Form SS-4 Application for Employer Identification Number

EIN
OMB No. 1545-0003

(Rev. January 2010) (For use by employers, corporations, partnerships, trusts, estates, churches,
government agencies, Indian tribal entities, certain individuals, and others.)
Department of the Treasury
Internal Revenue Service ! See separate instructions for each line. ! 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 (if foreign, see instructions) 5b City, state, and ZIP code (if foreign, see instructions)

6 County and state where principal business is located

7a Name of responsible party 7b SSN, ITIN, or EIN

8a Is this application for a limited liability company (LLC) (or 8b If 8a is “Yes,” enter the number of
a foreign equivalent)? Yes No 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) Estate (SSN of decedent)
Partnership Plan administrator (TIN)
Corporation (enter form number to be filed) ! Trust (TIN of grantor)
Personal service corporation National Guard State/local government
Church or church-controlled organization Farmers’ cooperative Federal government/military
Other nonprofit organization (specify) ! REMIC Indian tribal governments/enterprises
Other (specify) ! Group Exemption Number (GEN) if any !
9b If a corporation, name the state or foreign country State Foreign country
(if applicable) where incorporated
10 Reason for applying (check only one box) Banking purpose (specify purpose) !

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

Purchased going business

Hired employees (Check the box and see line 13.) Created a trust (specify type) !

Compliance with IRS withholding regulations Created a pension plan (specify type) !
Other (specify) !
11 Date business started or acquired (month, day, year). See instructions. 12 Closing month of accounting year
14
If you expect your employment tax liability to be $1,000
13 Highest number of employees expected in the next 12 months (enter -0- if none). or less in a full calendar year and want to file Form 944
annually instead of Forms 941 quarterly, check here.
If no employees expected, skip line 14.
(Your employment tax liability generally will be $1,000
or less if you expect to pay $4,000 or less in total
Agricultural Household Other wages.) If you do not check this box, you must file
Form 941 for every quarter.
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. 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)
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 !
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) ! ( )
Applicant’s fax number (include area code)
Signature ! Date ! ( )
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 16055N Form SS-4 (Rev. 1-2010)
 Order#: __________________________
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1. Does your business own a highway motor vehicle with a taxable gross weight of 55,000 pounds or more? __ yes __ no

2. Does your business involve gambling/wagering? __ yes __ no

3. Does your business need to file Form 720 (Quarterly Federal Excise Tax Return)? __ yes __ no

4. Does your business sell or manufacture alcohol, tobacco, or firearms? __ yes __ no

5. Do you have, or expect to have, any employees who will receive Form W-2 in the next 12 months? __ yes __ no

6. If you own an LLC with two-members, are the members husband and wife? __ If yes, see below __ no __ n/a
If yes, select one: __ We elect to be classified as a multi-member LLC
__ We elect to be classified as a single-member LLC

!
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to!'#$!0)'$E6(9!96-!4$*$0'ed?!!

H@@IJJIKH"%IL.M __ Casino/Hotel __ Hotel __ Motel

__ Other; specify: ________________________________________

@IL."+N@"%ILM Do you focus on a single construction trade?

__ YES; specify: _____________________________
__ NO; specify primary activity: __ New residential properties __ Remodeling
__ Non-residential properties; specify: _____________________________
__ Other structures; specify: _____________________________________

C%LHL@OM __ Commodities broker __ Credit card issuing __ Investment advice __ Investment club
__ Investment holding __ Mortgage broker (agent for selling mortgages)
__ Mortgage company (lending funds with real estate as collateral) __ Portfolio management
__ Sales financing __ Securities broker __ Trust administration __ Venture capital company
__ Other; specify: ______________________________________________

CIIK!.O+P%@OM __ Bar __ Bar and restaurant __ Catering service __ Coffee shop __ Fast food restaurant
__ Full service restaurant __ Ice cream shop __ Mobile food service
__ Other; specify: __________________________________

QOHR"Q!@H+OM Do you have medical practitioners (M.D., D.O.)?

__ YES; specify: __ Medical doctor __ Psychiatrist __ Other; specify: __________________
__ NO; specify: __ Chiropractor __ Dentist __ HMO medical center __ Hospital
__ Kidney dialysis center __ Optometrist __ Outpatient care center __ Podiatrist
__ Psychologist __ Other mental health practitioner; specify: ___________________
__ Other; specify: _____________________________________________________

%L.N+HL@OM __ Insurance carrier __ Insurance agent or broker

__ Other; specify: ______________________________________
 Order#: __________________________!
!
!
JHLNCH@"N+%LSM What are the goods manufactured & materials used (example - wood furniture)?
Specify: _______________________________________________________________

!
+OHR!O."H"OM __ I rent or lease property that I own __ I rent residential real estate
__ I rent commercial, industrial, or other real estate __ I use capital to build property
__ I focus on a single construction trade; specify: _____________________________
__ I sell property for others __ I manage real estate for others
__ Other; specify: ______________________________________________________

+OL"HR!T!ROH.%LSM __ I rent, lease, or sell real estate. If yes, see below.

__ I am a real estate agent but I do not own the structures
__ I rent residential real estate that I own
__ I rent commercial industrial or other real estate that I own
__ I rent or lease goods. Specify the type of goods: _____________________________
__ I manage real estate for others.

