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Intel LetterHead Template With Logo

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Intel Corporation
Accounts Payable
P.O. Box 1000
Hillsboro, OR 97123-1000
U.S.A.
Tracking Number ________________
Supplier Number __ __ __ __ __ __
(If applicable)
COMPANY/BUSINESS NAME
ADDRESS
Substitute W-9
Intel Buyer __________________________
Phone
(______ )___________________
_____________________________________
________________________________________
________________________________________
Federal Law requires withholding of 31% federal income tax from payments made to suppliers for which we do not have
a Tax Identification number. