Form
W-13
(January 2014)
ExSTARS Reporting Information Request for
Employer Identification Number and Certification
Information about Form W-13 and its instructions is at www.irs.gov/formw13.
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Print or type
Name (as shown on your tax returns; see instructions)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
Individual/sole proprietor
C corporation S corporation Partnership
Trust/estate
Limited liability company (see instructions). Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
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Other (see instructions)
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Address (number, street, and apt. or suite no.)
City, state, and ZIP code
Requester’s name and address
Part I Employer Identification Number (EIN)
Enter your EIN in the appropriate box. The EIN provided must be for the ExSTARS transaction entity.
Report the disregarded entity's EIN, not the owner's EIN, when applicable.
Social security numbers not permitted in
ExSTARS reporting.
Employer identification number
–
Part II Certification
Under penalties of perjury, I certify that the number shown on this form is my correct employer identification number.
Sign
Here
Signature of
U.S. person
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Date
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Type or write
name and title
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Section references are to the Internal Revenue Code unless otherwise noted.
Future Developments
For the latest information about developments related to Form W-13
and its instructions, such as legislation enacted after they were
published, go to www.irs.gov/formw13.
General Instructions
Purpose of Form
Filers should use this form to request a valid employer identification
number (EIN) for purposes of Excise Summary Terminal Activity
Reporting System (ExSTARS) reporting.
A person who is required to file an ExSTARS information return with
the IRS must obtain your correct EIN to report. For example, a truck
carrier making a delivery to a terminal must provide the carrier
company's EIN to the terminal operator.
The receiving party returns the form to the requester after providing a
correct EIN.
Updating Your Information
You must provide the requester with updated information if the name or
EIN changes while still engaged in ExSTARS reporting activities.
Penalties
Failure to furnish EIN. If you fail to furnish your correct EIN to a
requester, you are subject to a penalty of $50 for each such failure
unless your failure is due to reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you
make a false statement with no reasonable basis that results in no
backup withholding, you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subject you to criminal penalties
including fines and/or imprisonment.
Misuse of EINs. If the requester discloses or uses EINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Specific Instructions
Name
Sole proprietor. Enter your individual name as shown on your income
tax return on the “Name” line. You may enter your business, trade, or
“doing business as (DBA)” name on the “Business name/disregarded
entity name” line.
Partnership, C corporation, or S corporation. Enter the entity's name
on the “Name” line and any business, trade, or “doing business as
(DBA) name” on the “Business name/disregarded entity name” line.
Limited liability company (LLC). If the person identified on the “Name”
line is an LLC, check the “Limited liability company” box only and enter
the appropriate code for the tax classification in the space provided. If
you are an LLC that is treated as a partnership for federal tax purposes,
enter “P” for partnership.
Note. If you are an LLC that has elected to be treated as a disregarded
entity separate from its owner under Regulation section 301.7701-3,
check the LLC box and select the appropriate classification of the
disregarded entity, not the owner listed in the “Name” line.
Disregarded entity. Enter the owner's name on the “Name” line. The
name of the entity entered on the “Name” line should never be a
disregarded entity. The name on the “Name” line must be the name
shown on the income tax return on which the income will be reported.
For example, if a foreign LLC that is treated as a disregarded entity for
U.S. federal tax purposes has a domestic owner, the domestic owner's
name is required to be provided on the “Name” line. If the direct owner
of the entity is also a disregarded entity, enter the first owner that is not
disregarded for federal tax purposes. Enter the disregarded entity's
name on the “Business name/disregarded entity name” line.
Note. Check the appropriate box for the federal tax classification of the
person whose name is entered on the “Name” line (Individual/sole
proprietor, partnership, C corporation, S corporation, trust/estate).
Cat. No. 62958V
Form W-13 (1-2014)
Department of the Treasury
Internal Revenue Service
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