+O"H%RM __ Selling goods exclusively over the Internet (includes independently selling on auction sites).
__ Sales from a storefront. Please specify type of store: _______________________________
__ Direct sales. Specify method (catalogue, mail order, door to door): ____________________
__ Auction house
__ Other; specify: ______________________________________

.I@%HR!H..%."HL@OM__ Nursing home __ Shelter __ Youth services

__ Other; specify: __________________________________________________________

"+HL.UI+"H"%ILM __ I transport cargo. If yes, see below.

__ Air __ Rail __ Trucking __ Water __ Other;specify: ____________
__ I transport passengers. If yes, see below.
__ Limousine service __ Shuttle bus __ Taxi service __ Other; specify: ____________
__ I provide a support activity for transportation. Specify activity: ________________________

VH+OQIN.%LSM __ Warehousing (no additional information required)

VQIRO.HROM All businesses: specify type of goods sold: _______________________________________

Do you own or take title to the goods?
__ Yes.
__ No. Do you receive commission or fee from selling these goods? __ yes __ no

I"QO+M __ Consulting; specify ( for example, management, marketing, etc.): ________________

__ Manufacturing - specify the type of goods that you manufacture and the primary materials
used (such as "wood furniture"): ___________________
__ One of the following types of organizations: __ Athletic __ Conservation __ Environmental
__ Fundraising __ Homeowners association __ Religious
__ Social or Civic __ Other; specify: ___________________
__ Repair. What are the primary goods you repair? _____________________________
__ Service. Specify the primary service you provide: ______________________________
__ Other; specify your primary business activity: ___________________________
Form SS-4 (Rev. 1-2010) 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–c (if applicable), 9a,
employees 9b (if applicable), and 10–14 and 16–18.
Hired (or will hire) employees, Does not already have an EIN Complete lines 1, 2, 4a–6, 7a–b (if applicable), 8a,
including household employees 8b–c (if applicable), 9a, 9b (if applicable), 10–18.
Opened a bank account Needs an EIN for banking purposes only Complete lines 1–5b, 7a–b (if applicable), 8a, 8b–c
(if applicable), 9a, 9b (if applicable), 10, and 18.
Changed type of organization Either the legal character of the organization or its Complete lines 1–18 (as applicable).
ownership changed (for example, you incorporate a
sole proprietorship or form a partnership) 2

Purchased a going business 3 Does not already have an EIN Complete lines 1–18 (as applicable).
Created a trust The trust is other than a grantor trust or an IRA Complete lines 1–18 (as applicable).
trust 4
Created a pension plan as a Needs an EIN for reporting purposes Complete lines 1, 3, 4a–5b, 9a, 10, and 18.
plan administrator 5
Is a foreign person needing an Needs an EIN to complete a Form W-8 (other than Complete lines 1–5b, 7a–b (SSN or ITIN optional),
EIN to comply with IRS Form W-8ECI), avoid withholding on portfolio assets, 8a, 8b–c (if applicable), 9a, 9b (if applicable), 10,
withholding regulations or claim tax treaty benefits 6 and 18.

Is administering an estate Needs an EIN to report estate income on Form 1041 Complete lines 1–6, 9a, 10–12, 13–17 (if applicable),
and 18.
Is a withholding agent for Is an agent, broker, fiduciary, manager, tenant, or Complete lines 1, 2, 3 (if applicable), 4a–5b, 7a–b (if
taxes on non-wage income spouse who is required to file Form 1042, Annual applicable), 8a, 8b–c (if applicable), 9a, 9b (if
paid to an alien (i.e., Withholding Tax Return for U.S. Source Income of applicable), 10, and 18.
individual, corporation, or Foreign Persons
partnership, etc.)
Is a state or local agency Serves as a tax reporting agent for public assistance Complete lines 1, 2, 4a–5b, 9a, 10, and 18.
recipients under Rev. Proc. 80-4, 1980-1 C.B. 581 7
Is a single-member LLC Needs an EIN to file Form 8832, Classification Complete lines 1–18 (as applicable).
Election, for filing employment tax returns and
excise tax returns, or for state reporting purposes 8

Is an S corporation Needs an EIN to file Form 2553, Election by a Small Complete lines 1–18 (as applicable).
Business Corporation 9
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 See Disregarded entities 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.
 Userid: ________ DTD INSTR04 Leadpct: 0% Pt. size: 9.5 ❏ Draft ❏ Ok to Print
PAGER/SGML Fileid: ...rs\sw2mb\documents\TF\2009 ASSIGNMENTS\SS-4INST\10ISS4.sgm (Init. & date)

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Instructions for Form SS-4 Department of the Treasury

Internal Revenue Service

(Rev. January 2010)

