Form W-9 Substitute Form - State of Colorado 8-2007 - Request for Taxpayer Identification Number and Certification

Sep 19, 2026

Request for Taxpayer Identification Number and Certification, including instructions for providing the correct TIN and certifying eligibility under federal backup withholding rules. Covers how to submit the form to the requester and not the IRS, lists required identification fields (name, business name if different, address, phone, and TIN type), and provides certification requirements under penalties of perjury. Includes guidance for U.S. persons, backup withholding exemptions, real estate and other transaction exceptions, and signature date requirements.

LanguageEnglish

CategoryForms

FormatPDF

Pages4

Reading Time2 min

AccessFree to download

Request for Taxpayer Identification Number and Certification

Instructions for Completing and Certifying

U.S. Person and Backup Withholding Rules

Certification and Signature Information

Minority and Women-owned Businesses Self Certification

| Form W-9 Substitute Form
State of Colorado 8-2007 | | | Request for Taxpayer Identification Number and Certification | | | Give form to the requester. Do not send to the IRS. | | --- | --- | --- | --- | --- | --- | --- | | | Name EMPLOYEE Y N | | | | | | | | Business name, if different from above | | | | | | | | Check appropriate box:
Individual/ Sole Proprietor Corporation Partnership Other Exempt from backup withholding
► | | | | | | | | Address (number, street, and apt. or suite no.) | | | | | | | | City, state, and ZIP code. | | | | | | | | Phone Number. | | | List Account number(s) here (optional) | | | | | | Taxpayer Identification Number (TIN) | | | | | | Enter your TIN in the appropriate box. For individuals, this is your social security number (SSN) However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN) . If you do not have a number, see How to geta TIN on page 3. | | | | | Social Security number | | | Note: If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. | | Employer identification number | | | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Certification | | | | | | | | | | | CDPHE Requester Name & Extension: Part I Part II Print or Type See Specific Instructions on page 3. Under penalties of perjury, I certify that: 1. 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 because. (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U. S. person (including a U. S. resident alien) . Certification instructions. You must cross out item 2 above if the IRS has notified you that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN.(See the instructions on page 3 .) | Sign
Here | Signature of
U. S. person ► Date ► | | --- | --- | | Minority and Women-owned Businesses (M/WBEs) Self Certification (Please check all boxes that apply)
In an effort to track levels of participation by women and minorities doing business with the State of Colorado, the following information is requested. Please indicate the appropriate category of ownership for your company. “Owned” in this context means a business that is at least 51 percent owned by an individual(s) who also control(s) and operate(s) it.“Control” in this context means exercising the power to make policy decisions .“Operate”means actively involved in the day-to-day management. If your business is jointly owned by both men and women or is a publicly held corporation, please check the box labeled“Not Applicable.”
Gender Information:
□ Female-Owned □ Male-Owned □ Not Applicable
Owner Ethnicity Information
□ African American □ Asian/Pacific American □ White (non-Hispanic) □ Not Applicable
□ Hispanic American □ Native American □ Other:
Small Business Information
Small Business (a business that is organized for profit, is independently owned and operated, an

FAQs

Who should receive the completed W-9 substitute form and how should it be used?

Give the form to the requester and do not send it to the IRS. The requester uses the provided TIN to report payments for applicable transactions.

What TIN should be entered on the form?

Enter the correct taxpayer identification number in the appropriate box. For individuals it is generally an SSN; for other entities it is typically an EIN. If you do not have a number, follow the page 3 guidance.

What does the certification under penalties of perjury require?

It requires certifying the shown TIN is correct (or waiting for issuance), stating you are not subject to backup withholding (or that you are exempt/not notified), and confirming you are a U.S. person (including a resident alien).

How does backup withholding apply and when are exceptions provided?

Certification instructions explain that item 2 may need to be crossed out if notified by the IRS that you are subject to backup withholding due to failures to report interest or dividends. Certain real estate and mortgage interest or other payment types may not require signing but require providing the correct TIN.

Sep 19, 2026

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