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Division of Accounting  >>  Substitute Form W9        

The State of Delaware requires the following information for all vendors (payees) before any payments can be made. This information is used to populate and maintain the State's vendor file.
*Required. Complete all required fields if new request or making a change.
* Form Type:
*Taxpayer ID:
(no hyphens)
  If a Foreign company, use IRS Form W-8 available at
Payment Method: The State reserves the right to provide payment by any of the following methods: credit card, ACH or by check, at the State's option.
* May we contact you about receiving credit card payments? 
* Would you like to receive payment by direct deposit?  
Applicant Information:
*Vendor Name(Name on IRS record)
Doing Business As(if different than IRS name)
Applicant Remittance Address & Contact Information:
* Address Line 1:
Address Line 2:
* City:
* State:
* Zip:
* Contact Name:
* Phone #:


Fax #:
* Contact E-mail address:
Applicant Ordering Address & Contact Information:
* Address Line 1:
Address Line 2:
* City:
* State:
* Zip:
* Contact Name:
* Phone#:


Fax #:
* Contact E-mail address:
Additional Reporting Elements:
Please check all that apply:
* 1099 Withholding Type:

       a) business is incorporated and not providing legal or medical services
       b) receiving a reimbursement from the state that is not 1099 reportable
           (energy grant, stipends, childcare)
       c) organization is a non-profit organization.
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,
  • 2. I am not subject to backup withholding because:
  • I am exempt from backup withholding,
  • 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
  • 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 (defined below).
    Definition of a U.S. Person. For federal tax purposes, you are considered a U.S. person if you are:
  • An individual who is a U.S. citizen or U.S. resident alien,
  • A partnership, corporation, company, or association created or organized in the United States or under the laws
    of the United States,
  • An estate (other than a foreign estate), or
  • A domestic trust (as defined in regulations section 301.7701-7)
Electronic System Submission:
Under penalties of perjury I certify that:   
* I am the same person (or payee's agent) accessing the system and submitting this form as identified on the Substitute Form W-9.

* By submitting this form electronically, I am affixing my electronic signature as the payee identified on the Substitute Form W-9 and I am in agreement with the State of Delaware to accept and process this transaction in electronic form

"The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding."

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