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SS-4 Application for Employer Identification Number

Form SS-4(Rev. December 2017)Department of the Treasury internal revenue Service Application for Employer Identification Number (For use by employers , corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others.) Go to for instructions and the latest information. See separate instructions for each line. Keep a copy for your No. 1545-0003 EINType or print Legal name of entity (or individual) for whom the EIN is being requested2 Trade name of business (if different from name on line 1)3 Executor, administrator, trustee, care of name4a Mailing address (room, apt., suite no. and street, or box)5a Street address (if different) (Do not enter a box.)4b City, state, and ZIP code (if foreign, see instructions)5b City, state, and ZIP code (if foreign, see instructions)6 County and state where principal business is located7a Name of responsible party7b SSN, ITIN, or EIN8a Is this Application for a limited liability company (LLC) (or a foreign equivalent)?

Form SS-4 (Rev. December 2017) Department of the Treasury Internal Revenue Service . Application for Employer Identification Number (For use by employers, corporations, partnerships, trusts, estates, churches,

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  Services, Applications, Internal revenue service, Internal, Revenue, Identification, Employers, Application for employer identification number, Number

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