Application for Employer Identification Number Form SS-4 EIN

(Rev. December 1993) (For use by employers, corporations, partnerships, trusts, estates, churches,

government agencies, certain individuals, and others. See instructions.) OMB No. 1545-0003

Department of the Treasury

Internal Revenue Service Expires 12-31-96

1 Name of applicant (Legal name) (See instructions.)

2 Trade name of business, if different from name in line 1 3 Executor, trustee, “care of” name

4a Mailing address (street address) (room, apt., or suite no.) 5a Business address, if different from address in lines 4a and 4b

4b City, state, and ZIP code 5b City, state, and ZIP code

6 County and state where principal business is located

7 Name of principal officer, general partner, grantor, owner, or trustor—SSN required (See instructions.) ©

8a Type of entity (Check only one box.) (See instructions.) Estate (SSN of decedent) Trust

Sole Proprietor (SSN) Plan administrator-SSN Partnership

REMIC Personal service corp. Other corporation (specify) Farmers’ cooperative

State/local government National guard Federal government/military Church or church controlled organization

Other nonprofit organization (specify) (enter GEN if applicable)

Other (specify) ©

8b If a corporation, name the state or foreign country

(if applicable) where incorporated ©

9 Reason for applying (Check only one box.) Changed type of organization (specify) ©

Started new business (specify) © Purchased going business

Hired employees Created a trust (specify) ©

Created a pension plan (specify type) ©

Banking purpose (specify) © Other (specify) ©

10 Date business started or acquired (Mo., day, year) (See instructions.) 11 Enter closing month of accounting year. (See instructions.)

12 First date wages or annuities were paid or will be paid (Mo., day, year). Note: If applicant is a withholding agent, enter date income will first

be paid to nonresident alien. (Mo., day, year) ©

13 Enter highest number of employees expected in the next 12 months. Note: If the applicant Nonagricultural Agricultural Household

does not expect to have any employees during the period, enter “0.” ©

14 Principal activity (See instructions.) ©

15 Is the principal business activity manufacturing? Yes No

16

If “Yes,” principal product and raw material used ©

To whom are most of the products or services sold? Please check the appropriate box. Business (wholesale)

Public (retail) Other (specify) © N/A

17a Has the applicant ever applied for an identification number for this or any other business? No

Note: If “Yes,” please complete lines 17b and 17c.

17b If you checked the “Yes” box in line 17a, give applicant’s legal name and trade name, if different than name shown on prior application.

Legal name © Trade name ©

17c Enter approximate date, city, and state where the application was filed and the previous employer identification number if known.

Approximate date when filed (Mo., day, year) City and state where filed Previous EIN

.

.

.

.

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. Business telephone number (include area code)

Name and title (Please type or print clearly.) ©

Signature © Date ©

Note: Do not write below this line. For official use only.

Geo. Ind. Class Size Reason for applying Please leave

blank ©

For Paperwork Reduction Act Notice, see attached instructions. Form SS-4 (Rev. 12-93)

Yes

Please type or print clearly.

Cat. No. 16055N

State Foreign country
Purpose

Who Must File

● You pay wages to one or more

employees.

● You are required to have an EIN to use

on any return, statement, or other

document, even if you are not an

employer.

● You are a withholding agent required

to withhold taxes on income, other than

wages, paid to a nonresident alien

(individual, corporation, partnership,

etc.). A withholding agent may be an

agent, broker, fiduciary, manager, tenant,

or spouse, and is required to file Form

1042, Annual Withholding Tax Return for

U.S. Source Income of Foreign Persons.

● You file Schedule C, Profit or Loss

From Business, or Schedule F, Profit or

Loss From Farming, of Form 1040, U.S.

Individual Income Tax Return, and have

a Keogh plan or are required to file

excise, employment, or alcohol,

tobacco, or firearms returns.

The following must use EINs even if

they do not have any employees:

● Trusts, except the following:

● Estates

● REMICS (real estate mortgage

investment conduits) (See the

instructions for Form 1066, U.S. Real

Estate Mortgage Investment Conduit

Income Tax Return.)

● Corporations

● Nonprofit organizations (churches,

clubs, etc.)

● Farmers’ cooperatives

● Plan administrators (A plan

administrator is the person or group of

persons specified as the administrator

by the instrument under which the plan

is operated.)

