Gao W 9 Arizona Form PDF Details

The Gao W 9 Arizona form is used to report and pay withholding taxes to the state of Arizona. This form is due on the 20th day of the month following the end of the tax quarter, and must be filed even if no taxes are owed. The Gao W 9 can be filed electronically or by mail, and instructions for completing the form can be found on the Arizona Department of Revenue website. Penalties may apply for late filing or payment, so it is important to submit this form on time.

QuestionAnswer
Form NameGao W 9 Arizona Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameshow to gao w 9, form vendor arizona, az fillable w9, gao w 9

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State of Arizona Substitute W-9: Request for Taxpayer Identification Number and Certification

Submit completed form to the State of Arizona Agency with whom you are doing business with for review and authorization.

Type of Request (Must select at least ONE)

 

 

New Location

Change - Select the

 

 

Tax ID

 

Legal Name

 

Entity Type

 

 

Minority Business Indicator

New Request

 

(Additional Address

type(s) of change from

 

Main Address

 

 

Remittance Address

 

 

Contact Information

 

 

 

 

 

 

 

ID)

the following:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Taxpayer Identification Number (TIN) (Provide ONE Only)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TIN

 

 

 

OR

SSN

 

 

 

 

 

-

 

 

 

-

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entity Name (As it appears on IRS EIN records, IRS Letter CP575, IRS Letter 147C or Social Security Administration Records, Social Security Card. If Individual, Sole Proprietor, Single Member LLC, enter First, Middle, Last Name.)

Legal Name

DBA Name

Entity Type (Must select ONE of the following)

 

Individual/Sole Proprietor or Single-Member LLC

The US or any of its political subdivisions or instrumentalities

 

 

 

 

 

Corporation

A state, a possession of the US, or any of their political subdivisions or

 

 

instrumentalities

 

 

Partnership

 

 

 

Other: Tax Reportable Entity

 

 

Limited Liability Company (LLC) including Corporations &

Description

 

 

 

 

Partnerships

Other: Tax Exempt Entity

 

 

Minority Business Indicator (Must select ONE of the following)

5

Small Business

Small Business- African American

Small Business- Asian

Small Business - Hispanic

Small Business- Native American

Small Business- Other Minority

Small, Woman Owned Business

Small, Woman Owned Business- African American

Small, Woman Owned Business- Asian

Small, Woman Owned Business- Hispanic

Small, Woman Owned Business- Native American

Small, Woman Owned Business- Other Minority

Woman Owned Business

Woman Owned Business- African American

Woman Owned Business- Asian

Woman Owned Business- Hispanic

Woman Owned Business- Native American

Woman Owned Business- Other Minority

Minority Owned Business- African American

Minority Owned Business- Asian

Minority Owned Business- Hispanic

Minority Owned Business- Native American

Minority Owned Business- Other Minority

Non-Profit, IRC §501(c)

Non-Small, Non-Minority or Non-Woman Owned Business

Individual, Non-Business

6

7

8

9

10

 

Veteran Owned Business

 

 

 

YES

 

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entity Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Main Address (Where tax information and general correspondence is to be mailed)

Remittance Address (Where payment is to be mailed)

 

Same as Main

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address Line 1

 

 

 

 

 

 

 

 

Address Line 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address Line 2

 

 

 

 

 

 

 

 

Address Line 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

State

 

 

Zip code

 

City

State

 

Zip code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vendor Contact Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Ext.

 

 

Fax

 

Email

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Exemption from Backup Withholding and FATCA Reporting: Complete this section if it is applicable to you. See instructions for more details

Exemption Code for Backup Withholding

 

Exemption Code for FATCA Reporting

 

 

 

Certification

Under penalties of perjury, I certify that:

1.The number shown on this form is my correct Taxpayer Identification Number, and

2.I am not subject to Backup Withholding because: (a) I am exempt from Backup Withholding, or (b) I have not been notified by the IRS that I am subject to Backup Withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to Backup Withholding, and

3.I am a US citizen or other US person, and

4.The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

Certification instructions: You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN.

