Univeristy of Kansas W9

0435-EX-PL-2015 Text Documents

University of Kansas

2015-07-16ELS_164835

Donot send to zorm W—9 Request for Taxpayer the 12S, send Identification Number to the requester Part 1 Tax Status (Complete one row of boxes) Individual: Individual Name: Scsial Security Number: A sole proprietorship may have a "doing business as" trade name, but the legal name is the name of the owner. Sole Proprietor: |Business Owner‘s Name: Owner‘s SSN or Employer ID No [Business or Trade Name: Par‘tnership: Name of Partnership; Partnership‘s EIN Partnership name on IRS records Corporation: |Name of Corporation or Entity Employer Identification Number University of Kansas ' 48—1124839 Part 2 Exemption: If exempt from Form 1099 reporting, check here: and mark your qualifying exemption reason below Corporation, (there is no exempltion for medical or legal corporations) s N aa Tax Exempt Charily under 501(a), or IRA (includes 501(c)(3)) The United States or any of its agencies or instrumentalities. «L. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions ° 6 A forsign: :overnment or any of its political subdivisions. Part 3 Signature: I am a U.S. person (including a U.S. resident alien) Person comg,leling!his—f‘:—;m'\ Rarry <ent Swanson. Date: Signature: > L___ Title: Director, Business Services weriee Address:" 1246 West Campus Rd. City: _Lawrence State: KS Zip: 66045 ~ Phone: 785/864—3970 Please complete the above information. We are required by law to obtain this information from you when making a reportable payment to you. If you do not provide us with information, your payments may be subject to 31% federa! income tax backup withholding. Also, if you do not provide us with this information you may be subject to a $50 penalty imposed by the Internal Revenue Service under section 6723. If you do not furnish a valid TIN, or if you are subject ‘a backup withholding, the payor is required to withhold 31% of its payment to you. Backup withholding is nol a failure to pay you It is an advance tax payment. You should report all backup withholding as a credit for taxes paid on your federal income lax raturn, Use this form only if you are a U.S. person, (including J.S. rasident alien}, If you are a forsign person, use Form W—8.


Document Created: 2013-09-23 13:35:58
Document Modified: 2013-09-23 13:35:58
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