Application for Employer Identification Number
Section references are to the Internal Revenue Code unless paying their federal taxes electronically. Whether you rely on
otherwise noted. a tax professional or handle your own taxes, IRS offers you
convenient programs to make filing and paying easier.
Spend less time and worry on taxes and more time running
What’s New your business. Use e-file and the Electronic Federal Tax
Payment System (EFTPS) to your benefit.
Name of responsible party. The instructions for Line • For e-file, visit www.irs.gov for additional information.
7a – b have been changed to request the name of the • For EFTPS, visit www.eftps.gov or call EFTPS Customer
responsible party. See Lines 7a – b, Name of responsible Service at 1-800-555-4477, 1-800-733-4829 (TDD), or
party on page 3 for details. 1-800-244-4829 (Spanish).
Election to file Form 944. Eligible employers may now Federal tax deposits. New employers that have a federal
elect to file Form 944 annually instead of Forms 941 tax obligation will be pre-enrolled in the Electronic Federal
quarterly. See Line 14. Do you want to file Form 944? on Tax Payment System (EFTPS). EFTPS allows you to make
page 5 for details. all of your federal tax payments online at www.eftps.gov or
by telephone. Shortly after we have assigned you your EIN,
General Instructions you will receive instructions by mail for activating your
EFTPS enrollment. You will also receive an EFTPS
Use these instructions to complete Form SS-4, Application Personal Identification Number (PIN) that you will use to
for Employer Identification Number. Also see Do I Need an make your payments, as well as instructions for obtaining an
EIN? on page 2 of Form SS-4. Internet password you will need to make payments online.
If you are not required to make deposits by EFTPS, you
Purpose of Form can use Form 8109, Federal Tax Deposit (FTD) Coupon, to
Use Form SS-4 to apply for an employer identification make deposits at an authorized depositary. If you would like
number (EIN). An EIN is a nine-digit number (for example, to receive Form 8109, call 1-800-829-4933. Allow 5 to 6
12-3456789) assigned to sole proprietors, corporations, weeks for delivery. For more information on federal tax
partnerships, estates, trusts, and other entities for tax filing deposits, see Pub. 15 (Circular E), Employer’s Tax Guide.
and reporting purposes. The information you provide on this
form will establish your business tax account. How To Apply
An EIN is for use in connection with your business You can apply for an EIN online, by telephone, by fax, or by
!
CAUTION
activities only. Do not use your EIN in place of your
social security number (SSN).
mail depending on how soon you need to use the EIN. Use
only one method for each entity so you do not receive more
than one EIN for an entity.
Online. Taxpayers and authorized third party designees
Reminders located within the United States and U.S. possessions can
Apply online. Generally, you can apply for and receive an receive an EIN online and use it immediately to file a return
EIN online using the Internet. See How To Apply later. or make a payment. Go to the IRS website at www.irs.gov/
businesses and click on Employer ID Numbers.
This is a free service offered by the Internal Revenue
!
CAUTION
Service at www.irs.gov. Beware of websites on the
Internet that charge for this free service.
Taxpayers who apply online have an option to view,
TIP print, and save their EIN assignment notice at the
end of the session. (Authorized third party designees
File only one Form SS-4. Generally, a sole proprietor will receive the EIN but the notice will be mailed to the
should file only one Form SS-4 and needs only one EIN, applicant.)
regardless of the number of businesses operated as a sole
proprietorship or trade names under which a business Applicants who are not located within the United
operates. However, if the proprietorship incorporates or ! States or U.S. possessions cannot use the online
CAUTION application to obtain an EIN. Please use one of the
enters into a partnership, a new EIN is required. Also, each
corporation in an affiliated group must have its own EIN. other methods to apply.
EIN applied for, but not received. If you do not have an Telephone. You can receive your EIN by telephone and
EIN by the time a return is due, write ‘‘Applied For’’ and the use it immediately to file a return or make a payment. Call
date you applied in the space shown for the number. Do not the IRS at 1-800-829-4933. The hours of operation are 7:00
show your SSN as an EIN on returns. a.m. to 10:00 p.m. local time (Pacific time for Alaska and
Hawaii). The person making the call must be authorized to
If you do not have an EIN by the time a tax deposit is sign the form or be an authorized designee. See Third Party
due, send your payment to the Internal Revenue Service Designee and Signature on page 6. Also see the TIP on
Center for your filing area as shown in the instructions for page 2.
the form that you are filing. Make your check or money order
payable to the ‘‘United States Treasury’’ and show your Note. International applicants must call 215-516-6999.
name (as shown on Form SS-4), address, type of tax, period If you are applying by telephone, it will be helpful to
covered, and date you applied for an EIN. complete Form SS-4 before contacting the IRS. An IRS
Electronic filing and payment. Now, more than ever representative will use the information from the Form SS-4
before, businesses can enjoy the benefits of filing and to establish your account and assign you an EIN. Write the

