W-9 Substitute Form
Mail: Smurfit-Stone Container Corp., Attn: Vendor Data Management, 9469-1 Eastport Rd., Jacksonville, FL, 32218 FAX: 904-714-7156 Email: jaxcmd2ssvndrs@smurfit.com
Please complete the following information. We are required by law to obtain this information from you when making a reportable payment to you. If you do not provide us with this information, your payments may be subject to 28% federal income tax backup withholding. Also, if you do not provide us with this information, you may be subject to a $50.00 penalty imposed by the Internal Revenue Service under section 6723. Federal law on backup withholding preempts any state or local law remedies, such as any right to a mechanic's lien. If you do not furnish a valid TIN, or if you are subject to backup withholding, the payor is required to withhold 28% of its payment to you. Backup withholding is not a failure to pay you. It is an advance tax payment. You should report all backup withholding as a credit for taxes paid on your federal income tax return. Instructions: 1. Complete Part 1 by completing the one row of boxes that corresponds to your tax status 2. Complete Part 2 if you are exempt from Form 1099 reporting 3. Complete Part 3 by filling in all lines 4. Return this completed form to us
Use this form only if you are a U.S. person (including U.S. resident alien). If you are a foreign person, use the appropriate Form W-8. If you were a nonresident alien and have now become a resident alien, read the note below and attach a statement, if necessary.
Note to U.S. Resident Aliens who formerly were Nonresident Aliens: If there is a tax treaty between the U.S. and your country, and it contains a ''saving clause'' to exempt certain types of income from U.S. tax even after you have become a Resident Alien, and you want to claim that exemption, fill out all of this form AND attach a page showing:
1. The treaty country 2. The treaty article about the income 3. The article number for the ''saving clause'' 4. The type and amount of income that qualified for the saving clause 5. Facts that provide a sufficient explanation of why the saving clause applies
Part 1 -Tax Status: (complete only one set of boxes)
Individuals:
Business Owner's Name: (REQUIRED) (First Name) (Middle initial)
Business Owner's Social Security Number Please complete the following information. We are required by law to or Use this form only if you are a U.S. person (including U.S. resident Business a foreign person, use obtain this information from you whenEmployer ID Number --- payment to you. making a reportable you are or Trade Name (OPTIONAL) the appropriate Form W-8. If you were If you do not provide us with this information, your payments may be nonresident alien and have now become a resident alien, read the n subject to 28% federal income tax backup withholding. Also, if you do not and attach a statement, if necessary. provide us with this information, you may be subject to a $50.00 penalty imposed by the a ''doing business as'' under section 6723. A sole proprietorship may haveInternal Revenue Servicetrade name, but the legal name is the name of the business owner. (Last Name)
Please complete the following information. We are required by law to Use this form only if you are a U.S. person (including U.S. re Federal law on backup withholding preempts any state or local law Note to U.S. Resident Aliens who formerly were Nonresident Aliens Sole Proprietor (or obtain this information from you when making a reportable payment to you. you are a foreign person, use the appropriate Form W-8. If y remedies, such as any right to a mechanic's lien. If you do not furnish a a- treaty between the U.S. and your country, and it contains a ''sa tax an LLC with one If you do not provide us with this information, your payments may be nonresident alien and have now become a resident alien, re valid are to exempt of income from U.S. tax even after y Individual Middle initial Last backup withholding, the payor is required do not Individual's Security and attach certain types if necessary. owner): Name First name TIN, or if you28% subject to name tax backup withholding. Also, if youSocial clause''Number subject to federal income a statement, to withhold 28% of its payment to you. Backup withholding is not a failure become a Resident Alien, and you want to claim that exemption, fill provide us with this information, you may be subject to a $50.00 penalty to pay you. It is an advance tax payment. You should report all backup this form AND attach a page showing: imposed by the Internal Revenue Service under section 6723. A foreign government or any of its withholding as a credit for taxes paid on your federal income tax return. A state, the District of Columbia, a
your tax status 3.Use this form only if for the ''saving clause'' (including U.S. residen The article number you are a U.S. person Partnership (or toPlease complete the following information. We are required by law to this and AND attach a the showing: 2.obtainto pay you. It is an advance tax payment.1099 shouldpayment to you. 4.you are a foreign person, income that qualifiedForm W-8. If you we Complete information from exempt from Forma You reporting an LLC with this Part 2 if you are you when making reportable report all backup The type formamount of usepageappropriate for the saving claus 3.If you withholding by filling in thislines 4. Returnyourpayments may be us Complete Part 3 as a credit for taxes paid onyour completed formtax return.5.nonresidentprovide a sufficient explanation of why the saving claus Facts that alien and have now become a resident alien, read the multiple do not provide us with all information, this