Form IC134: Minnesota Contractor Affidavit

You must have a Minnesota Tax ID Number if you have employees who work in Minnesota.

If you do not have employees and did all the work yourself, you do not need a Minnesota ID number. Instead, enter your Social Security Number or the FEIN for your business in the space for Minnesota ID number and explain who did the work.

If you do not have a Minnesota ID number, apply online or by calling the Business Registration Office at 651-282-5225 or 1-800-657-3605.

Enter the Company Name, Daytime Phone, Minnesota Tax ID Number, Address, Total Contract Amount, Month/Year Work Began, City, State, ZIP Code, Contract Amount Still Due, Month/Year Work Ended, Project Number and Project Location.

Enter the Contracting Government Entity with its Address, City, State and ZIP Code.

Did you have employees work on this project? Yes or No. If no, who did the work?

Check one or more boxes that describes your involvement in the project and complete all information requested.

Sole contractor: a business or individual, under contract with the governmental entity, who completed all work on the project without hiring subcontractors.

Subcontractor: a business or individual hired by someone other than the governmental entity to complete work on the project. Enter the Name of contractor who hired you and the Address.

Prime contractor: a business or individual who was responsible for completion of all or part of the project and hired subcontractors to help complete the project.

If You're a Prime Contractor and a Subcontractor on the Same Project: If you were hired as a subcontractor to do work on a project, and you subcontracted all or a part of your portion of the project to another contractor, you are also a prime contractor. Complete both the subcontractor and prime contractor sections on a single Form IC134.

If you hired subcontractors, please list each subcontractor with the Business name, Address and Owner/Officer. If you hired more than seven, attach a separate page listing all hired subcontractors. Include a copy of each subcontractor's Certificate of Compliance or Affidavit Number.

By signing you declare that this Form IC134, Contractor Affidavit, is correct and complete to the best of your knowledge and belief. The Department of Revenue may disclose and send copies of this form to the prime contractor of a subcontractor, and to any subcontractors of a prime contractor, and to the contracting agency under Minnesota Statute § 270B.09.

Print the Contractor's Name and Title, then enter the Contractor's Signature and Date.

If you are a subcontractor or sole contractor, submit the form when you have completed your part of the project.

If you are a prime contractor, submit the form when the entire project is completed and you have received either a confirmation page for electronically-submitted Forms IC134 or a Certificate of Compliance for Form IC134 from each of your subcontractors.

The Department of Revenue cannot process a Form IC134 until you and any subcontractors finish work on your project. If you submit the form before the project is completed, your Form IC134 will be denied.

Mail to: Minnesota Department of Revenue, Mail Station 6610, 600 N. Robert St., St. Paul, MN 55146-6610. If any of your subcontractors gave you a Certificate of Compliance for Form IC134, you must submit Form IC134 by mail or email. If you're a prime contractor and one or more subcontractors submitted their Contractor Affidavit by mail, you must also submit your Contractor Affidavit by mail.