SAMPLEForm W-9 Request for Taxpayer Identification Number and CertificationFor informational / sample purposes only — not an official IRS document.1 Name (as shown on your income tax return)Full Name2 Business name/disregarded entity name, if different from above—3 Federal tax classification Individual/sole proprietor 5–6 Address, city, state, and ZIP code , CA Part I Taxpayer Identification Number (TIN)Social security number—Employer identification number—