federal income to subject to and attach a statement, if necessary. owners): of Corporation or Entity 28% federal income tax backup withholding. Also, if you do not Legal Name Employer Identification Number provide us with this information, you may be subject to a $50.00 penalty Instructions: 1. The treaty country imposed by the Internal Revenueinitials, but its section 6723.that corresponds A corporation may use an1. Complete Part 1 by completing the one row ofname is the name on the articles of incorporation. the income abbreviated name or its Service under legal boxes 2. The treaty article about Please complete the following information. We are required Social Security Number or by law to Use this form only if you are a U.S. person (including U.S. r Business Owner's Corporation or tax to your tax status 3. The article number for the ''saving clause'' obtain this information from preempts any state reportable payment to you. to U.S. Resident Aliens who formerly were Nonresident Alien you are a W-8. If Business or Trade Name (OPTIONAL) Federal law on backup withholdingyou when-making a 1099 reporting or local law Note 4. The typeforeign person, use the appropriate Formthe savi exempt entity: 2. Complete Part 2 if you are exempt from Form and amount of income that qualified for Employer ID Number Business Owner's Name: (REQUIRED) us a Name) (Middle initial) If you do not furnish--- be If you do not provide (First mechanic's Employer Identification information, your payments may nonresident alien and have now become a resident alien, re remedies, such as Part right to with this lines lien. a between the U.S. and Name of Partnership 3. Complete anyfederal incomeall backup withholding. Also, if you do not tax treatyattach aprovide a sufficient explanation ofitwhy the savi 3 by filling inPartnership's Return this completed a Partnership's Name on IRS records statement, if necessary. 4. form to us 5. Facts that (see IRS mailing your country, and contains a ' subject you are tax and Number label) valid TIN, or if to 28% subject to backup withholding, the payor is required clause'' to exempt certain types of income from U.S. tax even afte provide us with this information, you may be subject to a $50.00 penaltybecome a Resident Alien, and you want to claim that exemption, f to withhold 28% of its payment to you. Backup withholding is not a failure Part 2 - Exemption:you. It is an the Internal Revenue Service under section 6723. if exempt from Form 1099 reporting, check your qualifying exemption reason below. to pay imposed by advance tax payment. You should report all backup this form AND attach a page showing: (Last Name) Please complete the following information. for taxesrequired by law to Use this form withholding as a credit We are paid on your federal income tax return. only if you are a U.S. person (including U.S. resident alien). If Business foreign Number U.S. Resident Aliens who formerly were Nonreside obtain this information from you when making a reportable payment to you. state or local law Social SecurityNote toor Federal law on backup withholding preempts any you are aOwner's person, use the appropriate Form W-8. If you were a remedies, such as yourright to a mechanic's initial) nonresidentNumber a any payments may be a tax become a Business U.S. and your country, and If you do not provide us with this information, (REQUIRED) (First Name) (Middlelien. If you do not furnish and have nowtreaty between theoralien, Name (OPTIONAL)below it conta resident Trade read the note Employer ID alien --Business Owner's Name: Instructions: or if you are subject to backup withholding, theattach a statement, if necessary. exempt certain types of income from U.S. tax ev 1. treaty country subject to 28% federal income tax backup withholding. Also, if you do not valid TIN, and payor is requiredThe clause'' toIndividual Name First name by completing Middle initialyou. Backup 1. Complete Part 1 2. The become Security Number treaty article about Alien, and to withhold 28% of its payment one row of boxes that corresponds provide us with this information, you may be subject tothe$50.00 Last name withholding is not a failure Individual's Social a Resident the income you want to claim that exem a to penalty to yourto pay Service an advance tax payment. You should report all backup 3. The this form AND attach a''saving clause'' tax status article number for the page showing: imposed by the Internal Revenue you. It is under section 6723. 2. Complete Part 2as you are exempt from Form 1099 reporting withholding if a credit for taxes paid on your federal income tax return. 4. The type and amount of income that qualified for the saving cla A foreign government or (Last Name) 3. Complete Part there in Exempt 4. Return 5. Aliens A provide District ofNonresident a were Columbia, of why the is Corporation Note that 3 by fillingTax all lines Entity under 501 Federal law on backup withholding preempts any state or local law this completed to U.S. Residentof its thatstate, the of the United States, a Aliens: If theresaving or a The United States or any Facts who formerly sufficient explanationpolitical subdivisions cla Note form to us possession or Part 3 - Certification: Personmechanic's lien. form (please print): ________________________________ Title: ___________________________ organization is no corporatea completing this If you do 501 furnishor exemption for (a) (includes not (c) (3), a agencies or instrumentalities U.S. and your country, and it contains ainternational remedies, such as any right to a tax treaty between the ''saving any of their political Instructions: 1. The treaty country subdivisions or the United