Cat. No. 62736F

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number you are given on the upper right corner of the form information about workshops in your area, call
and sign and date it. Keep this copy for your records. 1-800-829-4933.
If requested by an IRS representative, mail or fax the
signed Form SS-4 (including any Third Party Designee Related Forms and Publications
authorization) within 24 hours to the IRS address provided The following forms and instructions may be useful to filers
by the IRS representative. of Form SS-4.
• Form 990-T, Exempt Organization Business Income Tax
Taxpayer representatives can apply for an EIN on Return.
TIP behalf of their client and request that the EIN be • Instructions for Form 990-T.
faxed to their client on the same day. Note. By using • Schedule C (Form 1040), Profit or Loss From Business.
this procedure, you are authorizing the IRS to fax the EIN • Schedule F (Form 1040), Profit or Loss From Farming.
without a cover sheet. • Instructions for Form 1041 and Schedules A, B, D, G, I, J,
Fax. Under the Fax-TIN program, you can receive your EIN and K-1, U.S. Income Tax Return for Estates and Trusts.
by fax within 4 business days. Complete and fax Form SS-4 • Form 1042, Annual Withholding Tax Return for U.S.
to the IRS using the appropriate Fax-TIN number listed Source Income of Foreign Persons.
below. A long-distance charge to callers outside of the local • Instructions for Form 1065, U.S. Return of Partnership
calling area will apply. Fax-TIN numbers can only be used to Income.
apply for an EIN. The numbers may change without notice. • Instructions for Form 1066, U.S. Real Estate Mortgage
Fax-TIN is available 24 hours a day, 7 days a week. Investment Conduit (REMIC) Income Tax Return.
Be sure to provide your fax number so the IRS can fax • Instructions for Forms 1120.
the EIN back to you. • Form 2553, Election by a Small Business Corporation.
• Form 2848, Power of Attorney and Declaration of
Note. By using this procedure, you are authorizing the IRS Representative.
to fax the EIN without a cover sheet. • Form 8821, Tax Information Authorization.
Mail. Complete Form SS-4 at least 4 to 5 weeks before you • Form 8832, Entity Classification Election.
will need an EIN. Sign and date the application and mail it to For more information about filing Form SS-4 and related
the service center address for your state. You will receive issues, see:
your EIN in the mail in approximately 4 weeks. See also • Pub. 51 (Circular A), Agricultural Employer’s Tax Guide;
Third Party Designee on page 6. • Pub. 15 (Circular E), Employer’s Tax Guide;
Call 1-800-829-4933 to verify a number or to ask about • Pub. 538, Accounting Periods and Methods;
the status of an application by mail. • Pub. 542, Corporations;
• Pub. 557, Tax-Exempt Status for Your Organization;
• Pub. 583, Starting a Business and Keeping Records;
Where to File or Fax • Pub. 966, The Secure Way to Pay Your Federal Taxes for
Business and Individual Taxpayers;
If your principal business, File or fax with the “Internal • Pub. 1635, Understanding Your EIN;
office or agency, or legal Revenue Service Center” • Package 1023, Application for Recognition of Exemption
residence in the case of an at: Under Section 501(c)(3) of the Internal Revenue Code; and
individual, is located in: • Package 1024, Application for Recognition of Exemption
Under Section 501(a).
Attn: EIN Operation
One of the 50 states or the Cincinnati, OH 45999
District of Columbia
Fax-TIN: 859-669-5760 Specific Instructions
Print or type all entries on Form SS-4. Follow the
If you have no legal Attn: EIN Operation instructions for each line to expedite processing and to avoid
residence, principal place of Philadelphia, PA 19255 unnecessary IRS requests for additional information. Enter
business, or principal office “N/A” (nonapplicable) on the lines that do not apply.
or agency in any state: Fax-TIN: 215-516-1040
Line 1. Legal name of entity (or individual) for whom the
EIN is being requested. Enter the legal name of the entity
(or individual) applying for the EIN exactly as it appears on
How To Get Forms and Publications the social security card, charter, or other applicable legal
Internet. You can access the IRS website 24 hours a day, document. An entry is required.
7 days a week at www.irs.gov to download forms, Individuals. Enter your first name, middle initial, and
instructions, and publications. last name. If you are a sole proprietor, enter your individual
Phone. Call 1-800-TAX-FORM (1-800-829-3676) to order name, not your business name. Enter your business name
forms, instructions, and publications. You should receive on line 2. Do not use abbreviations or nicknames on line 1.
your order or notification of its status within 10 workdays. Trusts. Enter the name of the trust as it appears on the
trust instrument.
DVD for Tax Products. For small businesses, return
preparers, or others who may frequently need tax forms or Estate of a decedent. Enter the name of the estate. For
publications, a DVD containing over 2,000 tax products an estate that has no legal name, enter the name of the
(including many prior year forms) can be purchased from the decedent followed by “Estate.”
National Technical Information Service (NTIS). Partnerships. Enter the legal name of the partnership
To order Pub.1796, IRS Tax Products CD, call as it appears in the partnership agreement.
1-877-233-6767 or connect to www.irs.gov/cdorders. Corporations. Enter the corporate name as it appears
in the corporate charter or other legal document creating it.
Tax Help for Your Business Plan administrators. Enter the name of the plan
IRS-sponsored Small Business Workshops provide administrator. A plan administrator who already has an EIN
information about your federal and state tax obligations. For should use that number.
-2- Instr. for Form SS-4 (2010)
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Line 2. Trade name of business. Enter the trade name of You must enter an SSN, ITIN, or EIN on line 7b unless
the business if different from the legal name. The trade the only reason you are applying for an EIN is to make an
name is the ‘‘doing business as’’ (DBA) name. entity classification election (see Regulations sections
301.7701-1 through 301.7701-3) and you are a nonresident
Use the full legal name shown on line 1 on all tax
alien or other foreign entity with no effectively connected
! returns filed for the entity. (However, if you enter a
CAUTION trade name on line 2 and choose to use the trade
income from sources within the United States.
name instead of the legal name, enter the trade name on all Lines 8a – c. Limited liability company (LLC) information.
returns you file.) To prevent processing delays and errors, An LLC is an entity organized under the laws of a state or
always use the legal name only (or the trade name only) on foreign country as a limited liability company. For federal tax
all tax returns. purposes, an LLC may be treated as a partnership or
corporation or be disregarded as an entity separate from its
Line 3. Executor, administrator, trustee, ‘‘care of’’ name.
owner.
Trusts enter the name of the trustee. Estates enter the name
of the executor, administrator, or other fiduciary. If the entity By default, a domestic LLC with only one member is
applying has a designated person to receive tax information, disregarded as an entity separate from its owner and must
enter that person’s name as the ‘‘care of’’ person. Enter the include all of its income and expenses on the owner’s tax
individual’s first name, middle initial, and last name. return (for example, Schedule C (Form 1040)). Also by
Lines 4a – b. Mailing address. Enter the mailing address default, a domestic LLC with two or more members is
for the entity’s correspondence. If the entity’s address is treated as a partnership. A domestic LLC may file Form
outside the United States or its possessions, you must enter 8832 to avoid either default classification and elect to be
the city, province or state, postal code, and the name of the classified as an association taxable as a corporation. For
country. Do not abbreviate the country name. If line 3 is more information on entity classifications (including the rules
completed, enter the address for the executor, trustee or for foreign entities), see the instructions for Form 8832.
“care of” person. Generally, this address will be used on all If the answer to line 8a is “Yes,” enter the number of LLC
tax returns. members. If the LLC is owned solely by a husband and wife
If the entity is filing the Form SS-4 only to obtain an EIN in a community property state and the husband and wife
for the Form 8832, use the same address where you would choose to treat the entity as a disregarded entity, enter “1”
like to have the acceptance or nonacceptance letter sent. on line 8b.

