Federal Tax ID Information

1. Legal name of entitty (or individual) for whom the EIN is being requested*

2. New (DBA) Business Name (if different from name of line 1)

3. Address *

City*

County

State* --- Choose State --- AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDist. of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip:*

Phone*

Email:*

Name of principal officer, general partner, grantor, owner, or trustor*

Social Security Number *

Reason for applying

Principal Activity* --- Choose Activity --- Health care & social assistance Wholesale–agent/broker Construction Rental & leasing Transportation & warehousing Accommodation & food service Wholesale–other Retail Real estate Manufacturing Finance & insurance Other

Principal line*

Has the applicant ever applied for an employer identification number for this or any other business? No Yes

Legal Name

Trade Name

Approximate date when filed

City and state where filed

Previous EIN

Back

NEXT