Form W-7 - Application For Irs Individual Taxpayer Identification Number
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1Form
W-7
(Rev. August 2013)
Department of the Treasury
Internal Revenue Service
Application for IRS Individual
Taxpayer Identification Number
► For use by individuals who are not U.S. citizens or permanent residents.
► See instructions.
OMB
No. 1545-0074
An IRS individual taxpayer identification number (ITIN) is for federal tax purposes only.
Before you begin:
• Do not submit
this form if you have, or are eligible to get, a U.S. social security number (SSN).
• Getting an ITIN does not change your immigration status or your right to work in the United States
and does not make you eligible for the earned income credit.
Reason you are submitting Form W-7. Read the instructions for the box you check. Caution: If you check box b, c,
e, f,
or
g, you must file a tax return with Form W-7 unless you meet one of the exceptions (see instructions).
a
Nonresident alien required to get ITIN to claim tax treaty benefit
b
Nonresident alien filing a U.S. tax return
c
U.S. resident alien (based on days present in the United States) filing a U.S. tax return
d 171 Dependent of U.S. citizen/resident alien I Enter name and SSN/ITIN of U.S. citizen/resident alien (see instructions) ►
ell' Spouse of U.S. citizen/resident alien
f
g
h
Name
(see instructions)
Name at birth if
different
.
.
►
la First name
Middle name
Last name
lb First name
Middle name
Last name
Applicant's
mailing address
2
Street address, apartment number, or rural route number. If you have a P.O. box, see separate instructions.
City or town, state or province, and country. Include ZIP code or postal code where appropriate.
Foreign (non-
U.S.) address
(if different from
above)
(see instructions)
3
Street address, apartment number, or rural route number. Do not use a P.O. box number.
City or town, state or province, and country. Include ZIP code or postal code where appropriate.
Birth
information
4
Date of birth (month / day / year)
Country of birth
City and state or province (optional)
5
•
Male
Female
Other
information
6a Country(ies) of citizenship
6b Foreign tax I.D. number (if any)
6c Type of U.S. visa (if any), number, and expiration date
6d Identification document(s) submitted (see instructions)
Passport
Driver's license/State I.D.
USCIS documentation
Other
Date of entry into the
United States
Issued by:
No.:
Exp. date:
/
/
(MM/DD/YYYY)
/
/
6e Have you previously received a Internal Revenue Service Number (IRSN) or employer identification number (EIN)?
No/Do not know. Skip line 6f.
Yes. Complete line 6f. If more than one, list on a sheet and attach to this form (see instructions).
6f Enter: IRSN or EIN
►
and
Name under which it was issued
►
6g Name of college/university or company (see instructions)
City and state
Length of stay
S
ign
Here
Keep a copy for
your records.
Under penalties of perjury, I (applicant/delegate/acceptance agent)
documentation and statements, and to the best of my knowledge and
acceptance agent returns or return information necessary to resolve matters
number (ITIN), including any previously assigned taxpayer identifying number.
Signature of applicant (if delegate, see instructions)
declare that I have examined
belief, it is true, correct, and complete.
regarding the assignment
Date (month / day / year)
/
/
this application, including accompanying
I authorize the IRS to disclose to my
of my IRS individual taxpayer identification
Phone number
Name of delegate, if applicable (type or print)
Delegate's relationship
•
Parent
•
Court-appointed guardian
to applicant
•
Power of Attorney
Acceptance
Agent's
Use ONLY
Signature
Fax
Date (month / day / year)
phone
/
/
Name and title (type or print)
Name of company
EIN
PTIN
Office Code
FOR IRS USE ONLY
Nonresident alien student, professor, or researcher filing a U.S. tax return or claiming an exception
Dependent/spouse of a nonresident alien holding a U.S. visa
Other (see instructions) ►
Additional information for
a
and f: Enter treaty country ►
and treaty article number ►
Form
W-7
(Rev. 8-2013)
Cat. No. 10229L
For Paperwork Reduction Act Notice, see separate instructions.
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