Change To Domestic Employer Identification Number (EIN) Assignment by Toll-Free Phones
Change To Domestic Employer Identification Number (EIN) Assignment by Toll-Free Phones
Change To Domestic Employer Identification Number (EIN) Assignment by Toll-Free Phones
Personal service corporation
REMIC
Church or church-controlled organization
National Guard
Trust (TIN of grantor)
Group Exemption Number (GEN) if any
Other nonprofit organization (specify)
Other (specify)
9b
If a corporation, name the state or foreign country
(if applicable) where incorporated
Changed type of organization (specify new type)
Reason for applying (check only one box)
10
Purchased going business
Started new business (specify type)
Hired employees (Check the box and see line 13.)
Created a trust (specify type)
Created a pension plan (specify type)
Banking purpose (specify purpose)
Other (specify)
12
11
Closing month of accounting year
Date business started or acquired (month, day, year). See instructions.
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)
Household
Agricultural
13 Highest number of employees expected in the next 12 months (enter -0- if none).
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
Complete this section only if you want to authorize the named individual to receive the entitys EIN and answer questions about the completion of this form.
Designees telephone number (include area code)
Date
Signature
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Form SS-4 (Rev. 1-2010)
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Cat. No. 16055N
Foreign country
State
Designees fax number (include area code)
Third
Party
Designee
Designees name
Address and ZIP code
Federal government/military
Indian tribal governments/enterprises
State/local government
If you expect your employment tax liability to be $1,000
or less in a full calendar year and want to file Form 944
annually instead of Forms 941 quarterly, check here.
(Your employment tax liability generally will be $1,000
or less if you expect to pay $4,000 or less in total
wages.) If you do not check this box, you must file
Form 941 for every quarter.
Is this application for a limited liability company (LLC) (or
a foreign equivalent)?
No
Yes
8a
If 8a is Yes, enter the number of
LLC members
8b
If 8a is Yes, was the LLC organized in the United States?
8c
No
Yes
14
Check one box that best describes the principal activity of your business.
16
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
If Yes, write previous EIN here
If no employees expected, skip line 14.
dan kelly reed
reed's pool service dan kelly reed
536 s temple st
mesa, az 85204
maricopa arizona
dan kelly reed 600845986
600 84 5986
pool service
april, 16, 2014
april