Part I
Student Identification
Please print or type
Name of student
Taxpayer identification number
Address (number, street, and apt. or suite no.)
City, state, and ZIP code
Part II
Taxpayer Identification Number Certification
I certify that the number shown on this form is my correct taxpayer identification number.
Part III
Requester Information
Requester’s name and address
Finance Office – Student Accounts
Hagerstown Community College
11400 Robinwood Drive
Ha
erstown
MD 21742
Student ID number
General Instructions
Purpose of form. An eligible educational institution, such as
Hagerstown Community College, must get your correct
identifying number to file Form 1098-T, Tuition Statement,
with the IRS and to furnish a statement to you. This will be
your social security number (SSN) or, if you are not eligible
to obtain an SSN, your individual taxpayer identification
number (ITIN). Form 1098-T contains information about
qualified tuition and related expenses to help determine
whether you, or the person who can claim you as a
dependent, may take either the tuition and fees deduction or
claim an education credit to reduce Federal income tax. For
more information, see IRS Pub. 970, Tax Benefits for Higher
Education.
Use Form W-9S to give your correct SSN or ITIN to
Hagerstown Community College. Under federal law, you are
required to provide the requested information.
Note: Hagerstown Community College
may request your
SSN and certification using Form W-9S or by other means,
such as electronically.
Specific Instructions
Part I. Student Identification
You must complete this part.
Name and address. Enter the name and mailing address of
the student. The name should match that used by the Social
Security Administration or Internal Revenue Service.
Taxpayer identification number. Enter your SSN or ITIN. If
you do not have an SSN or ITIN, apply for one and fill out
and return this form when you receive it.
Part II. Certification
Sign your name in the space provided.
Part III. Requester Information
This information is provided to identify the requestor and
provide the address to which the form should be sent. Fill in
your student account number in the box provided. Note:
Deliver, fax or mail the completed form to the address
provided. Do not email the
form. Email is not a secure way to
transmit
personal information.
Penalties
Failure to furnish correct SSN. If you fail to furnish your
correct SSN to the requester, you are subject to a penalty of
$50 unless your failure is due to reasonable cause and not to
willful neglect.
Misuse of SSNs. If Hagerstown Community College discloses
or uses your SSN in violation of Federal law, Hagerstown
Community College may be subject to civil and criminal
penalties.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to
give your correct SSN or ITIN to persons who must file
information returns with the IRS to report certain
information. The IRS uses the numbers for identification
purposes and to help verify the accuracy of your tax return.
The IRS may also provide this information to the
Department of Justice
Substitute Form
W-9S
National Association of College and
University Business Officers
Form W-9S
(Substitute Oct 2014)
Request for Student’s Taxpayer
Identification Number and Certification
Give form to the
requester. Do NOT
send to the IRS.
Sign
Signature
Date