UD Request for Taxpayer Identification (Substitute W-9)

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This form is required to load a vendor into the University's vendor database for payment (please use this form, not the IRS-issued W-9). If you have questions, contact Procurement Services at (302) 831-2161 or email procurement@udel.edu.

This form is considered substantially similar to IRS Form W-9 and must be used in lieu of the IRS form.

Per IRS regulations, the University is required to obtain this information for all persons and organizations receiving payment from us. Without this information, your payments may be subject to 28% backup withholding. You may also be subject to a $50 penalty imposed by the IRS under Section 6723. Federal law on backup withholding preempts any state or local law remedies, such as any right to a mechanic's lien. If you do not furnish a valid TIN, or if you are subject to backup withholding, the University is required to withhold 28% of its payment to you. Backup withholding is not a failure to pay you; it is an advance tax payment. Report all backup withholding as a credit for taxes paid on your federal income tax return.

This form is for vendors located in the United States. International vendors should contact Procurement Services.

Correct the errors below, and then click "Submit".

Tax information

Tax status:

Taxpayer Identification Number (TIN):

Provide numbers only. Do not include dashes or spaces.

If you are an Individual or Sole Proprietor, enter your Social Security Number (SSN).

If you are a partnership or a corporation, enter your Federal Employer Identification Number (FEIN or EIN).

Retype your Taxpayer Identification Number (TIN):

Provide numbers only. Do not include dashes or spaces.

Legal name:

(Name as it appears on IRS or SSN Records or Name of owner/business that belongs to FEIN/EIN)
Do not enter the business name of a Sole Proprietorship on this line.

Trade name:

If Doing Business As (D.B.A.) or business name of Sole Proprietorship

Exemption information

Exemption from 1099 reporting:

If you marked EXEMPT, please indicate the reason:

Corporation
Tax Exempt Entity under 501(a), 501(c)(3) or IRA
The United States or any of its agencies or instrumentalities
A foreign government or any of its political subdivisions
A state, the District of Columbia, a possession of the US, or any of their political subdivisions
A Resident Alien claiming tax treaty benefits (Note: a statement satisfying IRS requirements must be attached)

If a Resident Alien claiming tax treaty benefits, attach statement satisfying IRS requirements:

Additional information

Primary address:

Address where correspondence, payments, purchase orders, or 1099s should be sent.

Street

City

State

Zip or postal code

Phone (use format nnn-nnn-nnnn)

Fax (use format nnn-nnn-nnnn)

Remittance address:

Address where payments, if different from primary address, should be sent

Street

City

State

Zip or postal code

Phone (use format nnn-nnn-nnnn)

Fax (use format nnn-nnn-nnnn)

Email (for payment notifications)

Please indicate if your company is categorized as any of the following:

Legal Service
Medical/Healthcare
Minority-Owned Business
HUB Zone Business
Woman-Owned Business
Small Business
Veteran-Owned Business
Government Agency

Please indicate which payment methods you accept:

If you chose ACH, please provide direct deposit account information:

Please have a check in front of you, so that you can locate the information required below.

Bank name

Type of account

Routing number

Bank account number

Retype bank account number

Are you currently a student at the University of Delaware?

Are you currently an employee of the University of Delaware?

Are any of your company's principals or their immediate family members employed by the University?

Has your firm ever been involved in Federal debarment proceedings?

Certification

Certification: I certify under penalties of perjury that (1) the Tax Identification Number I have provided is correct, (2) if I have marked "Exempt" the above entity is backup withholding exempt, and (3) I am a US Person (including Resident Alien).

Comments:

Signature:

Type your legal name.

Date: