W-9
(Rev. March 2024)
Dept. of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Go to www.irs.gov/FormW9 for instructions and the latest information.
Give form to the
requester. Do not
send to the IRS.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
Print or type.
See Specific Instructions on page 3.
1 Name of entity/individual. An entry is required.
LA FAMILIA SIMON FOUNDATION
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification:
Individual/sole proprietor
C corporation
S corporation
Partnership
Trust/estate
LLC
Other (see instructions) ▸
Nonprofit corporation exempt under IRC 501(c)(3)
3b Foreign partners/owners/beneficiaries (see instructions)
Not applicable
4 Exemptions (codes apply only to certain entities):
Exempt payee code (if any): 1
Exemption from FATCA reporting code (if any):
5 Address (number, street, and apt. or suite no.)
Provided privately upon request
6 City, state, and ZIP code
St. Cloud, FL · USA
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. For entities, this is your Employer Identification Number (EIN).
Employer identification number
••–
•••••••
Part II Certification
Under penalties of perjury, I certify that: (1) The number shown on this form is my correct taxpayer identification number; (2) I am not subject to backup withholding; (3) I am a U.S. person; and (4) The FATCA code(s) entered (if any) indicating exemption from FATCA reporting is correct.
Sign
Here
Signature of U.S. person ▸
Cat. No. 10231XForm W-9 (Rev. 3-2024)
Form W-9 — pre-filled for La Familia Simón Foundation
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