Additional information for a and f: Enter treaty country |
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and treaty article number |
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Name |
1a First name |
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Middle name |
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Last name |
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(see instructions) |
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Name at birth if |
1b First name |
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Middle name |
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Last name |
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different . . |
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Applicant’s |
2 Street address, apartment number, or rural route number. If you have a P.O. box, see separate instructions. |
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Mailing |
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City or town, state or province, and country. Include ZIP code or postal code where appropriate. |
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Address |
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Foreign (non- |
3 Street address, apartment number, or rural route number. Don’t use a P.O. box number. |
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U.S.) Address |
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(see instructions) |
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City or town, state or province, and country. Include postal code where appropriate. |
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Birth |
4 Date of birth (month / day / year) |
Country of birth |
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City and state or province (optional) |
5 |
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Male |
Information |
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Female |
Other |
6a Country(ies) of citizenship |
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6b Foreign tax I.D. number (if |
any) |
6c Type of U.S. visa (if any), number, and expiration date |
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Information |
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6d Identification document(s) submitted (see instructions) |
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Passport |
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Driver’s license/State I.D. |
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USCIS documentation |
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Other |
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Date of entry into |
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the United States |
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Issued by: |
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No.: |
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Exp. date: |
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(MM/DD/YYYY): |
/ / |
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6e Have you previously received an ITIN or an Internal Revenue Service Number (IRSN)? |
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No/Don’t know. Skip line 6f. |
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Yes. Complete line 6f. If more than one, list on a sheet and attach to this form (see instructions). |
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6f Enter ITIN and/or IRSN |
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IRSN |
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ITIN |
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— |
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— |
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— |
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— |
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and |
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name under which it was issued |
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First name |
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Middle name |
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Last name |
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6g Name of college/university or company (see instructions) ▶ |
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City and state |
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Length of stay ▶ |
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Sign |
Under penalties of perjury, I (applicant/delegate/acceptance agent) declare that I have examined this application, including accompanying |
documentation and statements, and to the best of my knowledge and belief, it is true, correct, and complete. I authorize the IRS to share |
Here |
information with my acceptance agent in order to perfect this Form W-7, Application for IRS Individual Taxpayer Identification Number. |
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Keep a copy for |
FF |
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Signature of applicant (if delegate, see instructions) |
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Date (month / day / year) |
F |
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Phone number |
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your records. |
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/ |
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Name of delegate, if applicable (type or print) |
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Delegate’s relationship |
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Parent |
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Court-appointed guardian |
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to applicant |
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Power of attorney |
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Acceptance |
F |
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Signature |
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Date (month / day / year) |
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Phone |
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/ |
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Fax |
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Agent’s |
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F |
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Name and title (type or print) |
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Name of company |
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EIN |
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PTIN |
Use ONLY |
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Office code |
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