Application for Employer Identification Number Form SS-4

EIN

(Rev. December 1995) (For use by employers, corporations, partnerships, trusts, estates, churches,

government agencies, certain individuals, and others. See instructions.)

Department of the Treasury OMB No. 1545-0003 Internal Revenue Service

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

2 Trade name of business (if different from name on 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 on 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.) ©

Trust

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

Partnership

Sole proprietor (SSN) Plan administrator-SSN

Farmers’ cooperative

Personal service corp. Other corporation (specify) ©

REMIC

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

Changed type of organization (specify) ©

9 Reason for applying (Check only one box.)

Purchased going business

Started new business (specify) ©

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 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 Highest number of employees expected in the next 12 months. Note: If the applicant does Nonagricultural Agricultural Household

not expect to have any employees during the period, enter -0-. (See instructions.) ©

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 “Yes” on line 17a, give applicant’s legal name and trade name shown on prior application, if different from line 1 or 2 above.

Legal name © Trade name ©

17c Approximate date when and city and state where the application was filed. Enter 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 page 4. Form SS-4 (Rev. 12-95)

Yes

Please type or print clearly.

Cat. No. 16055N

State Foreign country

Limited liability co.

Fax telephone number (include area code)

© Keep a copy for your records.
Purpose of Form

Who Must File

● You pay wages to one or more

employees including household 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, information, 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, Starting a Business and Keeping

Records, and Pub. 1635, Understanding

Your EIN.

How To Apply

Application by Tele-TIN.—Under the

Tele-TIN program, you can receive your

EIN over the telephone and use it

immediately to file a return or make a

payment. To receive an EIN by phone,

complete Form SS-4, then call the

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

can 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

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. 12-95) 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, type of tax, period covered, and

date you applied for an EIN. Send an

explanation with the deposit.

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

1041.)

2. Individual Retirement 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.)

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: If you are electing to be an

“S corporation,” be sure you file Form

2553, Election by a Small Business

Corporation.

● State and local agencies who serve as

tax reporting agents for public assistance

recipients, under Rev. Proc. 80-4, 1980-1

C.B. 581, should obtain a separate EIN for

this reporting. See Household employer

on page 3.

3. Certain trusts that are considered

household employers can use the trust EIN

to report and pay the social security and

Medicare taxes, Federal unemployment tax

(FUTA) and withheld Federal income tax. A

separate EIN is not necessary.

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

Kansas, New Mexico,

Oklahoma, Texas

Attn: Entity Control

Austin, TX 73301

(512) 460-7843

Indiana, Kentucky,

Michigan, Ohio, West

Virginia

Attn: Entity Control

Cincinnati, OH 45999

(606) 292-5467

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

4.)
Form SS-4 (Rev. 12-95) Page 3

Individuals.—Enter the first name, middle

initial, and last name. If you are a sole

proprietor, enter your individual name, not

your business name. Do not use

abbreviations or nicknames.

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. Do not list the

names of the partners on line 1. See the

specific instructions for line 7.

Corporations.—Enter the corporate name

as it appears 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”

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, information, or alcohol,

tobacco, or firearms returns. Enter your

SSN 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.”

REMIC.—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; or 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 corporation.—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,

and

● The employee-owners own 10% of the

fair market value of the outstanding stock

in the entity on the last day of the testing

period.

Other corporation.—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 organization.—Check this

box if the nonprofit organization is other

than a church or church-controlled

organization and specify the type of

nonprofit organization (for example, an

educational organization).

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.

Personal services include performance of

services in such fields as health, law,

accounting, or consulting. For more

information about personal service

corporations, see the Instructions for

Form 1120, U.S. Corporation Income Tax

Return, and Pub. 542, Tax Information on

Corporations.

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. For information on the

applicable employment taxes for family

members, see Circular E, Employer’s Tax

Guide (Publication 15).

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.

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.