File Form 8822, Change of Address, to report any Do not file Form 8832 if the LLC accepts the default
TIP subsequent changes to the entity’s mailing address. ! classifications above. If the LLC is eligible to be
CAUTION treated as a corporation that meets certain tests and

it will be electing S corporation status, it must timely file

Lines 5a – b. Street address. Provide the entity’s physical Form 2553. The LLC will be treated as a corporation as of
address only if different from its mailing address shown in the effective date of the S corporation election and does not
lines 4a – b. Do not enter a P.O. box number here. If the need to file Form 8832. See the Instructions for Form 2553.
entity’s address is outside the United States or its Line 9a. Type of entity. Check the box that best describes
possessions, you must enter the city, province or state, the type of entity applying for the EIN. If you are an alien
postal code, and the name of the country. Do not abbreviate individual with an ITIN previously assigned to you, enter the
the country name. ITIN in place of a requested SSN.
Line 6. County and state where principal business is
located. Enter the entity’s primary physical location. This is not an election for a tax classification of an
Lines 7a – b. Name of responsible party. Enter the full !
CAUTION
entity. See Disregarded entities on page 4.
name (first name, middle initial, last name, if applicable) and
SSN, ITIN, or EIN of the entity’s responsible party as Sole proprietor. Check this box if you file Schedule C,
defined below. C-EZ, or F (Form 1040) and have a qualified plan, or are
Responsible party defined. For entities with shares or required to file excise, employment, alcohol, tobacco, or
interests traded on a public exchange, or which are firearms returns, or are a payer of gambling winnings. Enter
registered with the Securities and Exchange Commission, your SSN (or ITIN) in the space provided. If you are a
“responsible party” is (a) the principal officer, if the business nonresident alien with no effectively connected income from
is a corporation, (b) a general partner, if a partnership, (c) sources within the United States, you do not need to enter
the owner of an entity that is disregarded as separate from an SSN or ITIN.
its owner (disregarded entities owned by a corporation enter Corporation. This box is for any corporation other than
the corporation’s name and EIN), or (d) a grantor, owner, or a personal service corporation. If you check this box, enter
trustor, if a trust. the income tax form number to be filed by the entity in the
For all other entities, “responsible party” is the person space provided.
who has a level of control over, or entitlement to, the funds If you entered “1120S” after the “Corporation”
or assets in the entity that, as a practical matter, enables the
individual, directly or indirectly, to control, manage, or direct
! checkbox, the corporation must file Form 2553 no
CAUTION later than the 15th day of the 3rd month of the tax

