Montana W 9 Form PDF Details

In today's fast-paced world, where every transaction and official process is meticulously recorded for transparency and compliance, the State of Montana, through its Department of Public Health and Human Services alongside the Department of Administration, extends its administrative diligence in managing taxpayer identification with the SW9 form, revised in April 2009. This form serves a pivotal role as a Substitute W-9, specifically designed to streamline the process of taxpayer identification number (TIN) verification. Unlike the standard W-9 form issued by the Internal Revenue Service (IRS) for collecting information such as an individual’s or entity’s TIN, the Montana SW9 form incorporates unique state-level requirements to facilitate accurate tax reporting and minimize the overhead associated with backup withholding and incorrect TIN submissions. Essential for entities and individuals engaging in business transactions within the state, this form calls for detailed information including legal name, entity designation (ranging from sole proprietorships to corporations and government entities), primary and remit addresses, and certification against backup withholding. Furthermore, the form acknowledges a spectrum of entity structures, underlining the state's adaptability to diverse business operations while ensuring compliance with federal regulations as it requests direct deposit details to expedite payment processing. Inherently, the rigorousness of the SW9 form upholds Montana's commitment to fostering an efficient, transparent, and compliant financial environment for its citizens and businesses.

QuestionAnswer
Form NameMontana W 9 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesmontana w 9 form, SSN, grantor, SW9

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State of Montana

Department of Public Health

Department of Administration

and Human Services

SW9 (4/2009)

PO Box 4210

 

111 N Sanders

 

Helena, MT 59604

 

Phone: 406-444-5932

 

Send faxes to: 406-444-9763

Substitute W-9

Taxpayer Identification Number (TIN) Verification

DO NOT send to IRS

Print or Type

Please see attachment or reverse for complete instructions.

Legal Name

Entity Designation (check only one type)

(as entered with IRS) If Sole Proprietorship, enter your Last, First, MI

Corporation

 

 

 

 

S-Corp

C-Corp

 

Do you provide medical or legal services?

Trade Name

Yes

No

If doing business as (DBA) or enter business name of Sole Proprietorship

Individual

 

 

 

 

Sole Proprietorship

Primary Address (for 1099 form)

Partnership

 

PO Box or Number and Street, City, State, ZIP + 4

General

Limited

 

 

LLC (for federal tax purposes taxed as)

 

Individual

Partnership

 

Corporation

 

 

Estate/Trust

 

 

Organization Exempt from Tax

Remit Address (where payment should be mailed, if different from Primary

(under Section 501 (a)(b)(c)(d)(e))

Address) PO Box or Number and Street, City, State, ZIP + 4

Government Entity

 

 

 

 

Other_________________

 

 

 

Taxpayer Identification Number (TIN) (Provide Only One) (If sole proprietorship provide FEIN, if applicable)

Social Security Number

Federal Employer Identification No

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 Internal Revenue Service (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.

3.I am a U.S. person (including a US resident alien).

Printed Name

Printed Title

Telephone Number

Signature

Date

Optional Direct Deposit Information (used at agency discretion) (all fields required to receive electronic payments) (Must Include a Voided Check, No Direct Deposit Slips Accepted)

Your Bank Account Number

Checking

Name on Bank Account

Bank Routing No. (ABA)

 

 

Savings

 

 

 

 

 

 

THIS IS A:

 

 

 

New Direct Deposit

Change of Existing

Additional Direct Deposit

Email Change Only

Email Address (Please make this LEGIBLE)

If you provide bank information and an email address, we will send a message notifying you when an electronic payment is issued. We will NOT share your email address with anyone or use it for any other purpose than communicating information about your electronic payments to

you. If you have questions about completing this form, please call the Warrant Writer Unit at 406-444-5932.

SW9 (4/2009)

Instructions for Completing Taxpayer Identification Number Verification

(Substitute W-9)

Legal Name As entered with IRS

Individuals: Enter Last Name, First Name, MI

Sole Proprietorships: Enter Last Name, First Name, MI

LLC Single Owner: Enter owner's Last Name, First Name, MI

All Others: Enter Legal Name of Business

Trade Name

Individuals: Leave Blank

Sole Proprietorships: Enter Business Name

LLC Single Owner: Enter LLC Business Name

All Others: Complete only if doing business as a D/B/A

Primary Address

Address where 1099 should be mailed.

Remit Address

Address where payment should be mailed. Complete only if different from primary address.