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

Limited liability co.—See the definition of

limited liability company in the Instructions

for Form 1065. If you are classified as a

partnership for Federal income tax

Household employer.—If you are an

individual, check the “Other” box and enter

“Household employer” and your SSN. If

you are a state or local agency serving as

a tax reporting agent for public assistance

recipients who become household

employers, check the “Other” box and

enter “Household employer agent.” If you

are a trust that qualifies as a household

employer, you do not need a separate EIN

for reporting tax information relating to

household employees; use the EIN of the

trust.

person. Print or type the first name, middle

initial, and last name.

purposes, mark the “Limited liability co.”

checkbox. If you are classified as a

corporation for Federal income tax

purposes, mark the “Other corporation”

checkbox and write “Limited liability co.” in

the space provided.

Created a trust.—Check this box if you

created a trust, and enter the type of trust

created.

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.”

Purchased going business.—Check this

box if you purchased an existing business.

Do not use the former owner’s EIN. Do

not apply for a new EIN if you already

have one. Use your own EIN.

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 or an investment club for

dividend and interest reporting).
REMIC.—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, or

investment club). Also state if the business

will involve the sale or distribution of

alcoholic beverages.

Governmental.—Enter the type of

organization (state, county, school district,

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, or quarrying dimension

stone).

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 or

electrical subcontractor).

Trade.—Specify the type of sales and

the principal line of goods sold (for

example, wholesale dairy products,

manufacturer’s representative for mining

machinery, or retail hardware).

Manufacturing.—Specify the type of

establishment operated (for example,

sawmill or vegetable cannery).

Signature block.—The application must

be signed by (a) the individual, if the

applicant is an individual, (b) the president,

vice president, or other principal officer, if

the applicant is a corporation, (c) a

responsible and duly authorized member or

officer having knowledge of its affairs, if

the applicant is a partnership or other

unincorporated organization, or (d) the

fiduciary, if the applicant is a trust or

estate.

Form SS-4 (Rev. 12-95) 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 45 min.

If you have comments concerning the

accuracy of these time estimates or

suggestions for making this form simpler,

we would be happy to hear from you. You

can write to the Tax Forms Committee,

Western Area Distribution Center, Rancho

Cordova, CA 95743-0001. Do not send

this form to this address. 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 (a) the

majority partners; (b) the principal partners;

(c) the tax year that results in the least

aggregate (total) deferral of income; or (d)

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). You

should receive your order or notification of

its status within 7 to 15 workdays of your

call.

Pub. 1635, Understanding Your EIN

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

Package 1024, Application for Recognition

of Exemption Under Section 501(a) or for

Determination Under Section 120

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.

Printed on recycled paper

Line 13.—For a definition of agricultural

labor (farmworker), see Circular A,

Agricultural Employer’s Tax Guide

(Publication 51).

Pub. 583, Starting a Business and Keeping

Records

Package 1023, Application for Recognition

of Exemption

Note: Do not file this form if you are the

grantor/owner of certain revocable trusts.

You must use your SSN for the trust. See

the Instructions for Form 1041.

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.

Pub. 15-A, Employer’s Supplemental Tax

Guide

Use your computer.—If you subscribe to

an on-line service, ask if IRS information is

available and, if so, how to access it. You

can also get information through IRIS, the

Internal Revenue Information Services, on

FedWorld, a government bulletin board.

Tax forms, instructions, publications, and

other IRS information, are available through

IRIS.

IRIS is accessible directly by calling

703-321-8020. On the Internet, you can

telnet to fedworld.gov. or, for file transfer

protocol services, connect to

ftp.fedworld.gov. If you are using the

WorldWide Web, connect to

http://www.ustreas.gov

FedWorld’s help desk offers technical

assistance on accessing IRIS (not tax help)

during regular business hours at

703-487-4608. The IRIS menus offer

information on available file formats and

software needed to read and print files.

You must print the forms to use them; the

forms are not designed to be filled out

on-screen.

Tax forms, instructions, and publications

are also available on CD-ROM, including

prior-year forms starting with the 1991 tax

year. For ordering information and software

requirements, contact the Government

Printing Office’s Superintendent of

Documents (202-512-1800) or Federal

Bulletin Board (202-512-1387).

Pub. 15, Employer’s Tax Guide