have an EIN Complete lines 1, 2, 4a–6, 7a–b (if applicable),
employees, including 8a, 8b (if applicable), and 9–16c.
household employees

Opened a bank account Needs an EIN for banking purposes only Complete lines 1–5b, 7a–b (if applicable), 8a,
9, and 16a–c.

Changed type of Either the legal character of the organization Complete lines 1–16c (as applicable).
organization or its ownership changed (for example, you
incorporate a sole proprietorship or form a
partnership)2

Purchased a going Does not already have an EIN Complete lines 1–16c (as applicable).
business3

Created a trust The trust is other than a grantor trust or an Complete lines 1–16c (as applicable).
IRA trust4

Created a pension plan as Needs an EIN for reporting purposes Complete lines 1, 3, 4a–b, 8a, 9, and 16a–c.
a plan administrator5

Is a foreign person needing Needs an EIN to complete a Form W-8 (other Complete lines 1–5b, 7a–b (SSN or ITIN
an EIN to comply with IRS than Form W-8ECI), avoid withholding on optional), 8a–9, and 16a–c.
withholding regulations portfolio assets, or claim tax treaty benefits6

Is administering an estate Needs an EIN to report estate income on Complete lines 1, 2, 3, 4a–6, 8a, 9-11, 12-15
Form 1041 (if applicable), and 16a–c.

Is a withholding agent for Is an agent, broker, fiduciary, manager, tenant, Complete lines 1, 2, 3 (if applicable), 4a–5b,
taxes on non-wage income or spouse who is required to file Form 1042, 7a–b (if applicable), 8a, 9, and 16a–c.
paid to an alien (i.e., Annual Withholding Tax Return for U.S.
individual, corporation, or Source Income of Foreign Persons
partnership, etc.)

Is a state or local agency Serves as a tax reporting agent for public Complete lines 1, 2, 4a–5b, 8a, 9, and 16a–c.
assistance recipients under Rev. Proc. 80-4,
1980-1 C.B. 5817

Is a single-member LLC Needs an EIN to file Form 8832, Entity Complete lines 1–16c (as applicable).
Classification Election, for filing employment tax
returns, or for state reporting purposes8
Is an S corporation Needs an EIN to file Form 2553, Election by a Complete lines 1–16c (as applicable).
Small Business Corporation9
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 3. 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 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.

Printed on recycled paper