EIN Irs Number

Responsible party Information ● - REQUIRED FIELDS

First Name: ●

Middle Name:

Last Name: ●

Suffix:

Social Security Number: ●

Trust Information

Legal Entity Name of Trust: ●

Type of Trust: ●

Trustee Information

First Name: ●

Middle Name:

Last Name: ●

Suffix:

Title: ●

Trustee Address (No PO Boxes)

Address: ●

City: ●

State: ●

ZIP :

County : ●

Phone : ●

Is the responsible party an existing business ?

Your mailing address is different than your Business Address ?

Mailing Address

Address: ●

City: ●

State: ●

ZIP : ●

County : ●

Entity owned by another business:

Business Name:

Business EIN:

Dates

Date S-Corporation Funded: ●

Closing Month of Accounting Year: ●

Additional Information

Trust filing as an Estate under Section 645 (chek if Yes)

Do you have, or do you expect to have, any employees who will receive Forms W-2 in the next 12 months?

Yes No

Has the applicant entity ever applied for and received an EIN?

Yes No

Employees

Number of OR expected number of Agricultural Employees: ●

Number of OR expected number of Household Employees: ●

Number of OR expected number of Other Employees: ●

First date wages were/will be paid: ●

Do you expect your employment tax liability to be $1,000 or less in a full calendar year (January-December) ?

Previous EIN number

2 first digits from previous EIN number: ●

7 last digits from previous EIN number: ●

EIN/Tax ID Recipient Information

EIN Recipient Name : ●

EIN Recipient Phone : ●

EIN Recipient Email : ●

Confirm your EIN Recipient Email : ●

Customer Agreement

By checking this box, (i) I represent and warrant that all of the information provided above is accurate and complete; (ii) I agree that I have carefully read and agree to be bound by the Terms of Use (see below) and (iii) I have read and understand that I am hereby authorizing EIN Tax ID Filing Service as a "Third Party Designee" as described in the instructions to Form SS-4 to apply to the IRS for the Employer Identification Number of the person or entity listed above, answer any questions on my behalf or the behalf of the entity listed above about the completion of Form SS-4, and to receive and deliver to me the Employer Identification Number for me or the entity listed above.