HomeMy WebLinkAboutRequest for Identification• W-9
Request for Taxpayer
Identification Number and Certification
Glue tram to the
retpaester. Do not
5end to the IRS,
Specific Insinocinows
RFEN5 LAND5cAPiNiG
Speci.ftc ninclions
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; .A1;941,4:749711+99 9-,92f.+11 TI -11799979 „
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1 0 NI 14 e. rcl •
MIAMI ,3305.5
111111,1_Tattpayr•Ictentificattioo Number (TIN)
▪ ,997141.979,49,711+9
.19:10,A.199;9,77tY1 . ..gm1y
tlostiever. frif a resident diem cote
proprietor. or oksrerjarded. amity. see the Pan t
instructions ort page 2s 1-tit
..:1,1proogr 3(1%.. cg2S.
4ow to get a tiff 9"97; .77
Mate: tI7,- 1111.)-r
▪ fog
Piw 14L
Certiftcahon
Social .,acurty outrider
Or
For 1.1.S. Payees EICerepE From
Backup Withholding
Employer nierioncation riorehiw 2 I
L.5..5019 0_19_7_8_
99.9113:9 4:`, :tt ▪ -II-
-217 -, • .79,9171414;91 901 1 ....Fr +M1,9 17,19 :1-..0:1-0.71 [9.7 4nd
3. 3 ,911,:- r:31 v.:1117:0+.1.79.cj (ad fuggr, (134 I (.I3 ▪ 31.1tyy 91:17191.11
Iii4 I!" I V, 1.11,:.ti.,I) Sg a:" 41 re-6.u.i of tg.....Ng to r,,-.0.yr, og$
:101:94+.1 14. 199,91 9 '141 1,111.51.0 and
3. i ,s
Certification instructions. 2
.9;'*7,1 717 r•el, r .Orlf al'...`4Orrrl On yr:AA' ',I.:, 1.,711, 2
str
.. lc} ($:..::i.f391K31, A,71 t1C7-4.9"9791 ',11:491 1/•97. A11," .1.
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Sign Supattce of
Here 'U.S. person lit -
Purpose of Form
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LI :99 91:=
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97: I 9 1911 • 11; L3,C4
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Use Form Vit-9 us it yen are a Li S person
;10 ..,3.111..
2. ▪ iurp
1 you are a !amigo person, liirk the
apurrionate Form w.s. o Fula SIS.
s...1
What Es backup withholding?
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to 'no rge,
▪ ;1633+.7 :+1.11.11C3:t 14 L1.I. kv6:3
13,11-1,AA.901179.
t . 0.4 :iru$
▪ -,119T4 :9+9.91 +99 ;+:7:91-...9 ;
anq
••:n.
i97199:7: 6,97119,-,
!it-Apr.▪ ..gamy. Paynient% you receive
wit Lie suloyect 110: baCkLIP
t 1999: .3,19 9.7+1.9.9'
131f: t7,77.199917191.09
-9,779,9,99:9 9:1
siz.; if; 791:,9
7:1;ol
.99t+1.
Date
9";11- 79'4 ,
33199391,4+ ::. 33.6,1,11774
▪ ,,,,,,, 1.1.,,..9+7:
IL:9:1"99: 9 196_9 0:
pap+.
tt<irri 1,141i r,..4^ 1611, P73
7,..:1:19j:99:,1 XI 9 7.+‘ 7-01p..79,11,9. $111S11110.:99141% for
the Requester of Form W-9
Penalties
Fagure to turruth THU ‘.7 • 1,
T% A, '11 1
• 2. 7 ..,(!;
t.9 -. 1;9,0.1-.77
Coil penalty tor false unfonnatiell with respect
vitinissoidaq.
• AU,
Criminal penalty tor labolying
9/27/04
, 1:;211g.
www.miamidade.gov/dpm/ 20