Lieu of IRS W-9 or W-7) STD 204 (Rev. 03/2021) Section 1 Payee Information NAME (This is required. Do not leave this line blank. Must match the payee s federal tax return) BUSINESS NAME, DBA NAME or DISREGARDED SINGLE MEMBER LLC NAME (If different from above) MAILING ADDRESS (number, street, apt. or suite no.) (See instructions on Page 2) CITY, STATE, ZIP CODE E-MAIL ADDRESS Section 2 Entity Type Check one (1) box only that matches the entity type of the Payee listed in Section 1.
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