Signature

Print Name

Date

 

 

 

GAO-W-9 (10/2019)

The State of Arizona Substitute W-9 Form Instructions

The State of Arizona (State), like all organizations that file an information return with the IRS, must obtain your correct Taxpayer Identification Number (TIN) to report income paid to you or your organization. The State uses the Substitute W-9 Form to obtain certification of your TIN in order to ensure accuracy of information contained in its payee/vendor system and to avoid Backup Withholding as mandated by the IRS. According to IRS regulations, the State must withhold 28% of all payments if a vendor/payee fails to provide the State its certified TIN. The Substitute Form W-9 certifies a vendor/payee's TIN. Any vendor/payee who wishes to do business with the State must complete the Substitute W-9 Form.

Part 1 - Type of Request: Select only one.

Part 2 - Taxpayer Identification Number (TIN): Enter your nine-digit TIN. The TIN is either your nine-digit Social Security Number (SSN) assigned by the Social Security Administration (SSA) or Employer Identification Number (EIN) assigned by the Internal Revenue Service (IRS).

Part 3 - Entity Name: Enter the legal name as it appears on IRS EIN records, IRS Letter CP575, IRS Letter 147C or Social Security Administration Records, Social Security Card. If Individual, Sole Proprietor, Single Member LLC, enter First, Middle, Last Name. Enter your DBA in the designated line if applicable.

Part 4 - Entity Type: Select only one for TIN given.

Part 5 - Minority Business Indicator: Select only one for TIN given.

Part 6 - Veteran Owned Business: Select only one for TIN given.

Part 7 - Entity Address: List the locations for tax reporting purposes and where payments should be mailed.

Part 8 - Entity Contact Information: List the contact information.

Part 9 - Backup Withholding and FATCA Exemptions: If you are exempt from Backup Withholding and/or FATCA reporting, enter in the Exemptions box, any code(s) that may apply to you.

Backup Withholding Exemption Codes: Generally, Individuals (including Sole Proprietors) are not exempt from Backup Withholding. Additionally, Corporations are not exempt from Backup Withholding when supplying legal or medical services. If you do not fall under the categories below, leave this field blank. The following codes identify payees that are exempt from Backup Withholding:

Code 1: An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b) (7) if the account satisfies the requirements of section 401(f) (2)

Code 2: The United States or any of its agencies or instrumentalities

Code 3: A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or Instrumentalities

Code 4: A foreign government or any of its political subdivisions, agencies, or instrumentalities

Code 5: A corporation

Code 6: A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States Code 7: A futures commission merchant registered with the Commodity Futures Trading Commission

Code 8: A real estate investment trust

Code 9: An entity registered at all times during the tax year under the Investment Company Act of 1940

Code 10: A common trust fund operated by a bank under section 584(a)

Code 11: A financial institution

Code 12: A middleman known in the investment community as a nominee or custodian

Code 13: A trust exempt from tax under section 664 or described in section 4947

FATCA Exemption Codes: The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. If you are only submitting this form for an account you hold in the United States, leave this field blank. The following codes identify payees that are exempt from FATCA Reporting:

Code A: An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a) (37)

Code B: The United States or any of its agencies or instrumentalities

Code C: A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities

Code D: A corporation the stock of which is regularly traded on one or more established securities markets, as described in Reg. section 1.1472-1(c)(1)(i)

Code E: A corporation that is a member of the same expanded affiliated group as a corporation described in Reg. section 1.1472-1(c) (1) (i)

Code F: A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state

Code G: A real estate investment trust

Code H: A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940

Code I: A common trust fund as defined in section 584(a)

Code J: A bank as defined in section 581 Code K: A broker

Code L: A trust exempt from tax under section 664 or described in section 4947(a) (1)

Code M: A tax-exempt trust under a section 403(b) plan or section 457(g) plan

Part 10 - Certification: Please sign, date and provide preparer's name in appropriate space.

GAO-W-9 (10/2019)

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Stage no. 1 of completing az fillable w9

2. When this array of blanks is done, proceed to type in the suitable information in all these: Veteran Owned Business, YES, Entity Address, Main Address Where tax information, Remittance Address Where payment, Same as Main, Address Line, Address Line, City, State, Zip code, City, State, Zip code, and Address Line.

az fillable w9 completion process explained (portion 2)

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