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W-9 Tax Form Instructions and Certification

The document is a completed Form W-9 for taxpayer identification and certification by Ghulam Murtaza, indicating his status as an individual/sole proprietor. It includes his address in Brooklyn, NY, and his social security number, which is partially redacted. The form certifies that he is not subject to backup withholding and is a U.S. citizen, with a signature dated February 16, 2023.

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6 views1 page

W-9 Tax Form Instructions and Certification

The document is a completed Form W-9 for taxpayer identification and certification by Ghulam Murtaza, indicating his status as an individual/sole proprietor. It includes his address in Brooklyn, NY, and his social security number, which is partially redacted. The form certifies that he is not subject to backup withholding and is a U.S. citizen, with a signature dated February 16, 2023.

Uploaded by

ihsan
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Reference Id: A00172235WZEDDLJ9HJ7

Request for Taxpayer


Form W-9 Identification Number and Certification
SUBSTITUTE
(October 2018)

Name (as shown on your income tax return)

Ghulam Murtaza

Business name/disregarded entity name, if different from above

Check appropriate box for federal tax classification.


✔ Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate
or single-member LLC

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ▶

Other (see instructions) ▶

Requester's name and address (optional)


Address (number, street, and apt. or suite no.)

City, state, country, and ZIP code

BROOKLYN NY United States 11214

List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match Social security number
the name given on the "Name" line to avoid backup withholding. For
individuals, this is your social security number (SSN). However, for XXXXX7690
a resident alien, sole proprietor, or disregarded entity, see the Part I
instructions on page 3. For other entities, it is your employer identification
Employer identification number
number (EIN). If you do not have a number, see How to get a TIN on page
3.
Note. If the account is in more than one name, see the chart on page 4 for
guidelines on whose number to enter.

Part II Certification

Under penalties of perjury, I certify that:


1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service(IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined in the instructions), and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding.
You will need to print out your hard copy form at the end of the interview and cross out item 2 before signing and mailing to the address provided.

The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid
backup withholding.

withholding.
Signature Date
GHULAM MURTAZA 02-16-2023
of U.S. (MM-DD-
Person : YYYY) :

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