W9 & Direct Deposit Authorization - Rocky Mountain University Secure Form Intranet

Welcome to the secure data collection portal. The W9 is a US Government Form called ‘Request for Taxpayer Identification Number’. In order to meet IRS compliance, we are required to collect this W9 information before we can setup a vendor in our accounting system. Our current payment method to vendors is Direct Deposit, so the second portion of this form is the Direct Deposit Authorization form. The purpose of collecting this information is to expedite the payment process to our vendors. If you have any questions or concerns, please contact the Accounts Payable Office at AP@rm.edu or 801-375-5125 Option 5.

Name

First Last

Email*

Please provide your primary email address

Enter Email Confirm Email

Phone*

Please provide your primary phone number

Please select the appropriate response

I need to submit a W9 and Direct Deposit Authorization

I have already submitted a W9, but need to update my Direct Deposit Information

I only need to submit a W9 because I cannot accept direct deposit as a payment method

W9

Full W9 Instructions can be viewed here

Name*

Name (as shown on your income tax return). Name is required; do not leave this line blank.

Business Name (if applicable)

Disregarded entity name, if different from above

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Tax Classification*

Select appropriate box for federal tax classification of the person whose name is entered above.

Individual/sole proprietor or single-member LLC

C Corporation

S Corporation

Partnership

Trust/estate

Limited liability company

Other

Enter the Tax Classification for your Limited liability company*

Part I Taxpayer Identification Number (TIN)

Enter your TIN. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.

Which TIN will you be providing?*

Social Security Number (SSN)

Employer Identification Number (EIN)

Social security number*

Please provide your Social Security Number (SSN)

Employer identification number*

Please provide Employer identification number (EIN)

Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.

Sign Here

Signature of U.S. person

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Requester Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country