W9-Form Submission

In order for us to process your honorarium payment, please submit your tax information by completing the W-9 form below. If you don’t provide updated information to Skipta at this time, the United States Internal Revenue Service (IRS) will require additional information to be provided in the future in order to verify your tax details.

W-9 Instructions

For assistance, you can contact us at [email protected]

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General Tax Info
Name (as shown on your income tax return)*
Business Name/Disregarded Entity Name, if different from above
Federal Tax Classification*
- Individual/Sole Proprietor or single-member LLC
- C Corporation
- S Corporation
- Partnership
- Trust/Estate
- Limited Liability Company
Select the tax classification*
Address*
Street Address City State ZIP Code
Phone*
Email address*
Exemptions
Exceptions (codes apply only to certain entities, not individuals)
Exempt payee code (if any)
Exemption from FATCA reporting code (if any)
Taxpayer Indentification Number (TIN)
Select Taxpayer Identification Number*
Social Security Number*
Employer Identification Number*
Certification
Under penalities 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. citizen or other U.S. person; and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Signature*
Draw an e-signature using a mouse or touchpad
SSN1
SSN2
SSN3
EIN1
EIN2

General Tax Info

Exemptions

Taxpayer Indentification Number (TIN)

Certification