IRS Form SS-4 Application for Employer Identification Number

IRS Form SS-4 or the "Application For Employer Identification Number" is tax form released and collected by the United States Internal Revenue Service. The December 1, 2017 fillable version of the SS-4 Form can be downloaded below in PDF-format.

The IRS-issued "Application For Employer Identification Number" is available for digital filing or can be filled out through the Adobe Reader application on your desktop or mobile device.

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SS-4
Application for Employer Identification Number
OMB No. 1545-0003
(For use by employers, corporations, partnerships, trusts, estates, churches,
Form
EIN
government agencies, Indian tribal entities, certain individuals, and others.)
(Rev. December 2017)
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
1
Legal name of entity (or individual) for whom the EIN is being requested
2
3
Trade name of business (if different from name on line 1)
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)
8b If 8a is “Yes,” enter the number of
(or a foreign equivalent)?
.
.
.
.
.
.
.
.
LLC members .
.
.
.
.
.
Yes
No
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
Military/National Guard
State/local government
Church or church-controlled organization
Farmers’ cooperative
Federal government
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 (if
State
Foreign country
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
12
Closing month of accounting year
Date business started or acquired (month, day, year). See instructions.
14
If you expect your employment tax liability to be $1,000 or
less in a full calendar year and want to file Form 944
13
Highest number of employees expected in the next 12 months (enter -0- if none).
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 wages.)
Agricultural
Household
Other
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)
Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.
17
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)
Applicant’s telephone 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.
Name and title (type or print clearly)
Applicant’s fax number (include area code)
Signature
Date
SS-4
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Form
(Rev. 12-2017)
Cat. No. 16055N
SS-4
Application for Employer Identification Number
OMB No. 1545-0003
(For use by employers, corporations, partnerships, trusts, estates, churches,
Form
EIN
government agencies, Indian tribal entities, certain individuals, and others.)
(Rev. December 2017)
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
1
Legal name of entity (or individual) for whom the EIN is being requested
2
3
Trade name of business (if different from name on line 1)
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)
8b If 8a is “Yes,” enter the number of
(or a foreign equivalent)?
.
.
.
.
.
.
.
.
LLC members .
.
.
.
.
.
Yes
No
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
Military/National Guard
State/local government
Church or church-controlled organization
Farmers’ cooperative
Federal government
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 (if
State
Foreign country
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
12
Closing month of accounting year
Date business started or acquired (month, day, year). See instructions.
14
If you expect your employment tax liability to be $1,000 or
less in a full calendar year and want to file Form 944
13
Highest number of employees expected in the next 12 months (enter -0- if none).
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 wages.)
Agricultural
Household
Other
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)
Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.
17
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)
Applicant’s telephone 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.
Name and title (type or print clearly)
Applicant’s fax number (include area code)
Signature
Date
SS-4
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Form
(Rev. 12-2017)
Cat. No. 16055N
2
Form SS-4 (Rev. 12-2017)
Page
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,
9b (if applicable), and 10–14 and 16–18.
employees
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
Does not already have an EIN
Complete lines 1–18 (as applicable).
Purchased a going business
3
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
and 18.
or claim tax treaty benefits
6
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 (or
Needs an EIN to file Form 8832, Classification
Complete lines 1–18 (as applicable).
similar single-member entity)
Election, for filing employment tax returns and
8
excise tax returns, or for state reporting purposes
, or
is a foreign-owned U.S. disregarded entity and needs
an EIN to file Form 5472, Information Return of a 25%
Foreign-Owned U.S. Corporation or a Foreign
Corporation Engaged in a U.S. Trade or Business
(Under Sections 6038A and 6038C of the Internal
Revenue Code)
Is an S corporation
Needs an EIN to file Form 2553, Election by a Small
Complete lines 1–18 (as applicable).
9
Business Corporation
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.

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