APPLICATION FOR EMPLOYER IDENTIFICATION NUMBER

To be filed with Internal Revenue Service

1.  Name (True name as distinguished from trade name):

2.  Trade Name, if any (Name under which business is operated, if different from item 1):

3.  Social Security Number, if sole proprietor:

4.  Address of principal place of business (Number and Street):

            (City and State)                                                 (Zip)

5.  Ending Month of accounting year:

This is not a substitute for legal advice.  An attorney must be consulted.
Copyright ©1994 - 2009 by LAWCHEK, LTD.

6.  County of Business Location:

7.  Type of Organization:          __ Individual                __ Trust           __ Partnership

                        __ Other          __ Governmental        __ Nonprofit     __ Corporation

8.  Date you acquired or started this business (Mo., Day, Year):

9.  Reason for applying:

            __ Started New Business       __ Purchased Going Business  __ Other

10. First date you paid or will pay wages for this business (Mo., Day, Year):

11. Nature of Business:

This is not a substitute for legal advice.  An attorney must be consulted.
Copyright ©1994 - 2009 by LAWCHEK, LTD.

12. Do you operate more than one place of business?

                                                                        __ Yes             __ No

13. Peak number of employees expected in next 12 months (If none, enter "0"):

                        ____ Nonagricultural   ____ Agricultural         ____ Household

14. If nature of business is manufacturing, state principal product and raw material used:

15. To whom do you sell most of your products or services?

                        ____ Business Establishments          ____ General Public  ____ Other

16. Have you ever applied for an identification number for this or any other business?

                        ____ Yes                     _____ No

            If yes, enter name and trade name.  Also enter approx. date, city, state where you applied and previous number if known:

Date:                           Signature and Title:                 Telephone:

This is not a substitute for legal advice.  An attorney must be consulted.
Copyright ©1994 - 2013 by LAWCHEK, LTD.