Form W-10 - Dependent Care Provider's Identification and Certifications - Do NOT file with your tax return

Sep 19, 2026

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Form W-10 (Rev. August 1996) collects dependent care provider identity details, including the provider’s name, address, and taxpayer identification number (TIN), and provides a certification and signature section. It explains how the requesting person must obtain this information to claim child and dependent care benefits or credits and outlines penalties for failing to furnish a valid TIN. Instructions cover due diligence acceptable records, when incorrect information can deny credits, and how providers determine the correct TIN type, including SSN, ITIN, and tax-exempt organization handling.

LanguageEnglish

CategoryForms

FormatPDF

Pages1

AccessFree to download

Part I: Dependent Care Providers Identification

Certification and Signature

Part II: Name and Address of Person Requesting Part I Information

General Instructions

Purpose of form

Penalty for failure to furnish TIN

If incorrect information is reported

Due diligence

Specific Instructions

Part I details and TIN types

Tax-exempt dependent care provider

How to get a TIN

Income tax reporting requirements

Total Payments 2022: $0.00 Addin, Mrs. | Form W-1O
(Rev. August 1996) Department of the Treasury Internal Revenue Service | | Dependent Care Provider's Identification and Certifications Do NOT file Form W-10 with your tax return. Instead, keep it for your records. | | | | --- | --- | --- | --- | --- | | Part I | Dependent Care Providers Identification (See instructions. ) | | | | | Please print or type | Name of dependent care provider
BerkyTest | | Provider’s taxpayer identification number | | | | Address (number, street, and [apt. no](apt. no). )
123 Road St | | If the above number is a social security
number, check here ► | | | | City, state, and ZIP code
Dallas , TX 75234 | | | | Certification and Signature of Dependent Care Provider.-Under penalties of perjury I as the dependent care provider, certify that my name address, and taxpayer identification number shown above are correct. | Please Sign Here | Dependent care providers signature | | Date | | --- | --- | --- | --- | | Part II | Name and Address of Person Requesting Part I Information (See instructions. ) | | | | Name, street address, [apt. no](apt. no). , city, state and ZIP code of person requesting information | | | | | General Instructions
Section references are to the internal Revenue Code,
Purpose of form.-You must get the information shown in Part I from each person or organization that provides care for your child or other dependent if:
1. You plan to claim a credit for child and dependent care expenses on form 1040 or 1040A or
2. You receive benefits under your employers dependent care plan
If either 1 or 2 above applies, you must show the correct name, address and taxpayer identification number (TIN) of each care provider on Form 2441 , Child and Dependent Care Expenses or Schedule 2 , Child and Dependent Care Expenses for Form 1040 A Fliers, Whichever applies.
You may use Form W-10 or any of the other sources listed under Due diligence below to get this information from each provider
Penalty for failure to furnish TIN.-TlNs are needed to carryout the Internal Revenue laws of the United States Section 6109(a) re. quires a Provider of dependent care services to give to you a valid TIN even If the Provider Is not required to file a return . The IRS uses the TIN , to identify the Provider and verify the accuracy of the Providers return as well as yours.
A care provider who does not give you his or her correct TIN is subject to a penalty of $50 for each failure unless the failure is due to reasonable cause and not willful neglect. This penalty does not apply to an organization described in section 501(c)(3) . See Tax-exempt dependent care Provider later.
If incorrect information is reported.-You will not be allowed the tax credit or the exclusion for employer-Provided dependent care benefits if;
• You report an incorrect name address or TIN of the provider on your Form 2441 or Schedule 2, and
• You cannot establish , to the IRS upon its request, that you used due diligence in trying to get the required information. Due diligence.-You can show due diligence by getting and keeping in your records any one of the following:
• A Form W-IO properly completed by the provider.
• A copy of the provider’s social security card or driver’s license that includes his or her social security number.
• A recently Printed letterhead or Printed Invoice that shows the provider's name, address, and TIN.
• If the provider is your employer’s dependent care plan , a copy if the statement provided by your employer under the plan.
• If the provider is your household employee and he or she gave you a properly completed Form W-4 , Employee's Withholding | | Allowance Certificate, to have income tax withheld, a copy of that Form W-4 .
If your care provider does not comply with your request for one of these items, you must still report certain information on your Form 2441 or Schedule 2, whichev

FAQs

What is Form W-10 used for?

Form W-10 is used to obtain and document the dependent care provider’s identification information (name, address, and TIN) needed to claim child and dependent care credits or employer dependent care benefits.

What happens if a provider does not furnish a valid TIN?

A provider who does not give the correct TIN may be subject to a penalty of $50 for each failure unless it is due to reasonable cause and not willful neglect.

How can the person requesting the information show due diligence?

Due diligence is shown by keeping records such as a properly completed Form W-10, copies of the provider’s Social Security card or driver’s license with the SSN, a printed letterhead or invoice with name/address/TIN, or other specified documents depending on the provider type.

Sep 19, 2026

Upload by Noah