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Get Maine W 9 Form 2020-2024

State of Maine Substitute W-9 Vendor Authorization Form PURPOSE To establish or update an account with the State of Maine s accounting system. Complete this form if 1 You will receive payment from the State of Maine and/or 2 You are a vendor who provides services or goods to the State of Maine. RETURN TO by mail to the agency who requested the form or sent it to you or the agency you re doing business with. This form replaces the IRS W-9 form per the IRS W-9 language If a requester gives you a form other than Form W-9 to request your TIN you must use the requester s form if it is substantially similar to this Form W-9. All items with an asterisk must be completed* TYPE OF REQUEST Must select one. New New Location/Additional Request Entry Legal Name Change Choose Payment Address ie. DHHS/Labor/ DEP/Education/etc DBA Name Contact Info Ordering Address TAXPAYER ID NUMBER TIN Provide ONE only Social Security Number SSN Organization Type Individual choose ONE Classification Sole Proprietorship OR Federal Employer ID Number FEIN Company Foreign W8 required Corporation Trust Nonresident Alien State Gov t Partnership Other Gov t Other LEGAL NAME Must provide Legal name filed with IRS tied to the ID number SSN first last name/FEIN business name Alias/DBA Other Info Vendor Customer Number if known VC /VS Account/Client/Provider Number if known Billing Address My Address Admin* Address is the same. C/O Phone City/State/Zip Contact Name Send me Email notifications of DD/EFT Email requires Direct Deposit/EFT form to be completed Procurement/Physical Address Ext Authorized Signature Title Current Date 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 witholding 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 U* S* citizen or other U* S* person defined by the IRS. Ref www*irs*gov OFFICE USE ONLY State Agency SHS Information on State Agency Submitting Vendor Form Agency Contact Person Name Title Contact s Phone ME W9 V3 05/03/12. This form replaces the IRS W-9 form per the IRS W-9 language If a requester gives you a form other than Form W-9 to request your TIN you must use the requester s form if it is substantially similar to this Form W-9. All items with an asterisk must be completed* TYPE OF REQUEST Must select one. New New Location/Additional Request Entry Legal Name Change Choose Payment Address ie. All items with an asterisk must be completed* TYPE OF REQUEST Must select one. New New Location/Additional Request Entry Legal Name Change Choose Payment Address ie. DHHS/Labor/ DEP/Education/etc DBA Name Contact Info Ordering Address TAXPAYER ID NUMBER TIN Provide ONE only Social Security Number SSN Organization Type Individual choose ONE Classification Sole Proprietorship OR Federal Employer ID Number FEIN Company Foreign W8 required Corporation Trust Nonresident Alien State Gov t Partnership Other Gov t Other LEGAL NAME Must provide Legal name filed with IRS tied to the ID number SSN first last name/FEIN business name Alias/DBA Other Info Vendor Customer Number if known VC /VS Account/Client/Provider Number if known Billing Address My Address Admin* Address is the same.

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