The document is a fully completed IRS Form W-9 (Request for Taxpayer Identification Number and Certification) dated July 30, 2021. It provides the name (Valerie Vess Jimenez), business name (VJMZ, LLC), address (1703 W Woodward Ave., Manteca, CA 95337), and federal tax classification (individual/sole proprietor or single‑member LLC). The taxpayer identification number entered is the employer identification number 86‑2722509. The form includes the required certification under penalty of perjury, confirming the correctness of the TIN, exemption from backup withholding, U.S. person status, and FATCA exemption, and is signed by the individual. The document also contains the standard IRS instructions explaining the purpose of Form W‑9, the types of information returns it supports (e.g., Forms 1099‑INT, 1099‑MISC, 1099‑K, etc.), and the consequences of failing to provide a TIN.
Topics
Personal Identification and Business Details on Form W-9
Provides the individual's legal name, business name (VJMZ, LLC), and mailing address as required on line 1, 2, and 5‑6 of the form.
Federal Tax Classification Declaration: Individual/Sole Proprietor Single‑Member LLC
Selection of the appropriate tax classification box indicating the filer is an individual/sole proprietor or a single‑member LLC, with explanatory notes on classification rules.
Provision of Taxpayer Identification Number (EIN) 86‑2722509
Entry of the employer identification number in Part I, establishing the TIN that matches the name on the form.
Certification of U.S. Person Status and Backup Withholding Exemption
Signature block in Part II where the filer certifies under penalty of perjury that the TIN is correct, they are not subject to backup withholding, they are a U.S. person, and any FATCA codes are accurate.
Purpose and Use Cases of Form W‑9 in Information Reporting
Standard IRS instructions outlining why requesters need the form, the types of information returns it supports (e.g., 1099‑INT, 1099‑MISC, 1099‑K), and the implications of not providing a TIN.