Loading...
Tax ID# & Certification W-906/13/2003 13:45 FAX 214 292 0101 WF I 0O2 W-9 (Rev. June 2002 by VoiceStteam) Request for Taxpayer Identification Number and Certification Return to requestor: VoiceStream Wireless Corp,/DBA T-Mobile 12920 SE 38* Street; Bellevue, WA 98006 Fax: 425-378-4560 Attn: Please complete the following information. W]e are required by law to obtain this information from you when making a reporteble payment to you. If you do not provide us with this information, iyour payments may be subject to 31% federal income tax backup withholding. Also, if you do not provide us with this information, you may be subject to a $50 penalty imposed by the Internal Revenue Service under section 6723. If you do not finnish a valid TIN, or if you are gubject to backup withholding, the payee is required to withhold 31% of its payment to you. Backup withholding is not a failure to pay you. It is an advance tax payment. You should report all backup withholding as a credit for taxes paid on your federal income tax return. Uae this form only if you are an U.S. compan~ or individual. If you are a foreign entity, use the appropriate form W-SBEN. ..~ Business name (Include Sole Proprietor nam6 if ~pplicable) ~ crrY OF COPPELL I D°ins B~iness As (DBA) .~ Address (number, strr~, and apt. or suite no,) Phone number 255 PARKWAY BLVD., ~I'.0. BOX 9/+78 9?2-/+62-0022 ~..~ City, State, and ZIP code Fax number i~ COPPELL~ TF.X~¥/$ 75019 E-mail address Web-sltc address Check the appropriate box for your organization and provide the assigned Tax Identification Number. Corporation, Exempt, Government Sole Proprietor/Individual Social Security Number ~ Employer Identification Number [] 7 5- 1 1 8 3 2 0 7 OR Employer Identification Number · .Partnership : Other '} FI Partnership's Employer Identification Number El Employer Identification Number EXEMPTION: IF EXEMPT FROM 1099 REPORTING, PLEASE CHECK YOUR QUALIFYING EXEMPT REASON BELOW. Corporation, except there is no exc~nption for medical end healthcare payments or payments for legal services Tax exempt charity under 501 (a), or IRA The United States or any of its agencies or insVmmentalities A state, the District of Columbia, a tmssassion of the United States, or any ofthair political subdivisions A foreign ~ovornment or an}, of its political subdivisions CERTIFICATION Under penalties of perjury, I certify that: I. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding lJecause: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject ~o backup withholding as a result ora failure to report all interest or dividends, or (c) thc IRS has notified me that I am no longer subject to I~aclmp withholding and 3. I am a U.S. person (including a U.S. resideht alien). Certificeti0n Instructions - You mast cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. Person completing_thj~ form ~l~ease pr~')~ CHAD BEACH, ASSISTANT FINANCE DIRECTOR Signature: ~'/ '~ ~' '/ /~ff/~ ' Date: 6 / 16/03 Phone: If you have any questions, please call thc VoiceStream Accounts Payable Helpdesk at 1-888-526-4612.