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
name and address
Clarion University of Pennsylvania
840 Wood Street
Clarion, PA 16214
Student ID number
General Instructions
Purpose of form. An eligible educational institution, such as
Clarion University, 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 Clarion
University. Under federal law, you are required to provide
the requested information.
Clarion Univ. 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.
Deliver or mail the completed form to the address provided.
Do not email the
form. Email is not a secure way to transmit
personal information.
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 Clarion Univ. discloses or uses your SSN
in violation of Federal law, Clarion Univ. 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
Oct 2014)
Give form to the
send to the IRS.
click to sign
click to edit