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Form    W-7
(Rev. January 2010)
                                                          Application for IRS Individual
                                                         Taxpayer Identification Number                                                                  OMB No. 1545-0074
Department of the Treasury
                                                                         See instructions.
Internal Revenue Service                      For use by individuals who are not U.S. citizens or permanent residents.

An IRS individual taxpayer identification number (ITIN) is for federal tax purposes only.                                                     FOR IRS USE 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, d, 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        Dependent of U.S. citizen/resident alien                Enter name and SSN/ITIN of U.S. citizen/resident alien (see instructions)
 e        Spouse of U.S. citizen/resident alien
 f        Nonresident alien student, professor, or researcher filing a U.S. tax return or claiming an exception
 g        Dependent/spouse of a nonresident alien holding a U.S. visa
 h        Other (see instructions)
          Additional information for a and f: Enter treaty country                                           and treaty article number
                        1a First name                               Middle name                                             Last name
Name
(see instructions)
                             1b First name                                         Middle name                                   Last name
Name at birth if
different
                             2   Street address, apartment number, or rural route number. If you have a P.O. box, see page 4.
Applicant’s
mailing address                  City or town, state or province, and country. Include ZIP code or postal code where appropriate.


Foreign (non-                3   Street address, apartment number, or rural route number. Do not use a P.O. box number.
U.S.) address
(if different from               City or town, state or province, and country. Include ZIP code or postal code where appropriate.
above)
(see instructions)
Birth                        4   Date of birth (month / day / year)   Country of birth                 City and state or province (optional)         5  Male
information                           /            /                                                                                                    Female
                             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
Other
information
                             6d Identification document(s) submitted (see instructions)               Passport                 Driver’s license/State I.D.
                                     USCIS documentation                 Other                                                       Entry date in
                                 Issued by:         No.:                                       Exp. date:          /       /         United States           /     /
                             6e Have you previously received a U.S. temporary taxpayer identification number (TIN) 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: TIN or EIN                                                                                                                      and
                                Name under which it was issued
                             6g Name of college/university or company (see instructions)
                                City and state                                                              Length of stay
                             Under penalties of perjury, I (applicant/delegate/acceptance agent) declare that I have examined this application, including
Sign                         accompanying documentation and statements, and to the best of my knowledge and belief, it is true, correct, and complete. I
                             authorize the IRS to disclose to my acceptance agent returns or return information necessary to resolve matters regarding the
Here                         assignment of my IRS individual taxpayer identification number (ITIN), including any previously assigned taxpayer identifying number.

                                  Signature of applicant (if delegate, see instructions)               Date (month / day / year)       Phone number

                                                                                                               /       /               (       )

Keep a copy for                   Name of delegate, if applicable (type or print)                      Delegate’s relationship             Parent   Court-appointed guardian
your records.                                                                                          to applicant
                                                                                                                                           Power of Attorney
                                  Signature                                                            Date (month / day / year)       Phone (     )
Acceptance
                                                                                                               /       /               Fax    (    )
Agent’s                                                                                                                                EIN
                                  Name and title (type or print)                                       Name of company
Use ONLY                                                                                                                               Office Code

For Paperwork Reduction Act Notice, see page 5.                                             Cat. No. 10229L                                        Form   W-7 (Rev. 1-2010)

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Fw7

  • 1. Form W-7 (Rev. January 2010) Application for IRS Individual Taxpayer Identification Number OMB No. 1545-0074 Department of the Treasury See instructions. Internal Revenue Service For use by individuals who are not U.S. citizens or permanent residents. An IRS individual taxpayer identification number (ITIN) is for federal tax purposes only. FOR IRS USE 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, d, 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 Dependent of U.S. citizen/resident alien Enter name and SSN/ITIN of U.S. citizen/resident alien (see instructions) e Spouse of U.S. citizen/resident alien f Nonresident alien student, professor, or researcher filing a U.S. tax return or claiming an exception g Dependent/spouse of a nonresident alien holding a U.S. visa h Other (see instructions) Additional information for a and f: Enter treaty country and treaty article number 1a First name Middle name Last name Name (see instructions) 1b First name Middle name Last name Name at birth if different 2 Street address, apartment number, or rural route number. If you have a P.O. box, see page 4. Applicant’s mailing address City or town, state or province, and country. Include ZIP code or postal code where appropriate. Foreign (non- 3 Street address, apartment number, or rural route number. Do not use a P.O. box number. U.S.) address (if different from City or town, state or province, and country. Include ZIP code or postal code where appropriate. above) (see instructions) Birth 4 Date of birth (month / day / year) Country of birth City and state or province (optional) 5 Male information / / Female 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 Other information 6d Identification document(s) submitted (see instructions) Passport Driver’s license/State I.D. USCIS documentation Other Entry date in Issued by: No.: Exp. date: / / United States / / 6e Have you previously received a U.S. temporary taxpayer identification number (TIN) 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: TIN or EIN and Name under which it was issued 6g Name of college/university or company (see instructions) City and state Length of stay Under penalties of perjury, I (applicant/delegate/acceptance agent) declare that I have examined this application, including Sign accompanying documentation and statements, and to the best of my knowledge and belief, it is true, correct, and complete. I authorize the IRS to disclose to my acceptance agent returns or return information necessary to resolve matters regarding the Here assignment of my IRS individual taxpayer identification number (ITIN), including any previously assigned taxpayer identifying number. Signature of applicant (if delegate, see instructions) Date (month / day / year) Phone number / / ( ) Keep a copy for Name of delegate, if applicable (type or print) Delegate’s relationship Parent Court-appointed guardian your records. to applicant Power of Attorney Signature Date (month / day / year) Phone ( ) Acceptance / / Fax ( ) Agent’s EIN Name and title (type or print) Name of company Use ONLY Office Code For Paperwork Reduction Act Notice, see page 5. Cat. No. 10229L Form W-7 (Rev. 1-2010)