W9 - All Utility Support Services

Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.*

Business name/disregarded entity name, if different from above

Check appropriate box for federal tax classification; check only one of the following seven boxes:*

Individual/sole proprietor
C Corporation
S Corporation
Partnership
Trust/estate
Single-member LLC
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
Other (see instructions)

Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):

Exempt payee code (if any)

Exemption from FATCA reporting code (if any)

Address*

Street Address City State / Province / Region ZIP / Postal Code

Requester’s name and address (optional)

List account number(s) here (optional)

PART 1. Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). For other entities, it is your employer identification number (EIN).

Please Select Your TIN Type*

SSN
EIN

Social Security Number*

Employer Identification Number*

PART 2. Certification

Signature*

Date*

W-9 Form

PART 1. Taxpayer Identification Number (TIN)

PART 2. Certification