the entity and the disposition of its funds and assets. The year the election is to take effect. Until Form 2553 has been
ability to fund the entity or the entitlement to the property of received and approved, you will be considered a Form 1120
the entity alone, however, without any corresponding filer. See the Instructions for Form 2553.
authority to control, manage, or direct the entity (such as in Personal service corporation. Check this box if the
the case of a minor child beneficiary), does not cause the entity is a personal service corporation. An entity is a
individual to be a responsible party. personal service corporation for a tax year only if:
If the person in question is an alien individual with a • The principal activity of the entity during the testing period
previously assigned individual taxpayer identification (prior tax year) for the tax year is the performance of
number (ITIN), enter the ITIN in the space provided and personal services substantially by employee-owners, and
submit a copy of an official identifying document. If • The employee-owners own at least 10% of the fair market
necessary, complete Form W-7, Application for IRS value of the outstanding stock in the entity on the last day of
Individual Taxpayer Identification Number, to obtain an ITIN. the testing period.
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Personal services include performance of services in • Withholding agent. If you are a withholding agent
such fields as health, law, accounting, or consulting. For required to file Form 1042, check the ‘‘Other’’ box and enter
more information about personal service corporations, see ‘‘Withholding Agent.’’
the Instructions for Form 1120 and Pub. 542. Disregarded entities. A disregarded entity is an eligible
If the corporation is recently formed, the testing entity that is disregarded as separate from its owner for
! period begins on the first day of its tax year and ends
CAUTION on the earlier of the last day of its tax year, or the last
federal income tax purposes. Disregarded entities include
single-member limited liability companies (LLCs) that are
day of the calendar year in which its tax year begins. disregarded as separate from their owners, qualified
subchapter S subsidiaries (qualified subsidiaries of an S
Other nonprofit organization. Check this box if the corporation), and certain qualified foreign entities. See the
nonprofit organization is other than a church or instructions for Form 8832 and Regulations section
church-controlled organization and specify the type of 301.7701-3 for more information on domestic and foreign
nonprofit organization (for example, an educational disregarded entities.
organization). A disregarded entity must have an EIN if it is subject to
If the organization also seeks tax-exempt status, you employment taxes or certain excise taxes. For wages paid
!
CAUTION
must file either Package 1023 or Package 1024. See
Pub. 557 for more information.
during 2008 and in prior years, the reporting and payment of
employment taxes for employees could be made using the
name and EIN of either the owner or the disregarded entity
If the organization is covered by a group exemption letter, (as explained in Notice 99-6, 1999-3 I.R.B. 12).
enter the four-digit group exemption number (GEN) in the For wages paid on or after January 1, 2009, the
last entry. (Do not confuse the GEN with the nine-digit EIN.) disregarded entity is required to use its name and EIN for
If you do not know the GEN, contact the parent organization. reporting and payment of employment taxes. A disregarded
Get Pub. 557 for more information about group exemption entity is also required to use its name and EIN to register for
numbers. excise tax activities on Form 637, pay and report excise
If the organization is a section 527 political organization, taxes reported on Forms 720, 730, 2290, and 11-C, and
check the box for Other nonprofit organization and specify claim any refunds, credits, and payments on Form 8849.
“section 527 organization” in the space to the right. To be This requirement for reporting and paying excise taxes
recognized as exempt from tax, a section 527 political became effective after December 31, 2007. See the
organization must electronically file Form 8871, Political instructions for the employment and excise tax returns for
Organization Notice of Section 527 Status, within 24 hours more information.
of the date on which the organization was established. The Complete Form SS-4 for disregarded entities as follows.
organization may also have to file Form 8872, Political • If a disregarded entity is filing Form SS-4 to obtain an EIN
Organization Report of Contributions and Expenditures. See because it is required to report and pay employment and
www.irs.gov/polorgs for more information. excise taxes (see above) or for non-federal purposes such
Plan administrator. If the plan administrator is an as a state requirement, check the “Other” box for line 9a and
individual, enter the plan administrator’s taxpayer write “disregarded entity” (or “disregarded entity-sole
identification number (TIN) in the space provided. proprietorship” if the owner of the disregarded entity is an
individual).
REMIC. Check this box if the entity has elected to be
treated as a real estate mortgage investment conduit
• If the disregarded entity is requesting an EIN for purposes
of filing Form 8832 to elect classification as an association
(REMIC). See the Instructions for Form 1066 for more
taxable as a corporation, or Form 2553 to elect S
information.
corporation status, check the “Corporation” box for line 9a
State/local government. If you are a government and write “single-member” and the form number of the
employer and you are not sure of your social security and return that will be filed (Form 1120 or 1120S).
Medicare coverage options, go to www.ncsssa.org/ • If the disregarded entity is requesting an EIN because it
ssaframes.html to obtain the contact information for your has acquired one or more additional owners and its
state’s Social Security Administrator. classification has changed to partnership under the default
Other. If not specifically listed, check the ‘‘Other’’ box, rules of Regulations section 301.7701-3(f), check the
enter the type of entity and the type of return, if any, that will “Partnership” box for line 9a.
be filed (for example, “Common Trust Fund, Form 1065” or Line 10. Reason for applying. Check only one box. Do
“Created a Pension Plan”). Do not enter “N/A.” If you are an not enter “N/A.” A selection is required.
alien individual applying for an EIN, see the Lines 7a – b Started new business. Check this box if you are
instructions on page 3. starting a new business that requires an EIN. If you check
• Household employer. If you are an individual that will this box, enter the type of business being started. Do not
employ someone to provide services in your household, apply if you already have an EIN and are only adding
check the ‘‘Other’’ box and enter ‘‘Household Employer’’ and another place of business.
your SSN. If you are a trust that qualifies as a household Hired employees. Check this box if the existing
employer, you do not need a separate EIN for reporting tax business is requesting an EIN because it has hired or is
information relating to household employees; use the EIN of hiring employees and is therefore required to file
the trust. employment tax returns. Do not apply if you already have an
• Household employer agent. If you are an agent of a EIN and are only hiring employees. For information on
household employer that is a disabled individual or other employment taxes (for example, for family members), see
welfare recipient receiving home care services through a Pub. 15 (Circular E).
state or local program, check the “Other” box and enter
“Household Employer Agent.” (See Rev. Proc. 80-4, 1980-1 You may have to make electronic deposits of all
C.B. 581 and Notice 2003-70, 2003-43 I.R.B. 916.) If you
are a state or local government also check the box for state/
! depository taxes (such as employment tax, excise
CAUTION tax, and corporate income tax) using the Electronic

