W-13
ExSTARS Reporting Information Request for
Form
Employer Identification Number and Certification
(January 2014)
Department of the Treasury
Information about Form W-13 and its instructions is at www.irs.gov/formw13.
Internal Revenue Service
Name (as shown on your tax returns; see instructions)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
C corporation
S corporation
Partnership
Trust/estate
Individual/sole proprietor
Limited liability company (see instructions). Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
Other (see instructions)
Address (number, street, and apt. or suite no.)
Requester’s name and address
City, state, and ZIP code
Part I
Employer Identification Number (EIN)
Social security numbers not permitted in
Enter your EIN in the appropriate box. The EIN provided must be for the ExSTARS transaction entity.
ExSTARS reporting.
Report the disregarded entity's EIN, not the owner's EIN, when applicable.
Employer identification number
Part II
Certification
Under penalties of perjury, I certify that the number shown on this form is my correct employer identification number.
Sign
Signature of
Here
U.S. person
Date
Type or write
name and title
Section references are to the Internal Revenue Code unless otherwise noted.
Misuse of EINs. If the requester discloses or uses EINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Future Developments
Specific Instructions
For the latest information about developments related to Form W-13
and its instructions, such as legislation enacted after they were
Name
published, go to www.irs.gov/formw13.
Sole proprietor. Enter your individual name as shown on your income
General Instructions
tax return on the “Name” line. You may enter your business, trade, or
“doing business as (DBA)” name on the “Business name/disregarded
Purpose of Form
entity name” line.
Partnership, C corporation, or S corporation. Enter the entity's name
Filers should use this form to request a valid employer identification
on the “Name” line and any business, trade, or “doing business as
number (EIN) for purposes of Excise Summary Terminal Activity
(DBA) name” on the “Business name/disregarded entity name” line.
Reporting System (ExSTARS) reporting.
Limited liability company (LLC). If the person identified on the “Name”
A person who is required to file an ExSTARS information return with
line is an LLC, check the “Limited liability company” box only and enter
the IRS must obtain your correct EIN to report. For example, a truck
the appropriate code for the tax classification in the space provided. If
carrier making a delivery to a terminal must provide the carrier
you are an LLC that is treated as a partnership for federal tax purposes,
company's EIN to the terminal operator.
enter “P” for partnership.
The receiving party returns the form to the requester after providing a
Note. If you are an LLC that has elected to be treated as a disregarded
correct EIN.
entity separate from its owner under Regulation section 301.7701-3,
Updating Your Information
check the LLC box and select the appropriate classification of the
disregarded entity, not the owner listed in the “Name” line.
You must provide the requester with updated information if the name or
EIN changes while still engaged in ExSTARS reporting activities.
Disregarded entity. Enter the owner's name on the “Name” line. The
name of the entity entered on the “Name” line should never be a
Penalties
disregarded entity. The name on the “Name” line must be the name
Failure to furnish EIN. If you fail to furnish your correct EIN to a
shown on the income tax return on which the income will be reported.
requester, you are subject to a penalty of $50 for each such failure
For example, if a foreign LLC that is treated as a disregarded entity for
unless your failure is due to reasonable cause and not to willful neglect.
U.S. federal tax purposes has a domestic owner, the domestic owner's
name is required to be provided on the “Name” line. If the direct owner
Civil penalty for false information with respect to withholding. If you
of the entity is also a disregarded entity, enter the first owner that is not
make a false statement with no reasonable basis that results in no
disregarded for federal tax purposes. Enter the disregarded entity's
backup withholding, you are subject to a $500 penalty.
name on the “Business name/disregarded entity name” line.
Criminal penalty for falsifying information. Willfully falsifying
Note. Check the appropriate box for the federal tax classification of the
certifications or affirmations may subject you to criminal penalties
person whose name is entered on the “Name” line (Individual/sole
including fines and/or imprisonment.
proprietor, partnership, C corporation, S corporation, trust/estate).
W-13
Form
(1-2014)
Cat. No. 62958V
W-13
ExSTARS Reporting Information Request for
Form
Employer Identification Number and Certification
(January 2014)
Department of the Treasury
Information about Form W-13 and its instructions is at www.irs.gov/formw13.
Internal Revenue Service
Name (as shown on your tax returns; see instructions)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
C corporation
S corporation
Partnership
Trust/estate
Individual/sole proprietor
Limited liability company (see instructions). Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
Other (see instructions)
Address (number, street, and apt. or suite no.)
Requester’s name and address
City, state, and ZIP code
Part I
Employer Identification Number (EIN)
Social security numbers not permitted in
Enter your EIN in the appropriate box. The EIN provided must be for the ExSTARS transaction entity.
ExSTARS reporting.
Report the disregarded entity's EIN, not the owner's EIN, when applicable.
Employer identification number
Part II
Certification
Under penalties of perjury, I certify that the number shown on this form is my correct employer identification number.
Sign
Signature of
Here
U.S. person
Date
Type or write
name and title
Section references are to the Internal Revenue Code unless otherwise noted.
Misuse of EINs. If the requester discloses or uses EINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Future Developments
Specific Instructions
For the latest information about developments related to Form W-13
and its instructions, such as legislation enacted after they were
Name
published, go to www.irs.gov/formw13.