Entity Designation

Check ONE box which describes the type of business entity.

Taxpayer Identification Number

LIST ONLY ONE: Social Security Number OR Employer Identification Number. See “What Name and Number to Give the Requester” at right.

If you do not have a TIN, apply for one immediately. Individuals use federal form SS-05 which can be obtained from the Social Security Administration. Businesses and all other entities use federal form SS-04 which can be obtained from the Internal Revenue Service.

Certification

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.

Privacy Act Notice

Section 6109 of the Internal Revenue Code requires you to furnish your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, or contributions you made to an IRA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and

certain other payments to a payee who does not furnish a TIN to a payer. Certain penalties may also apply.

What Name and Number to Give the Requester

For this type of account:

Give name and SSN of:

1.

Individual

The individual

2.

Two or more individuals (joint

The actual owner of the account

 

account)

or, if combined funds, the first

 

 

individual no the account 1

3.

Custodian account of a minor

The minor 2

 

(Uniform Gift to Minors Act)

 

 

4. a. The usual revocable savings

The grantor-trustee 1

 

trust (grantor is also trustee)

 

 

 

b. So-called trust account that

The actual owner 1

 

is not a legal or valid trust

 

 

 

under state law

 

 

5.

Sole proprietorship or Single-

The owner

3

 

Owner LLC

 

 

 

 

For this type of account:

Give name and EIN of:

6.

Sole Proprietorship or Single-

The owner 3

 

Owner LLC

 

 

7.

A valid trust, estate, or pension

Legal entity 4

 

trust

 

 

8.

Corporate or LLC electing

The corporation

 

corporate status on Form

 

 

 

8832

 

 

9.

Association, club, religious,

The organization

 

charitable, educational, or

 

 

 

other tax-exempt organization

 

 

10. Partnership or multi-member

The partnership

 

LLC

 

 

11. A broker or registered

The broker or nominee

 

nominee

 

 

12. Account with the Department

The public entity

 

of Agriculture in the name of a

 

 

 

public entity (such as a state

 

 

 

or local government, school

 

 

 

district or prison) that receives

 

 

 

agricultural program payments

 

 

 

 

 

 

1List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished.

2 Circle the minor’s name and furnish the minor’s SSN.

3 You must show your individual name, but you may also enter your business or “DBA” name. You may use either your SSN or EIN (if you have one).

4 List first and circle the name of the legal trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.)

NOTE: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.

Taxpayer Identification Request

In order for the State of Montana to comply with the Internal Revenue Service regulations, this letter is to request that you complete the enclosed Substitute Form W-9. Failure to provide this information may result in delayed payments or backup withholding. This request is being made at the direction of the Montana Department of Administration, State Accounting Division, in order that the State may update its vendor file with the most current information.

Please return or FAX the Substitute Form W-9 even if you are exempt from backup withholding within (10) days of receipt. Please make sure that the form is complete and correct. Failure to respond in a timely manner may subject you to a 28% withholding on each payment, or require the State to withhold payment of outstanding invoices until this information is received per Internal Revenue Code 3406(a).

We are required to inform you that failure to provide the correct Taxpayer Identification Number (TIN) / Name combination may subject you to a $50 penalty assessed by the Internal Revenue Service under Section 6723 of the Internal Revenue Code.

Only the individual’s name to which the Social Security Number was assigned should be entered on the first line.

The name of a partnership, corporation, club, or other entity, must be entered on the first line exactly as it was registered with the IRS when the Employer Identification Number was assigned.

DO NOT submit your name with a Tax Identification Number that was not assigned to your name. For example, a doctor MUST NOTsubmit his or her name with the Tax Identification Number of a clinic he or she is associated with.

Thank you for your cooperation in providing us with this information. Please return the completed form to Department of Public Health and Human Services, Business and Financial Services Division:

DPHHS, BFSD

PO Box 4210

Helena, MT 59604

Phone: 406-444-5932

Fax: 406-444-9763

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2009 completion process outlined (part 1)

2. The next part is to fill in all of the following blank fields: Printed Name, Signature, Printed Title, Telephone Number, Date, cid Optional Direct Deposit, Must Include a Voided Check No, Your Bank Account Number, Checking, Savings, Name on Bank Account, Bank Routing No ABA, THIS IS A, New Direct Deposit, and Change of Existing.

2009 conclusion process outlined (portion 2)

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