ENROLLMENT SERVICES
REQUEST FOR STUDENT’S SOCIAL SECURITY NUMBER
Submit this form in person or mail Green River College, do not send to the IRS. Read, complete, sign, and submit this form in person or by mail to:
Green River College
Enrollment Services Office
12401 SE 320th St
Auburn, WA 98092-3622
PURPOSE
Pursuant to the Internal Revenue Service (IRS) Internal Revenue Code (IRC) 6050S and 6051 the College is required to solicit and students are required
to provide Social Security Numbers. Failure to comply with this requirement may result in civil penalties, assessed by the IRS. The purpose of providing
Social Security Numbers is for the issuance of Form 1098-T, Tuition Payments Statement. The College reports the amount you paid for qualifying tuition
and fees to both you and the IRS on Form 1098-T. The 1098-T contains information related to claiming tuition and fee deduction, the Hope Scholarship
credit and/or the Lifetime Learning Credit on your taxes. The College also uses Social Security Numbers to verify enrollment, degree(s) and transcripts,
administer financial aid, collect student debt, and conduct research. The College will only utilize your Social Security Number in a manner that does not
permit personal identification of you. The Social Security Number is confidential and, pursuant to state law (RCW 28B.10.042) and the Federal Family
Educational Rights and Privacy Act (FERPA), will not be released and only used as stated above.
SECTION I – STUDENT MUST COMPLETE THIS SECTION IN FULL
Social Security Number (Taxpayer identification number). Enter your Social Security number (SSN). If you have an IRS Individual Taxpayer
Identification Number (ITIN) because you are not eligible to obtain an SSN, enter the ITIN. If you DO NOT have an SSN or ITIN and you have applied for
one or you intend to apply for one soon, write ‘‘Applied For’’ in the space provided.
How to get a SSN or ITIN. To apply for an SSN, use Form SS-5, Application for a Social Security Card, which you can get from your local Social
Security Administration office. To apply for an ITIN because you are not eligible to get an SSN, use Form W-7, Application for IRS Individual Taxpayer
Identification Number, which you can get from the IRS by calling 1-800-TAX-FORM (1-800-829-3676) or from the IRS website at www.irs.gov.
Name:
Last First M.I.
Social Security Number: Student ID Number:
Address:
Street City State Zip
SECTION II
❑ Under penalties of perjury I certify that the Social Security Number shown on this form is my true Social Security Number.
Student Signature: Date:
SECTION III
Please read, sign, and date this section ONLY if you are not willing to provide your Social Security Number.
❑ I do not wish to provide my Social Security Number at this time. I have read this document and am aware of the following:
Pursuant to the Internal Revenue Service (IRS) Internal Revenue Code (IRC) 6050S and 6051 the College is required to solicit from students. The IRS
can levy penalties on the student for refusing to provide his/her SSN and subsequently claiming qualifying expenditures for the Hope Scholarship Tax
Credit and/or the Lifetime Learning Tax Credit.
Student Signature: Date:
PRIVACY ACT NOTICE
Section 6109 of the Internal Revenue Code requires you to provide 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 for civil and criminal litigation and to cities, states, and the District of Columbia to carry out their
tax laws. The IRS may also disclose this information to Federal and state agencies to enforce Federal nontax criminal laws and to combat terrorism.
ES1509SocialSecNoRqst
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This document is available in alternative formats to individuals with disabilities by contacting Disability Support Services at 253-833-9111, ext. 2631; TTY 253-288-3359; or by email at dss@greenriver.edu.
Green River College is an equal opportunity educator and employer. Learn more at www.greenriver.edu/accessibility.
greenriver.edu/enrollment • (253) 833-9111 Ext. 2500 • 12401 SE 320th St., Auburn, WA 98092
enrollmentservices@greenriver.edu • fax (253) 288-3454
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