States particip valid TIN, or if youmedical and healthcare withholding, the payor is required are subject to backup IRA) clause'' to exempt certain types of income from U.S. tax even after you have agencies article about the income payments1. Completefor or payments Part 1 by completing the one row of boxes that corresponds 2. The treaty treaty all Tax Correspondence its payment to Name First name withholding Middle initial to withhold 28% of Address: _________________________________________ is not a failure name become a Resident Alien, and you want to Securitythat exemption,afill outor Act of Congre _________________________________________ of claim Number Individual you. Backup Last to your 3. Individual's Social to pay you. It is anlegal services payment. You should report all backup advance tax tax status this form Social Security Number orThe article number for the ''saving clause'' a page showing: _________________________________________ Owner'sAND attach _________________________________________ 2. Complete Part 2 if you income tax return. Business 4. The type and amount of income that qualified for the sav Business withholding as a credit for taxes paid on your federalare exempt from Form 1099 reporting (Remit address if different) or Trade Name (OPTIONAL) Employer ID Number form 5. Facts that provide a sufficient explanation of foreign govern Business3. Complete (REQUIRED) (First Name) (Middle 4. Return this completed --- to us Owner's Name: Part 3 by filling in all lines initial) A why the sav A state, the District of Columbia, a Telephone: ( _______) __________________________Tax Exempt Entity under 501 Corporation Note that there The United States or any of its political subdivis possession of the United States, or is no corporate exemption for (a) (includes 501 (c) Employer Identification Numberinstrumentalities (3), or1. The treaty country agencies or international org Under penalties of perjury, I Name ofthat: Instructions: Legal certify Corporation or Entity any of their political subdivisions or medical and the United State 1. 1. Complete Part 1 by completing my healthcare of boxesIRA) corresponds I am waiting for a number to about the to me), and The number shown on this form is thecorrect taxpayer identification number (or one row that 2. The treaty article be issued income agencies payments or because for 2. I am not subject backup withholdingpayments (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am treaty or Act o a to your tax status to (Last Name) 3. The article number for the ''saving clause'' subject to backup withholding as a result of failure to report all interest or divide nds, or (c) the IRSOwner's Social me that Number or Business has notified Security I am no longer subject to backup withholding. legal services 2. Complete Part 2 if (includingexempt from Form 1099 reporting you are a U.S. resident Alien). 4. The type and amount of income that qualified foror Trade Nameclause the saving (OPTIONAL) Business 3. I am a U.S. Person Business Owner's Return this completed form to initial) 5. Employer ID Number --- sufficient explanation of why the saving clause applies 3. Complete Part 3 by filling in all lines 4.Name: (REQUIRED) (First Name) (Middleus Facts that provide a Signature of U.S.
Partnership's Employer Identification Partnership's Name on IRS records (see IRS mailing Number label) Individual Name First name Middle initial Last name Individual's Social Security Number Person: ______________________________________________ Date: Identification Number Legal Name of Corporation or Entity Employer _____________________ Name of Partnership
Corporation Note that there Tax Exempt Entity under 501 The United States or any of its political subdivisions or an possession of the United States, or is no corporate exemption for (a) law on 501 (c) withholding agencies or any state or local law international organization in which Federal(includes backup(3), or preempts instrumentalities Note to U.S. Resident Aliens who formerly were Nonresiden any of their political subdivisions or medical and healthcare the U.S. States participates and Instructions: remedies, such as any right to a mechanic's lien. If you do not furnish a1. The treaty treaty between the Unitedand your country, underit conta a tax country IRA) agencies payments or payments for a treaty or valid TIN, or if completing the to backup boxes that corresponds clause'' to exempt certain types of income from 1. Complete Part 1 by you are subject one row of withholding, the payor is required 2. The treaty article about the income Act of Congress U.S. tax eve legal services to withhold 28% of its payment to you. Backup withholding is not a failure become a Resident Alien, and you want to claim that exemp
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A foreign government o Business Owner's Social Security Number or A state, the District of Columbia, a Corporation Note that there Business its Tax Exempt Entity under 501 The United States or any ofor Trade Name (OPTIONAL) political subdivisions o possession of the United States, or Employer ID Number Business Owner's Name: (REQUIRED) (First Name) (Middle initial) (includes 501 (c) (3), or is no corporate exemption for (a) agencies or instrumentalities international organizati any of their political subdivisions or medical and healthcare the United States partic IRA) Name of Partnership Partnership's Employer Identification Partnership's Name on IRS records (see IRS mailing Individual Name First Middle initial Last name Individual's Social Security Number agencies payments or payments for name
(Last Name)
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