SS-4
Application for Employer Identification Number

(For use by employers, corporations, partnerships, trusts, estates, churches,
government agencies, Indian tribal entities, certain individuals, and others.)

See separate instructions for each line. - Keep a copy for your records.

1 Legal name of entity (or individual) for whom the EIN is being requested

2 Trade name of business (if different from name on line 1)

3 Executor, administrator, trustee, “care of” name

4a Mailing address (room, apt., suite no. and street, or P.O. box)

4b City, state, and ZIP code (if foreign, see instructions)

5a Street address (if different) (Do not enter a P.O. box.)

5b City, state, and ZIP code (if foreign, see instructions)

6 County and state where principal business is located

7a Name of responsible party

7b SSN, ITIN, or EIN

8a Is this application for a limited liability company (LLC) (or a foreign equivalent)? Yes - No

8b If 8a is “Yes,” enter the number of LLC members >

And much more...