Sole proprietor. Enter your individual name as shown on your income
General Instructions
tax return on the “Name” line. You may enter your business, trade, or
“doing business as (DBA)” name on the “Business name/disregarded
Purpose of Form
entity name” line.
Partnership, C corporation, or S corporation. Enter the entity's name
Filers should use this form to request a valid employer identification
on the “Name” line and any business, trade, or “doing business as
number (EIN) for purposes of Excise Summary Terminal Activity
(DBA) name” on the “Business name/disregarded entity name” line.
Reporting System (ExSTARS) reporting.
Limited liability company (LLC). If the person identified on the “Name”
A person who is required to file an ExSTARS information return with
line is an LLC, check the “Limited liability company” box only and enter
the IRS must obtain your correct EIN to report. For example, a truck
the appropriate code for the tax classification in the space provided. If
carrier making a delivery to a terminal must provide the carrier
you are an LLC that is treated as a partnership for federal tax purposes,
company's EIN to the terminal operator.
enter “P” for partnership.
The receiving party returns the form to the requester after providing a
Note. If you are an LLC that has elected to be treated as a disregarded
correct EIN.
entity separate from its owner under Regulation section 301.7701-3,
Updating Your Information
check the LLC box and select the appropriate classification of the
disregarded entity, not the owner listed in the “Name” line.
You must provide the requester with updated information if the name or
EIN changes while still engaged in ExSTARS reporting activities.
Disregarded entity. Enter the owner's name on the “Name” line. The
name of the entity entered on the “Name” line should never be a
Penalties
disregarded entity. The name on the “Name” line must be the name
Failure to furnish EIN. If you fail to furnish your correct EIN to a
shown on the income tax return on which the income will be reported.
requester, you are subject to a penalty of $50 for each such failure
For example, if a foreign LLC that is treated as a disregarded entity for
unless your failure is due to reasonable cause and not to willful neglect.
U.S. federal tax purposes has a domestic owner, the domestic owner's
name is required to be provided on the “Name” line. If the direct owner
Civil penalty for false information with respect to withholding. If you
of the entity is also a disregarded entity, enter the first owner that is not
make a false statement with no reasonable basis that results in no
disregarded for federal tax purposes. Enter the disregarded entity's
backup withholding, you are subject to a $500 penalty.
name on the “Business name/disregarded entity name” line.
Criminal penalty for falsifying information. Willfully falsifying
Note. Check the appropriate box for the federal tax classification of the
certifications or affirmations may subject you to criminal penalties
person whose name is entered on the “Name” line (Individual/sole
including fines and/or imprisonment.
proprietor, partnership, C corporation, S corporation, trust/estate).
W-13
Form
(1-2014)
Cat. No. 62958V
2
Form W-13 (1-2014)
Page
Privacy Act Notice
Other entities. Enter your business name as shown on required federal
tax documents on the “Name” line. This name should match the name
Section 6109 requires you to provide your correct EIN to persons
shown on the charter or other legal document creating the entity. You
(including federal agencies) who are required to file information returns
may enter any business, trade, or DBA name on the “Business name/
with the IRS. The person collecting this form uses the information on the
disregarded entity name” line.
form to file information returns with the IRS. Routine uses of this
Part I. Employer Identification Number (EIN)
information include giving it to the Department of Justice for civil and
criminal litigation and to cities, states, the District of Columbia, and U.S.
Persons engaging in ExSTARS activities must possess an employer
commonwealths and possessions for use in administering their tax laws.
identification number (EIN). Social Security Numbers and “Applied For”
The information also may be disclosed to other countries under a treaty,
type designations are not valid. If you do not have an EIN, see How to
to federal and state agencies to enforce civil and criminal laws, or to
get an EIN below.
federal law enforcement and intelligence agencies to combat terrorism.
Enter your EIN in the appropriate box. Enter the EIN associated with
You must provide your EIN whether or not you are required to file a tax
the ExSTARS activities.
return. Certain penalties may also apply for providing false or fraudulent
information.
How to get an EIN. If you do not have an EIN, apply for one
immediately. Use Form SS-4, Application for Employer Identification
If you have comments concerning the accuracy of these time
Number, to apply for an EIN. You can apply for an EIN online by going
estimates or suggestions for making this form simpler, we would be
to www.irs.gov/businesses and clicking on Employer Identification
happy to hear from you. You can send your comments from
Number (EIN) under Starting a Business. You can get Form SS-4 from
www.irs.gov/formspubs/. Click on "More Information" and then on
the IRS by visiting www.irs.gov/formspubs or by calling 1-800-TAX-
"Comment on Tax Forms and Publications." You can also write to:
FORM (1-800-829-3676).
Internal Revenue Service
Part II. Certification
Tax Forms and Publications
1111 Constitution Ave. NW, IR-6526
Signature requirements. Signing Form W-13 certifies that the EIN you
Washington, DC 20224
are providing is correct, and establishes the proper U.S entity engaging
Do not send the form to this address. Instead, see Purpose of Form.
in ExSTARS activities.
We respond to many letters by telephone. Therefore, it would be
Form W-13 must be signed by an owner or principal officer. Complete
helpful if you would include your daytime phone number, including the
the signature requirement by typing or clearly writing the name and title
area code, in your correspondence.
of the signee.
Although we cannot respond individually to each comment received,
we do appreciate your feedback and will consider your comments as we
revise our tax products.
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