New Business.—If you become the new

owner of an existing business, DO NOT

use the EIN of the former owner. If you

already have an EIN, use that number. If

you do not have an EIN, apply for one

on this form. If you become the “owner”

of a corporation by acquiring its stock,

use the corporation’s EIN.

File Only One Form SS-4.—File only

one Form SS-4, regardless of the

number of businesses operated or trade

names under which a business

operates. However, each corporation in

an affiliated group must file a separate

application.

EIN Applied For, But Not Received.—If

you do not have an EIN by the time a

return is due, write “Applied for” and the

date you applied in the space shown for

the number. DO NOT show your social

security number as an EIN on returns.

For more information about EINs, see

Pub. 583, Taxpayers Starting a Business

and Pub. 1635, EINs Made Easy.

How To Apply

Application by Tele-TIN.—Under the

Tele-TIN program, you can receive your

EIN over the telephone and use it

An IRS representative will use the

information from the Form SS-4 to

establish your account and assign you

an EIN. Write the number you are given

on the upper right-hand corner of the

form, sign and date it.

The Tele-TIN phone numbers listed

below will involve a long-distance charge

to callers outside of the local calling

area, and should be used only to apply

for an EIN. THE NUMBERS MAY

CHANGE WITHOUT NOTICE. Use

1-800-829-1040 to verify a number or to

ask about an application by mail or other

Federal tax matters.

Application by Mail.—Complete Form

SS-4 at least 4 to 5 weeks before you

will need an EIN. Sign and date the

application and mail it to the service

center address for your state. You will

receive your EIN in the mail in

approximately 4 weeks.

Where To Apply

New York (all other

counties), Connecticut,

Maine, Massachusetts,

New Hampshire, Rhode

Island, Vermont

Attn: Entity Control

Andover, MA 05501

(508) 474-9717

Illinois, Iowa, Minnesota,

Missouri, Wisconsin

Attn: Entity Control

Stop 57A

2306 E. Bannister Rd.

Kansas City, MO 64131

(816) 926-5999

Delaware, District of

Columbia, Maryland,

Pennsylvania, Virginia

Attn: Entity Control

Philadelphia, PA 19255

(215) 574-2400

If your principal business,

office or agency, or legal

residence in the case of an

individual, is located in:

Call the Tele-TIN

phone number

shown or file with

the Internal Revenue

Service center at:

Attn: Entity Control

Atlanta, GA 39901

(404) 455-2360

Florida, Georgia,

South Carolina

New Jersey, New York

City and counties of

Nassau, Rockland,

Suffolk, and Westchester

Attn: Entity Control

Holtsville, NY 00501

(516) 447-4955

Form SS-4 (Rev. 12-93) Page 2

General Instructions

Changes in Organization or

Ownership.—If you already have an

EIN, you may need to get a new one if

either the organization or ownership of

your business changes. If you

incorporate a sole proprietorship or form

a partnership, you must get a new EIN.

However, DO NOT apply for a new EIN

if you change only the name of your

business.

If you do not have an EIN by the time

a tax deposit is due, send your payment

to the Internal Revenue service center

for your filing area. (See Where To

Apply below.) Make your check or

money order payable to Internal

Revenue Service and show your name

(as shown on Form SS-4), address, kind

of tax, period covered, and date you

applied for an EIN.

(Section references are to the Internal

Revenue Code unless otherwise noted. )

Ä

When To Apply for A New

EIN

● Partnerships

Use Form SS-4 to apply for an employer

identification number (EIN). An EIN is a

nine-digit number (for example,

12-3456789) assigned to sole

proprietors, corporations, partnerships,

estates, trusts, and other entities for

filing and reporting purposes. The

information you provide on this form will

establish your filing and reporting

requirements.

You can apply for an EIN either by mail

or by telephone. You can get an EIN

immediately by calling the Tele-TIN

phone number for the service center for

your state, or you can send the

completed Form SS-4 directly to the

service center to receive your EIN in the

mail.

You must file this form if you have not

obtained an EIN before and

Taxpayer representatives can receive

their client’s EIN by phone if they first

send a facsimile (FAX) of a completed

Form 2848, Power of Attorney and

Declaration of Representative, or Form

8821, Tax Information Authorization, to

the Tele-TIN unit. The Form 2848 or

Form 8821 will be used solely to release

the EIN to the representative authorized

on the form.

Ä

1. Certain grantor-owned revocable

trusts (see the Instructions for Form

1040).

