Federal Free Printable Form SS-4 (Rev. January 2010) for 2017 Federal Application for Employer Identification Number

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Application for Employer Identification Number
Form SS-4 (Rev. January 2010)

Note: Form SS-4 begins on the next page of this document. Change to Fax-TIN Numbers There is a change to the Instructions for Form SS-4 (Rev. February 2016). On page 2, under the "Where to File or Fax" table, the Fax-TIN numbers have changed. If you have a principal place of business, office or agency, or File or Fax to: legal residence in the case of an individual, located in: Internal Revenue Service Attn: EIN Operation One of the 50 states or the Cincinnati, OH 45999 District of Columbia Fax: (855) 641-6935 If you have no legal residence, principal place of business, or principal office or agency, in any state: Internal Revenue Service Attn: EIN Operation Cincinnati, OH 45999 Fax: (855) 215-1627 (within the U.S.) Fax: (304) 707-9471 (outside the U.S.) These changes will be included in the next revision of the Instructions for Form SS-4. SS-4 Form (Rev. January 2010) Type or print clearly. Department of the Treasury Internal Revenue Service 8a Application for Employer Identification Number OMB No. 1545-0003 EIN (For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others.) 1 ▶ See separate instructions for each line. ▶ Keep a copy for your records. Legal name of entity (or individual) for whom the EIN is being requested 2 Trade name of business (if different from name on line 1) 3 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 Is this application for a limited liability company (LLC) (or a foreign equivalent)? . . . . . . . . 8b If 8a is “Yes,” enter the number of LLC members . . . . . . ▶ 8c Yes If 8a is “Yes,” was the LLC organized in the United States? . . 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) Partnership Corporation (enter form number to be filed) No . . . SSN, ITIN, or EIN . ▶ 10 11 13 Other (specify) ▶ If a corporation, name the state or foreign country (if applicable) where incorporated Reason for applying (check only one box) Started new business (specify type) ▶ . . . . . . . . . . . Yes No Estate (SSN of decedent) Plan administrator (TIN) Trust (TIN of grantor) Personal service corporation Church or church-controlled organization Other nonprofit organization (specify) ▶ 9b . National Guard Farmers’ cooperative REMIC State State/local government Federal government/military Indian tribal governments/enterprises Group Exemption Number (GEN) if any Foreign country ▶ Banking purpose (specify purpose) ▶ 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) ▶ 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 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.) Household Other Agricultural 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 Other (specify) ▶ Finance & insurance 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 Party Designee Designee’s name Designee’s telephone number (include area code) Address and ZIP code Designee’s fax 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. Applicant’s telephone number (include area code) Name and title (type or print clearly) ▶ Applicant’s fax number (include area code) Signature ▶ Date ▶ For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 16055N Form SS-4 (Rev. 1-2010) Page 2 Form SS-4 (Rev. 1-2010) 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... Started a new business AND... Does not currently have (nor expect to have) employees THEN... Complete lines 1, 2, 4a–8a, 8b–c (if applicable), 9a, 9b (if applicable), and 10–14 and 16–18. Hired (or will hire) employees, including household employees Does not already have an EIN Complete lines 1, 2, 4a–6, 7a–b (if applicable), 8a, 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 ownership changed (for example, you incorporate a sole proprietorship or form a partnership) 2 Complete lines 1–18 (as applicable). Purchased a going business 3 Created a trust Does not already have an EIN The trust is other than a grantor trust or an IRA trust 4 Complete lines 1–18 (as applicable). Complete lines 1–18 (as applicable). Created a pension plan as a plan administrator 5 Needs an EIN for reporting purposes Complete lines 1, 3, 4a–5b, 9a, 10, and 18. Is a foreign person needing an EIN to comply with IRS withholding regulations Needs an EIN to complete a Form W-8 (other than Form W-8ECI), avoid withholding on portfolio assets, or claim tax treaty benefits 6 Complete lines 1–5b, 7a–b (SSN or ITIN optional), 8a, 8b–c (if applicable), 9a, 9b (if applicable), 10, and 18. 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 taxes on non-wage income paid to an alien (i.e., individual, corporation, or partnership, etc.) Is a state or local agency Is an agent, broker, fiduciary, manager, tenant, or spouse who is required to file Form 1042, Annual Withholding Tax Return for U.S. Source Income of Foreign Persons Complete lines 1, 2, 3 (if applicable), 4a–5b, 7a–b (if applicable), 8a, 8b–c (if applicable), 9a, 9b (if applicable), 10, and 18. Serves as a tax reporting agent for public assistance recipients under Rev. Proc. 80-4, 1980-1 C.B. 581 7 Complete lines 1, 2, 4a–5b, 9a, 10, and 18. Is a single-member LLC Needs an EIN to file Form 8832, Classification Election, for filing employment tax returns and excise tax returns, or for state reporting purposes 8 Complete lines 1–18 (as applicable). Is an S corporation Needs an EIN to file Form 2553, Election by a Small Business Corporation 9 Complete lines 1–18 (as applicable). 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 12month 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.
Extracted from PDF file 2016-federal-form-ss-4.pdf, last modified September 2016

More about the Federal Form SS-4 Other TY 2016

We last updated the Application for Employer Identification Number in May 2017, so this is the latest version of Form SS-4, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form SS-4 directly from TaxFormFinder. You can print other Federal tax forms here.

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Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form SS-4 from the Internal Revenue Service in May 2017.

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Historical Past-Year Versions of Federal Form SS-4

We have a total of four past-year versions of Form SS-4 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2016 Form SS-4

Form SS-4 (Rev. January 2010)

Application for Employer Identification Number 2015 Form SS-4

Form SS-4 (Revised January 2010)

Application for Employer Identification Number 2012 Form SS-4

Form SS-4 (Rev. January 2010)

Application for Employer Identification Number 2011 Form SS-4

Form SS-4 (Rev. January 2010)

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