local government. Federal Tax Payment System (EFTPS). See Federal tax
• QSub. For a qualified subchapter S subsidiary (QSub) deposits on page 1; section 11, Depositing Taxes, of Pub.
check the ‘‘Other’’ box and specify ‘‘QSub.’’ 15 (Circular E); and Pub. 966.
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Banking purpose. Check this box if you are requesting • The tax year that results in the least aggregate deferral of
an EIN for banking purposes only, and enter the banking income.
purpose (for example, a bowling league for depositing dues • In certain cases, some other tax year.
or an investment club for dividend and interest reporting). See the Instructions for Form 1065 for more information.
Changed type of organization. Check this box if the REMICs. REMICs must have a calendar year as their
business is changing its type of organization. For example, tax year.
the business was a sole proprietorship and has been
incorporated or has become a partnership. If you check this Personal service corporations. A personal service
box, specify in the space provided (including available space corporation generally must adopt a calendar year unless it
immediately below) the type of change made. For example, meets one of the following requirements.
‘‘From Sole Proprietorship to Partnership.’’ • It can establish a business purpose for having a different
tax year.
Purchased going business. Check this box if you • It elects under section 444 to have a tax year other than a
purchased an existing business. Do not use the former calendar year.
owner’s EIN unless you became the “owner” of a
corporation by acquiring its stock. Trusts. Generally, a trust must adopt a calendar year
except for the following trusts.
Created a trust. Check this box if you created a trust, • Tax-exempt trusts.
and enter the type of trust created. For example, indicate if • Charitable trusts.
the trust is a nonexempt charitable trust or a split-interest • Grantor-owned trusts.
trust.
Line 13. Highest number of employees expected in the
Exception. Do not file this form for certain grantor-type next 12 months. Complete each box by entering the
trusts. The trustee does not need an EIN for the trust if the number (including zero (“-0-”)) of “Agricultural,” “Household,”
trustee furnishes the name and TIN of the grantor/owner or “Other” employees expected by the applicant in the next
and the address of the trust to all payers. However, grantor 12 months.
trusts that do not file using Optional Method 1 and IRA trusts
that are required to file Form 990-T, Exempt Organization If no employees are expected, skip line 14.
Business Income Tax Return, must have an EIN. For more Line 14. Do you want to file Form 944? If you expect
information on grantor trusts, see the Instructions for Form your employment tax liability to be $1,000 or less in a full
1041. calendar year, you are eligible to file Form 944 annually
(once each year) instead of filing Form 941 quarterly (every
Do not check this box if you are applying for a trust three months). Your employment tax liability generally will
TIP EIN when a new pension plan is established. Check be $1,000 or less if you expect to pay $4,000 or less in total
‘‘Created a pension plan.’’ wages subject to social security and Medicare taxes and
Created a pension plan. Check this box if you have federal income tax withholding. If you qualify and want to file
created a pension plan and need an EIN for reporting Form 944 instead of Forms 941, check the box on line 14. If
purposes. Also, enter the type of plan in the space provided. you do not check the box, then you must file Form 941 for
every quarter.
Check this box if you are applying for a trust EIN
TIP when a new pension plan is established. In addition, For employers in the U.S. possessions, generally, if
check the “Other” box on line 9a and write “Created TIP you pay $6,536 or less in wages subject to social
a Pension Plan” in the space provided. security and Medicare taxes, you are likely to pay
$1,000 or less in employment taxes.
Other. Check this box if you are requesting an EIN for
any other reason; and enter the reason. For example, a For more information on employment taxes, see Pub. 15
newly-formed state government entity should enter (Circular E); or Pub. 51 (Circular A) if you have agricultural
“Newly-Formed State Government Entity” in the space employees (farmworkers).
provided. Line 15. First date wages or annuities were paid. If the
Line 11. Date business started or acquired. If you are business has employees, enter the date on which the
starting a new business, enter the starting date of the business began to pay wages. If the business does not plan
business. If the business you acquired is already operating, to have employees, enter “N/A.”
enter the date you acquired the business. If you are Withholding agent. Enter the date you began or will
changing the form of ownership of your business, enter the begin to pay income (including annuities) to a nonresident
date the new ownership entity began. Trusts should enter alien. This also applies to individuals who are required to file
the date the trust was funded. Estates should enter the date Form 1042 to report alimony paid to a nonresident alien.
of death of the decedent whose name appears on line 1 or Line 16. Check the one box on line 16 that best describes
the date when the estate was legally funded. the principal activity of the applicant’s business. Check the
Line 12. Closing month of accounting year. Enter the “Other” box (and specify the applicant’s principal activity) if
last month of your accounting year or tax year. An none of the listed boxes applies. You must check a box.
accounting or tax year is usually 12 consecutive months, Construction. Check this box if the applicant is
either a calendar year or a fiscal year (including a period of engaged in erecting buildings or engineering projects (for
52 or 53 weeks). A calendar year is 12 consecutive months example, streets, highways, bridges, tunnels). The term
ending on December 31. A fiscal year is either 12 “Construction” also includes special trade contractors (for
consecutive months ending on the last day of any month example, plumbing, HVAC, electrical, carpentry, concrete,
other than December or a 52-53 week year. For more excavation, etc. contractors).
information on accounting periods, see Pub. 538.
Real estate. Check this box if the applicant is engaged
Individuals. Your tax year generally will be a calendar in renting or leasing real estate to others; managing, selling,
year. buying, or renting real estate for others; or providing related
Partnerships. Partnerships must adopt one of the real estate services (for example, appraisal services). Also
following tax years. check this box for mortgage real estate investment trusts
• The tax year of the majority of its partners. (REITS). Mortgage REITS are engaged in issuing shares of
• The tax year common to all of its principal partners. funds consisting primarily of portfolios of real estate
