Nm W 9 Form – Fill Out and Use This PDF

Enter the name as shown on your income tax return. Name is required; do not leave blank. Business name/disregarded entity name: enter it if different from the name.

Legal Business Name: enter the legal name as registered with the IRS or Social Security Administration.

DBA/Trade Name: individuals leave blank. Sole Proprietorships: enter DBA (doing business as) name. All Others: complete only if business name is different than Legal Name.

Entity Type: check only one box, unless you are or have been a State of New Mexico Employee, then also check the State of New Mexico Employee box.

The boxes are Government (Local, State, Federal, Tribe), Individual / Sole Proprietorship / Single Member LLC, Tax-Exempt organization under IRC Section 501 C, Partnership, C Corporation / S Corporation, State of New Mexico Employee (Agency No.), Trust / Estate and Limited liability company, where you enter the tax classification (C=C corporation, S=S corporation, P=Partnership).

If a current, past, or becoming a state employee, please also mark the State of New Mexico Employee box and enter the Business Unit number for the agency. Also, provide the 6 digit employee ID as assigned in SHARE HCM in the Part II Taxpayer Identification Number (TIN) & Taxpayer Identification Type section and mark the Employee ID box.

1099 Reporting: check the appropriate box that applies to the type of services being provided to the State.

The boxes are Health care or medical service, Royalties, Agency Volunteer (Agency No.), Attorney services, State of NM Appointed Board member / commissioner / committee member, DUAL Supplier & Active NM Employee, Rental of Real Property and Other.

If the type of service is not specifically stated, enter the type of service in the Other box.

Enter TIN with no dashes in the boxes provided. TIN is always a 9-digit number.

Provide the Social Security Number (SSN) assigned by the Social Security Administration (SSA) or the Federal Employer Identification Number (FEIN) assigned to the business or other entity by the Internal Revenue Service (IRS).

Taxpayer Identification Type (check appropriate box): Employer ID No. (EIN), Social Security No. (SSN), Employee ID, N/A (Non-United States Business Entity).

Employee ID is always a 6-digit number. Provide the employee ID assigned by the State of New Mexico for payroll processing in SHARE HCM.

Address: where correspondence, payment(s), purchase order(s) or 1099s should be sent.

Employees: if a current employee, please provide this following: Address Line #1: State Agency Name; Address Line #2: Field Office Mailing Address; Address Line #3: N/A.

When providing a Community Development Block Grant (CDBG) remittance address, enter CDBG on line #1 and entities remittance address in address line #2.

Remittance Address: if different than Address, enter the location specifically used for payment that is different than address 1, if applicable.

Zip Code: The 5 + 4 code will be required to be entered for all zip codes. If the last 4 digits are unknown, then 4 zeros (0) can be entered. Do not enter the "-" as part of the zip code.

The person signing this document should be the partner in the partnership, an officer of the corporation, the individual or sole proprietor noted under legal name, or the New Mexico State Employee for which the vendor account is established.

Under penalties of perjury, you certify that: 1. the number shown on this form is your correct tax payer identification number (or you are waiting for a number to be issued to you), AND 2. you are not subject to backup withholding because: (a) you are exempt from backup withholding, or (b) you have not been notified by the Internal Revenue Service (IRS) that you are subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified you that you are no longer subject to backup withholding, AND 3. you are a U.S. Citizen or other U.S. person. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

By signing this document you are certifying that all information provided is accurate and complete.

Identifying information is required of the person signing the form.

The lines are Printed Name, Occupation, Telephone Number, Signature, Email for receiving ACH advices and Date (mm/dd/yyyy).

When entering the phone number, only enter the 10 digit number. Do not enter the "( )" or "-" as part of the phone number.

You may elect to receive payments from the State of New Mexico through Automated Clearing House (ACH) direct deposit.

Warning: The State of New Mexico will not process International ACH Transactions (IAT). If any payment to you from the State will ever result in an IAT under National Automated Clearing House Association (NACHA) operating rules or if you are not sure if the rules apply to you DO NOT FILL OUT THIS SECTION OF THE FORM.

Select the type of account being provided.

Print name and sign to acknowledge the IAT warning and to authorize the State of New Mexico to initiate direct deposit of funds to your financial institution provided.

Do not send the form to the IRS. Submit the form to the requesting agency.