Form W-7
(Rev. September 2016)
Department of the Treasury
Internal Revenue Service
Application for IRS Individual
Taxpayer Identification Number
▶
For use by individuals who are not U.S. citizens or permanent residents.
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See separate instructions.
OMB No. 1545-0074
An IRS individual taxpayer identification number (ITIN) is for federal tax purposes only.
Before you begin:
• Don’t submit this form if you have, or are eligible to get, a U.S. social security number (SSN).
• Getting an ITIN doesn’t change your immigration status or your right to work in the United States
and doesn’t make you eligible for the earned income credit.
Application Type (Check one box):
Apply for a New ITIN
Renew an Existing ITIN
Reason you’re submitting Form W-7. Read the instructions for the box you check. Caution: If you check box b, c, d, e, f, or g, you
must file a U.S. federal tax return with Form W-7 unless you meet one of the exceptions (see instructions).
a Nonresident alien required to get an ITIN to claim tax treaty benefit
b
Nonresident alien filing a U.S. federal tax return
c
U.S. resident alien (based on days present in the United States) filing a U.S. federal tax return
d
Dependent of U.S. citizen/resident alien
e
Spouse of U.S. citizen/resident alien
}
Enter name and SSN/ITIN of U.S. citizen/resident alien (see instructions)
▶
f Nonresident alien student, professor, or researcher filing a U.S. federal tax return or claiming an exception
g
Dependent/spouse of a nonresident alien holding a U.S. visa
h
Other (see instructions)
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Additional information for a and f: Enter treaty country
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and treaty article number
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Name
(see instructions)
Name at birth if
different . .
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1a First name Middle name Last name
1b First name Middle name Last name
Applicant’s
mailing address
2 Street address, apartment number, or rural route number. If you have a P.O. box, see separate instructions.
City or town, state or province, and country. Include ZIP code or postal code where appropriate.
Foreign (non-
U.S.) address
(if different from
above)
(see instructions)
3 Street address, apartment number, or rural route number. Don’t use a P.O. box number.
City or town, state or province, and country. Include ZIP code or postal code where appropriate.
Birth
information
4
Date of birth (month / day / year)
Country of birth
City and state or province (optional) 5
Male
Female
Other
information
6a Country(ies) of citizenship 6b Foreign tax I.D. number (if any) 6c
Type of U.S. visa (if any), number, and expiration
date
6d Identification document(s) submitted (see instructions)
Passport Driver’s license/State I.D.
USCIS documentation
Other
Issued by: No.: Exp. date:
/ /
Date of entry into the
United States
(MM/DD/YYYY):
/ /
6e Have you previously received an ITIN or an Internal Revenue Service Number (IRSN)?
No/Don’t know. Skip line 6f.
Yes. Complete line 6f. If more than one, list on a sheet and attach to this form (see instructions).
6f Enter ITIN and/or IRSN
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ITIN
— —
IRSN
— —
and
name under which it was issued
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First name
Middle name Last name
6g Name of college/university or company (see instructions)
City and state Length of stay
Sign
Here
Keep a copy for
your records.
Under penalties of perjury, I (applicant/delegate/acceptance agent) declare that I have examined this application, including accompanying
documentation and statements, and to the best of my knowledge and belief, it is true, correct, and complete. I authorize the IRS to share
information with my acceptance agent in order to perfect this Form W-7, Application for IRS Individual Taxpayer Identification Number.
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Signature of applicant (if delegate, see instructions)
Name of delegate, if applicable (type or print)
Date (month / day / year)
/ /
Phone number
Delegate’s relationship
to applicant
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Parent
Court-appointed guardian
Power of Attorney
Acceptance
Agent’s
Use ONLY
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Signature
Date (month / day / year)
/ /
Phone
Fax
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Name and title (type or print) Name of company
EIN PTIN
Office Code
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 10229L
Form W-7 (Rev. 9-2016)
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signature
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