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mortgage assets with gross income of the trust solely SS-4. The designee’s authority terminates at the time the
derived from interest earned. EIN is assigned and released to the designee. You must
Rental and leasing. Check this box if the applicant is complete the signature area for the authorization to be valid.
engaged in providing tangible goods such as autos, Signature. When required, the application must be signed
computers, consumer goods, or industrial machinery and by (a) the individual, if the applicant is an individual, (b) the
equipment to customers in return for a periodic rental or president, vice president, or other principal officer, if the
lease payment. Also check this box for equity real estate applicant is a corporation, (c) a responsible and duly
investment trusts (REITS). Equity REITS are engaged in authorized member or officer having knowledge of its affairs,
issuing shares of funds consisting primarily of portfolios of if the applicant is a partnership, government entity, or other
real estate assets with gross income of the trust derived unincorporated organization, or (d) the fiduciary, if the
from renting real property. applicant is a trust or an estate. Foreign applicants may
Manufacturing. Check this box if the applicant is have any duly-authorized person (for example, division
engaged in the mechanical, physical, or chemical manager) sign Form SS-4.
transformation of materials, substances, or components into
Privacy Act and Paperwork Reduction Act Notice. We
new products. The assembling of component parts of
ask for the information on this form to carry out the Internal
manufactured products is also considered to be
Revenue laws of the United States. We need it to comply
manufacturing.
with section 6109 and the regulations thereunder, which
Transportation & warehousing. Check this box if the generally require the inclusion of an employer identification
applicant provides transportation of passengers or cargo; number (EIN) on certain returns, statements, or other
warehousing or storage of goods; scenic or sight-seeing documents filed with the Internal Revenue Service. If your
transportation; or support activities related to transportation. entity is required to obtain an EIN, you are required to
Finance & insurance. Check this box if the applicant is provide all of the information requested on this form.
engaged in transactions involving the creation, liquidation, or Information on this form may be used to determine which
change of ownership of financial assets and/or facilitating federal tax returns you are required to file and to provide you
such financial transactions; underwriting annuities/insurance with related forms and publications.
policies; facilitating such underwriting by selling insurance We disclose this form to the Social Security
policies; or by providing other insurance or employee-benefit Administration (SSA) for their use in determining compliance
related services. with applicable laws. We may give this information to the
Health care & social assistance. Check this box if the Department of Justice for use in civil and/or criminal
applicant is engaged in providing physical, medical, or litigation, and to cities, states, the District of Columbia, and
psychiatric care or providing social assistance activities such U.S. commonwealths and possessions for use in
as youth centers, adoption agencies, individual/family administering their tax laws. We may also disclose this
services, temporary shelters, daycare, etc. information to other countries under a tax treaty, to federal
Accommodation & food services. Check this box if and state agencies to enforce federal nontax criminal laws,
the applicant is engaged in providing customers with and to federal law enforcement and intelligence agencies to
lodging, meal preparation, snacks, or beverages for combat terrorism.
immediate consumption. We will be unable to issue an EIN to you unless you
Wholesale – agent/broker. Check this box if the provide all of the requested information that applies to your
applicant is engaged in arranging for the purchase or sale of entity. Providing false information could subject you to
goods owned by others or purchasing goods on a penalties.
commission basis for goods traded in the wholesale market, You are not required to provide the information requested
usually between businesses. on a form that is subject to the Paperwork Reduction Act
Wholesale – other. Check this box if the applicant is unless the form displays a valid OMB control number. Books
engaged in selling goods in the wholesale market generally or records relating to a form or its instructions must be
to other businesses for resale on their own account, goods retained as long as their contents may become material in
used in production, or capital or durable nonconsumer the administration of any Internal Revenue law. Generally,
goods. tax returns and return information are confidential, as
Retail. Check this box if the applicant is engaged in required by section 6103. Section 6109 requires paid
selling merchandise to the general public from a fixed store; preparers to provide their identifying number.
by direct, mail-order, or electronic sales; or by using vending The time needed to complete and file this form will vary
machines. depending on individual circumstances. The estimated
Other. Check this box if the applicant is engaged in an average time is:
activity not described above. Describe the applicant’s
principal business activity in the space provided. Recordkeeping . . . . . . . . . . . . . . . . . . . . . . 8 hrs., 36 min.
Line 17. Use line 17 to describe the applicant’s principal
Learning about the law or the form . . . . . . . 42 min.
line of business in more detail. For example, if you checked
the “Construction” box on line 16, enter additional detail Preparing, copying, assembling, and
such as “General contractor for residential buildings” on line sending the form to the IRS . . . . . . . . . . . . . 52 min.
17. An entry is required. For mortgage REITS indicate
mortgage REIT and for equity REITS indicate what type of If you have comments concerning the accuracy of these
real property is the principal type (residential REIT, time estimates or suggestions for making this form simpler,
nonresidential REIT, miniwarehouse REIT). we would be happy to hear from you. You can write to
Line 18. Check the applicable box to indicate whether or Internal Revenue Service, Tax Products Coordinating
not the applicant entity applying for an EIN was issued one Committee, SE:W:CAR:MP:T:T:SP, IR-6526, 1111
previously. Constitution Avenue, NW, Washington, DC 20224. Do not
Third Party Designee. Complete this section only if you send the form to this address. Instead, see Where to File or
want to authorize the named individual to receive the entity’s Fax on page 2.
EIN and answer questions about the completion of Form

-6- Instr. for Form SS-4 (2010)