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PatientCentered Community CareJoin Our Network!Identifying Information Practice Legal Name (as shown on W9) RequiredIf yes to multispecialty or facility, select one or more of the specialty services.

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This should be your full name. It should match the name on your individual tax return. If you have a business name, trade name, DBA name or disregarded entity name, fill it in here. If you do not have a business, you can leave this line blank.

The form requires a taxpayer to provide their name, address, tax classification, and withholding requirements. The form must be signed, and the signing taxpayer is subject to civil and/or criminal penalties for willful non-compliance.

How to fill out a W-9 Write the name as shown on your income tax return. Write the business name/disregarded entity name if different than above. Fill out the federal tax classification for the person whose name is entered on line 1. ... Include any exemption codes, if applicable.

The person or business paying you is responsible for requesting the W-9 Form from you. However, the requester has no obligation to file the W-9 with the IRS.

Who needs to fill out a W-9 form? Employers who work with independent contractors must provide them with a W-9 form to fill out before starting work. There are specific criteria for who is classified as an “independent contractor” and will need to fill out a W-9 form.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232