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Hawaii Free Printable Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification for 2024 Hawaii Dependent Care Provider's Identification and Certification

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Dependent Care Provider's Identification and Certification
Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

Clear Form Form HW-16 STATE OF HAWAII — DEPARTMENT OF TAXATION Dependent Care Provider’s Identification and Certification Please print or type (REV. 2016) (DO NOT file with your tax return. Keep for your records) Part I — Dependent Care Provider’s Identification (See Instructions) Name of dependent care provider Provider’s taxpayer identification number Address (number and street) If the above number is a social security number, check this box ä ............................................... £ City, State, and Postal/ZIP code GE/Use I.D. No. GE __ __ __-__ __ __-__ __ __ __ - __ __ Certification and Signature of Dependent Care Provider. Under penalties set forth in section 231-36, HRS, I as the dependent care provider, certify that my name, address, taxpayer identification number, and general excise tax identification number, as shown above, are correct. Please Signature of Dependent Care Provider Sign Here Date Part II — Name and Address of Taxpayer Requesting Part I Information (See Instructions) Name, street address, City, State, and Postal/ZIP code of person requesting information General Information and a GE/Use I.D. No. below. Part II You are required to get the information in Part I from anyone who provides care for your child or other dependent if: If the provider is exempt from federal income tax as an organization described in IRC section 501(c)(3), see If Provider Is an Exempt Organization below. You only need to complete this part if you give Form HW-16 to your provider and it is to be returned to you at some later time. • you intend to claim a tax credit on your tax return for child and dependent care expenses; or • you receive benefits from a dependent care assistance program provided by your employer. You must report the correct name, address, taxpayer identification number (TIN), and general excise tax identification number (GE/Use I.D. No.) of the dependent care provider (provider) on Schedule X, Tax Credits for Hawaii Residents. You may use Form HW-16 to get this information from each provider or you may use any one of the other methods described under Due Diligence, below. A copy of federal Form W-10 may not be submitted for Form HW-16. Do not file Form HW16 with your income tax return. Instead, keep it for your records. Section 235-55.6, Hawaii Revised Statutes (HRS), requires anyone providing dependent care services to you to give you this information. The Department of Taxation (Department) uses the TIN and GE/Use I.D. No. for identification purposes and to help verify the accuracy of the provider’s return as well as your return. Providers must give you their TIN and GE/Use I.D. No. whether or not they are required to file a tax return. Part I The provider completes this part. The provider’s name, address, TIN, and GE/Use I.D. No. should be entered in the spaces above. For individuals and sole proprietors, the TIN is a social security number (SSN). But if the provider is a nonresident or resident alien who does not have and is not eligible to get an SSN, the TIN is an Internal Revenue Service (IRS) individual taxpayer identification number (ITIN). For other entities, it is the federal employer identification number (FEIN). If the provider does not have a TIN or a GE/Use I.D. No., see How to Get a TIN How To Get a TIN and a GE/Use Tax I.D. No. — Providers who do not have a TIN or a GE/Use I.D. No. should apply for one immediately. To apply for an SSN, they should get federal Form SS-5, Application for a Social Security Card (for individuals), from their local office of the Social Security Administration. To apply for an ITIN, they should get federal Form W-7, Application for IRS Individual Taxpayer Identification Number, from their local IRS office. To apply for a FEIN, they should get federal Form SS-4, Application for Employer Identification Number (for businesses and other entities), from their local IRS office. To apply for a GE/Use I.D. No., they should get Form BB-1, State of Hawaii Basic Business Application, from their respective district Department office. Form BB-1 may also be obtained by calling the Department at 808-587-4242 or toll-free at 1-800-222-3229, or by downloading it from the Department’s website (tax.hawaii.gov). NOTE:  An ITIN is for tax use only. It does not entitle the individual to social security benefits or change employment or immigration status under U.S. law. If Provider Is an Exempt Organization. — If the provider is a tax-exempt organization of the type described in IRC section 501(c)(3), the provider is not required to supply its TIN or GE/Use I.D. No. In such cases, the organization completes the name and address part of Form HW-16 and writes “tax-exempt” in the space provided for the TIN and GE/Use I.D. No.. Generally, the type of exempt organization described in IRC section 501(c)(3) is one organized and operated exclusively for religious, charitable, scientific, testing for public safety, literary, or educational purposes, or for the prevention of cruelty to children or animals. Income Tax Reporting Requirements for Providers. — The provider must report on his or her income tax return all income received for providing care for any person. Other Information If No Information Is Reported. — You will not be allowed the tax credit or the income exclusion for employer-provided dependent care assistance if: • you do not include the name, address, TIN, or GE/Use I.D. No. of the provider on your income tax return; and • you cannot establish, to the Department upon its request, that you exercised due diligence in obtaining this information. Due Diligence. — You can show that you exercised due diligence in obtaining this information by getting and keeping: • a Form HW-16 properly completed by the provider; or • a copy of the provider’s social security card and general excise tax license; or • a recently printed letterhead or printed invoice that has on it the provider’s name, address, TIN, and GE/Use I.D. No.; or • where the employer is the provider, a copy of the statement furnished by the employer under a dependent care assistance program, showing the employer’s name, address, TIN and GE/Use I.D. No.; or • where the provider is your household employee and has given you a properly completed Form HW-4 to have income tax withheld, a copy of that HW-4. If your provider does not comply with your request for one of these items, you must still furnish the name, address, and, if known, the TIN and GE/ Use I.D. No. of the provider on Schedule X. Also, you should include a statement on Schedule X that you requested the information and that the provider did not comply with the request. This statement will show that you exercised due diligence, unless you know that the statement is incorrect.
Extracted from PDF file 2023-hawaii-form-hw-16.pdf, last modified August 2002

More about the Hawaii Form HW-16 Other TY 2023

We last updated the Dependent Care Provider's Identification and Certification in February 2024, so this is the latest version of Form HW-16, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form HW-16 directly from TaxFormFinder. You can print other Hawaii tax forms here.


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Other Hawaii Other Forms:

TaxFormFinder has an additional 164 Hawaii income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form HW-4 Employee's Withholding Exemption and Status Certificate
Form HW-14 (Obsolete) Periodic Withholding Tax Return
Form HW-3 Employer’s Annual Return & Reconciliation of Hawaii Income Tax Withheld from Wages
Form HW-7 Exemption from Withholding on Nonresident Employee's Wages
Form HW-16 Dependent Care Provider's Identification and Certification

Download all HI tax forms View all 165 Hawaii Income Tax Forms


Form Sources:

Hawaii usually releases forms for the current tax year between January and April. We last updated Hawaii Form HW-16 from the Department of Taxation in February 2024.

Show Sources >

Historical Past-Year Versions of Hawaii Form HW-16

We have a total of eleven past-year versions of Form HW-16 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

2022 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

2021 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

2020 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

2019 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

2018 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

2017 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

2016 Form HW-16

Form HW-16 Rev 2016 Dependent Care Provider's Identification and Certification

Forms 2013 2015 Form HW-16

Form HW-16 Rev 2013 Dependent Care Provider's Identification and Certification

Forms 2006 2012 Form HW-16

Form HW-16 Rev 2006 Dependent Care Provider's Identification and Certification

Forms 2006 2011 Form HW-16

Form HW-16 Rev 2006 Dependent Care Provider's Identification and Certification


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