2. Individual Retirment Arrangement

(IRA) trusts, unless the trust has to file

Form 990-T, Exempt Organization

Business Income Tax Return (See the

Instructions for Form 990-T.)

You should mail or FAX the signed

SS-4 within 24 hours to the Tele-TIN

Unit at the service center address for

your state. The IRS representative will

give you the FAX number. The FAX

numbers are also listed in Pub. 1635.

Note: Household employers are not

required to file Form SS-4 to get an EIN.

An EIN may be assigned to you without

filing Form SS-4 if your only employees

are household employees (domestic

workers) in your private home. To have

an EIN assigned to you, write “NONE” in

the space for the EIN on Form 942,

Employer’s Quarterly Tax Return for

Household Employees, when you file it.

immediately to file a return or make a

payment. To receive an EIN by phone,

complete Form SS-4, then call the

Tele-TIN phone number listed for your

state under Where To Apply. The

person making the call must be

authorized to sign the form (see

Signature block on page 3).
Form SS-4 (Rev. 12-93) Page 3

Individuals.—Enter the first name,

middle initial, and last name.

Trusts.—Enter the name of the trust.

Estate of a decedent.—Enter the name

of the estate.

Partnerships.—Enter the legal name of

the partnership as it appears in the

partnership agreement.

Corporations.—Enter the corporate

name as set forth in the corporation

charter or other legal document creating

it.

Plan administrators.—Enter the name

of the plan administrator. A plan

administrator who already has an EIN

should use that number.

Line 2.—Enter the trade name of the

business if different from the legal name.

The trade name is the “doing business

as” name.

Note: Use the full legal name on line 1

on all tax returns filed for the entity.

However, if you enter a trade name on

line 2 and choose to use the trade name

instead of the legal name, enter the

trade name on all returns you file. To

prevent processing delays and errors,

always use either the legal name only or

the trade name only on all tax returns.

Line 3.—Trusts enter the name of the

trustee. Estates enter the name of the

executor, administrator, or other

fiduciary. If the entity applying has a

designated person to receive tax

information, enter that person’s name as

the “care of” person. Print or type the

first name, middle initial, and last name.

Sole proprietor.—Check this box if you

file Schedule C or F (Form 1040) and

have a Keogh plan, or are required to file

excise, employment, or alcohol,

tobacco, or firearms returns. Enter your

SSN (social security number) in the

space provided.

Plan administrator.—If the plan

administrator is an individual, enter the

plan administrator’s SSN in the space

provided.

Withholding agent.—If you are a

withholding agent required to file Form

1042, check the “other” box and enter

“withholding agent.”

REMICs.—Check this box if the entity

has elected to be treated as a real

estate mortgage investment conduit

(REMIC). See the Instructions for Form

1066 for more information.

Line 7.—Enter the first name, middle

initial, last name, and social security

number (SSN) of a principal officer if the

business is a corporation; of a general

partner if a partnership; and of a grantor

owner, or trustor if a trust.

Line 8a.—Check the box that best

describes the type of entity applying for

the EIN. If not specifically mentioned,

check the “other” box and enter the

type of entity. Do not enter N/A.

If the organization also seeks

tax-exempt status, you must file either

Package 1023 or Package 1024,

Application for Recognition of

Exemption. Get Pub. 557, Tax-Exempt

Status for Your Organization, for more

information.

Personal service corporations.—Check

this box if the entity is a personal

service corporation. An entity is a

personal service corporation for a tax

year only if:

● The principal activity of the entity

during the testing period (prior tax year)

for the tax year is the performance of

personal services substantially by

employee-owners.

● The employee-owners own 10 percent

of the fair market value of the

outstanding stock in the entity on the

last day of the testing period.

Other corporations.—This box is for

any corporation other than a personal

service corporation. If you check this

box, enter the type of corporation (such

as insurance company) in the space

provided.

Other nonprofit organizations.—Check

this box if the nonprofit organization is

Group exemption number (GEN).—If

the organization is covered by a group

exemption letter, enter the four-digit

GEN. (Do not confuse the GEN with the

nine-digit EIN.) If you do not know the

GEN, contact the parent organization.

Get Pub. 557 for more information about

group exemption numbers.

Line 9.—Check only one box. Do not

enter N/A.

