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Cat. No. 16055N SS-4 Rev. 12-2017 Page 2 Form SS-4 Rev. 12-2017 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. See Disregarded entities on page 4 of the instructions for details on completing Form SS-4 for an LLC. 1 See also the separate instructions for each line on Form SS-4. IF the applicant. AND. Does not currently have nor expect to have employees THEN.. SS-4 Application for Employer Identification Number OMB No. 1545-0003 For use by employers corporations partnerships trusts estates churches government agencies Indian tribal entities certain individuals and others. Go to www.irs.gov/FormSS4 for instructions and the latest information. Department of the Treasury See separate instructions for each line. Keep a copy for your records. Internal Revenue Service Legal name of entity or individual for whom the EIN is being requested Type or print clearly. Complete lines 1 2 4a 8a 8b c if applicable 9a 9b if applicable and 10 14 and 16 18. Hired or will hire employees including household employees Does not already have an EIN Opened a bank account Needs an EIN for banking purposes only Either the legal character of the organization or its ownership changed for example you incorporate a The trust is other than a grantor trust or an IRA trust4 Is a foreign person needing an EIN to comply with IRS withholding regulations Needs an EIN to complete a Form W-8 other than Form W-8ECI avoid withholding on portfolio assets or claim tax treaty benefits6 8a 8b c if applicable 9a 9b if applicable 10 and 18. Sole proprietor SSN Partnership Corporation enter form number to be filed No. SSN ITIN or EIN. Other specify If a corporation name the state or foreign country if applicable where incorporated Reason for applying check only one box Started new business specify type Estate SSN of decedent Plan administrator TIN Trust TIN of grantor Personal service corporation Church or church-controlled organization Other nonprofit organization specify 9b Military/National Guard Farmers cooperative REMIC State State/local government Federal government Indian tribal governments/enterprises Group Exemption Number GEN if any Foreign country Banking purpose specify purpose 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 Closing month of accounting year Date business started or acquired month day year. Go to www*irs*gov/FormSS4 for instructions and the latest information* Department of the Treasury See separate instructions for each line. Keep a copy for your records. Internal Revenue Service Legal name of entity or individual for whom the EIN is being requested Type or print clearly. Form Rev* December 2017 8a EIN Trade name of business if different from name on line 1 4a Mailing address room apt.

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