Taxpayer Information
Foreign Province, State, County is required
Foreign Postal Code is required
Line 4: Taxable social security and Medicare wages and tips:
Include taxable qualified sick and family leave wages for leave taken after March 31, 2021, on line 4a.
Use lines 4a(i) and 4a(ii) only to report wages paid for leave taken before April 1, 2021
Part 2: Determine your FUTA tax before adjustments. If any
line does NOT apply, leave it blank.
Part 3: Determine your adjustments. If any line does NOT
apply, leave it blank.
Part 4: Determine your FUTA tax and balance due or
overpayment. If any line does NOT apply, leave it blank.
Part 5: Report your FUTA tax liability
Part 6: May we speak with your third-party designee?
Part 7: Sign here. You MUST complete both pages of this
form and SIGN it.
Use your cursor to sign your name above
Applicant's Mailing Address
Sign here :
Under penalties of perjury, I (applicant/delegate/acceptance agent) declare
that I have examined this application, including accompanying documentation and statements,
and to the best of my knowledge and belief, it is true, correct, and complete. I authorize
the IRS to share information with my acceptance agent in order to perfect this Form W-7,
Application for IRS Individual Taxpayer Identification Number.