Started new business.—Check this

box if you are starting a new business

that requires an EIN. If you check this

box, enter the type of business being

started. DO NOT apply if you already

have an EIN and are only adding another

place of business.

Changed type of organization.—Check

this box if the business is changing its

type of organization, for example, if the

business was a sole proprietorship and

has been incorporated or has become a

partnership. If you check this box,

specify in the space provided the type of

change made, for example, “from sole

proprietorship to partnership.”

Personal services include performance

of services in such fields as health, law,

accounting, consulting, etc. For more

information about personal service

corporations, see the instructions to

Form 1120, U.S. Corporation Income

Tax Return, and Pub. 542, Tax

Information on Corporations.

Purchased going business.—Check

this box if you purchased an existing

business. DO NOT use the former

owner’s EIN. Use your own EIN if you

already have one.

Hired employees.—Check this box if

the existing business is requesting an

EIN because it has hired or is hiring

employees and is therefore required to

file employment tax returns. DO NOT

apply if you already have an EIN and are

only hiring employees. If you are hiring

household employees, see Note under

Who Must File on page 2.

Created a trust.—Check this box if you

created a trust, and enter the type of

trust created.

Created a pension plan.—Check this

box if you have created a pension plan

and need this number for reporting

purposes. Also, enter the type of plan

created.

Banking purpose.—Check this box if

you are requesting an EIN for banking

purposes only and enter the banking

purpose (for example, a bowling league

for depositing dues, an investment club

for dividend and interest reporting, etc.).

Note: DO NOT file this form if you are

the individual-grantor/owner of a

revocable trust. You must use your SSN

for the trust. See the instructions for

Form 1040.

California (all other

counties), Hawaii

Attn: Entity Control

Fresno, CA 93888

(209) 452-4010

Alabama, Arkansas,

Louisiana, Mississippi,

North Carolina, Tennessee

Attn: Entity Control

Memphis, TN 37501

(901) 365-5970

If you have no legal residence,

principal place of business, or principal

office or agency in any state, file your

form with the Internal Revenue Service

Center, Philadelphia, PA 19255 or call

(215) 574-2400.

Specific Instructions

The instructions that follow are for those

items that are not self-explanatory. Enter

N/A (nonapplicable) on the lines that do

not apply.

Line 1.—Enter the legal name of the

entity applying for the EIN exactly as it

appears on the social security card,

charter, or other applicable legal

document.

Kansas, New Mexico,

Oklahoma, Texas

Attn: Entity Control

Austin, TX 73301

(512) 462-7843

Alaska, Arizona, California

(counties of Alpine, Amador,

Butte, Calaveras, Colusa, Contra

Costa, Del Norte, El Dorado,

Glenn, Humboldt, Lake, Lassen,

Marin, Mendocino, Modoc,

Napa, Nevada, Placer, Plumas,

Sacramento, San Joaquin,

Shasta, Sierra, Siskiyou, Solano,

Sonoma, Sutter, Tehama, Trinity,

Yolo, and Yuba), Colorado,

Idaho, Montana, Nebraska,

Nevada, North Dakota, Oregon,

South Dakota, Utah,

Washington, Wyoming

Attn: Entity Control

Mail Stop 6271-T

P.O. Box 9950

Ogden, UT 84409

(801) 620-7645

Indiana, Kentucky,

Michigan, Ohio, West

Virginia

Attn: Entity Control

Cincinnati, OH 45999

(606) 292-5467

other than a church or church-controlled

organization and specify the type of

nonprofit organization (for example, an

educational organization.)
REMICs.—Remics must have a

calendar year as their tax year.

Personal service corporations.—A

personal service corporation generally

must adopt a calendar year unless:

● It can establish a business purpose for

having a different tax year, or

● It elects under section 444 to have a

tax year other than a calendar year.

Line 12.—If the business has or will

have employees, enter the date on

which the business began or will begin

to pay wages. If the business does not

plan to have employees, enter N/A.

Withholding agent.—Enter the date

you began or will begin to pay income to

a nonresident alien. This also applies to

individuals who are required to file Form

1042 to report alimony paid to a

nonresident alien.

Line 14.—Generally, enter the exact type

of business being operated (for example,

advertising agency, farm, food or

beverage establishment, labor union, real

estate agency, steam laundry, rental of

coin-operated vending machine,

investment club, etc.). Also state if the

business will involve the sale or

distribution of alcoholic beverages.

