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Get Form W-9 Request For Taxpayer Give Form To The Requester. Do Not

Rint or type See Specific Instructions on page 2. Name (as shown on your income tax return) Business name, if different from above Check appropriate box: Individual/Sole proprietor Corporation Partnership Limited liability company. Enter the tax classification (D disregarded entity, C corporation, P partnership) Other (see instructions) Exempt payee Address (number, street, and apt. or suite no.) Requester s name and address (optional) City, state, and ZIP code List account n.

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