F ederal
E mployer
I dentification
N umber
Click
on the Business license, Corporation, Tax Ids or
DBA / FBN Below to Select State First
Click Here to Find Out About Other
Business Legal Documents You Need to Start
Federal Tax Id Online Special
*
=
Required
Legal name of entity (or individual)
for whom the EIN is being requested
Trade name of business (if different from name above )
Address
No P.O. Box
Address (cont.)
City
State/Province
Please choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
British Virgin Islands
Canada
Cayman Islands
Guam
Panama
Puerto Rico
Northern Marian Islands
US Virgin Islands
Zip
County where principal place of business is
located
Officer ,
Partner or Individual / Owner's Name
Officer, Partner or Individual / Owner 's
SSN,
ITIN, or EIN
NOTE: *
SOCIAL SECURITY # IS REQUIRED YOU WILL NOT BE ABLE TO SUBMIT THE FORM IF YOU
DON'T PROVIDE IT.
*
Ownership Type
Select Type of Owenership
Church or church-controlled organization
ChurchOrChurch_ControlledOrganization
OtherNonprofitOrgannization
Personal service corp.
Corporation
FarmersCooperative
Sole Owner
Husband Wife Co-Owenrship
General Partnership
Limited Partership
Partnership
Other
*
Other Type of
ownership: Specify
If a Corporation, enter the
tax
form #
you
will file taxes for this entity (if known
)
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Usually the reason is because
you started a new business
(note: provide date you started or will start below)
Select Reason For Applying
Changed type of organization
PurchasedGoingBusiness
StartedNewBusiness
HiredEmployees
*
DATE BUSINESS WILL START, IT HAS STARTED, OR WILL BE ACQUIRED
Choose Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
year
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
*
*
SPECIFY TYPE OF BUSINESS
Example: barber shop
If Corporation Enter
State
Please choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
British Virgin Islands
Canada
Cayman Islands
Guam
Panama
Puerto Rico
Northern Marian Islands
US Virgin Islands
If you are
applying because you Changed
type of organization (specify new type)
Select Changed Type of Owenership
Church or church-controlled organization
Personal service corp.
Corporation
FarmersCooperative
Sole Owner
Husband Wife Co-Owenrship
General Partnership
Limited Partership
Partnership
If you are a corporation, Enter
Closing Month of Accounting Year
Normally this month is December
Choose Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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Highest number of
employees
expected in the next 12 months.
IF YOU HAVE EMPLOYEES, ENTER
Date wages paid or will be paid above
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
If you entered a number of employee(s) above,
please enter the
First date wages o r
annuities
were paid or will be paid
Choose Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
year
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
*
TYPE
OF BUSINESS
Select Principal Business Activity
Construction
Rental Leasing
Transportation & Warehousing
Accomodation & Food Service
Health Care & Social Assistance
Retail
Service
Wholesale - agent / broker
Real Estate
Nanufacturing
Finance & insurance
Repair
Contractor
Other
If "other" Specify:
Indicate Principal type of merchandise sold;
Construction
work done; products produced; or services
provided.
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Has the applicant ever applied for an employer
identification number for this or any other business?
Select Yes or No
Yes
No
If yes, complete items 16b, 16c, if different
than your current legal or trade name
16 b - If
you checked "Yes" on line ABOVE,
- Give
applicant's legal name, AND
16 c - give applicants trade name
16c Approximate date when, and city and state
where ,
the application was filed.
Choose Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
year
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
Enter
previous employer identification number if known.
City in which you filed the tax id
and State
Please choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
British Virgin Islands
Canada
Cayman Islands
Guam
Panama
Puerto Rico
Northern Marian Islands
US Virgin Islands
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Comments:
* Phone
*
* FAX
*E-mail
Credit Card Last Name
(for order tracking)
i.e. the name on the credit card you will use
PLEASE RE- Enter
Email
*
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PLEASE NOTE:
BEFORE WE PROCESS YOUR APPLICATION
YOU MUST READ, UNDERSTAND AND AGREE TO THE TERMS BELOW
You understand that
the government
does not charge money to issue these tax id
NUMBERS
BUT you are are hiring us to obtain it for you
because we know what forms to file and where and how
to file it.
By Checking the Box
Below, I Agree with and Understand the statement that
I choose to hire xkr essex, inc, to obtain AN
EMPLOYER NUMBER FOR ME
-- because xkr essex knows what
forms to file, where to file them and how to file
them.
.
Thus, BY CHECKING THE BOX BELOW I HIRE AND
authorize xkr essex, inc, to obtain the federal
tax id number EIN on my behalf..
I
UNDERSTAND THAT I COULD OBTAIN THIS NUMBER MYSELF FROM
THE GOVERNMENT BUT BY CHECKING THE BOX BELOW, I
CHOOSE TO HIRE XKR ESSEX, INC TO HANDLE THIS
MATTER ON MY BEHALF.
*
By Checking the Box
Below, I Agree with and Understand the statement on
the left
*
By Checking the Box
Below, I Agree with and Understand the statement on
the left
*
Not
LEGAL ADVICE: Neither xkr essex,
inc., nor any of its employees or agents have
provided you with any professional, legal or financial
advice, and that
By Checking the Box
Below, I Agree with and Understand the statement on
the left
*
By Checking the Box
Below, I Agree with and Understand the statement on
the left
*
BY ENTERING MY SIGNATURE ON THE FIELDS, I UNDERSTAND
AND AGREE WITH ALL THE ABOVE TERMS AND STATEMENTS:
By Typing my name / Signing Below, I
Agree and Understand with all the above terms and statements
Signature: *
Please
type your signature
Example: if your name is Michael Jackson, type
/Michael
*
Jackson/
Date:
*
or just print, sign and mail to :
Xkr Essex, Inc. 2911 E. Vista St. #C Long Beach, Ca
90803.