Governmental.—Enter the type of

organization (state, county, school

district, or municipality, etc.).

Nonprofit organization (other than

governmental).—Enter whether

organized for religious, educational, or

humane purposes, and the principal

activity (for example, religious

organization—hospital, charitable).

Mining and quarrying.—Specify the

process and the principal product (for

example, mining bituminous coal,

contract drilling for oil, quarrying

dimension stone, etc.).

Contract construction.—Specify

whether general contracting or special

trade contracting. Also, show the type of

work normally performed (for example,

general contractor for residential

buildings, electrical subcontractor, etc.).

Trade.—Specify the type of sales and

the principal line of goods sold (for

example, wholesale dairy products,

manufacturer’s representative for mining

machinery, retail hardware, etc.).

Manufacturing.—Specify the type of

establishment operated (for example,

sawmill, vegetable cannery, etc.).

Signature block.—The application must

be signed by: (1) the individual, if the

applicant is an individual, (2) the

president, vice president, or other

principal officer, if the applicant is a

corporation, (3) a responsible and duly

authorized member or officer having

knowledge of its affairs, if the applicant

is a partnership or other unincorporated

organization, or (4) the fiduciary, if the

applicant is a trust or estate.

Form SS-4 (Rev. 12-93) Page 4

Paperwork Reduction Act

Notice

The time needed to complete and file

this form will vary depending on

individual circumstances. The estimated

average time is:

Learning about the 

law or the form 18 min.

Preparing the form 44 min.

If you have comments concerning the

accuracy of these time estimates or

suggestions for making this form more

simple, we would be happy to hear from

you. You can write to both the Internal

Revenue Service, Attention: Reports

Clearance Officer, PC:FP, Washington,

DC 20224; and the Office of

Management and Budget, Paperwork

Reduction Project (1545-0003),

Washington, DC 20503. DO NOT send

this form to either of these offices.

Instead, see Where To Apply on page 2.

Recordkeeping 7 min.

Copying, assembling, and

sending the form to the IRS 20 min.

Food or beverage establishments.—

Specify the type of establishment and

state whether you employ workers who

receive tips (for example, lounge—yes).

Trusts.—Generally, a trust must adopt

a calendar year except for the following:

● Tax-exempt trusts,

● Charitable trusts, and

● Grantor-owned trusts.

Line 11.—Enter the last month of your

accounting year or tax year. An

accounting or tax year is usually 12

consecutive months, either a calendar

year or a fiscal year (including a period

of 52 or 53 weeks). A calendar year is

12 consecutive months ending on

December 31. A fiscal year is either 12

consecutive months ending on the last

day of any month other than December

or a 52-53 week year. For more

information on accounting periods, see

Pub. 538, Accounting Periods and

Methods.

Individuals.—Your tax year generally

will be a calendar year.

Partnerships.—Partnerships generally

must adopt the tax year of either (1) the

majority partners; (2) the principal

partners; (3) the tax year that results in

the least aggregate (total) deferral of

income; or (4) some other tax year. (See

the Instructions for Form 1065, U.S.

Partnership Return of Income, for more

information.)

We ask for the information on this form

to carry out the Internal Revenue laws of

the United States. You are required to

give us the information. We need it to

ensure that you are complying with

these laws and to allow us to figure and

collect the right amount of tax.

Some Useful Publications

You may get the following publications

for additional information on the

subjects covered on this form. To get

these and other free forms and

publications, call 1-800-TAX-FORM

(1-800-829-3676).

Pub. 1635, EINs Made Easy

Pub. 538, Accounting Periods and

Methods

Pub. 541, Tax Information on

Partnerships

Pub. 542, Tax Information on

Corporations

Pub. 557, Tax-Exempt Status for Your

Organization

Pub. 583, Taxpayers Starting A Business

Package 1023, Application for

Recognition of Exemption

Package 1024, Application for

Recognition of Exemption Under Section

501(a) or for Determination Under

Section 120

Pub. 937, Employment Taxes and

Information Returns

Other (specify).—Check this box if you

are requesting an EIN for any reason

other than those for which there are

checkboxes, and enter the reason.

Line 10.—If you are starting a new

business, enter the starting date of the

business. If the business you acquired is

already operating, enter the date you

acquired the business. Trusts should

enter the date the trust was legally

created. Estates should enter the date of

death of the decedent whose name

appears on line 1 or the date when the

estate was legally funded.

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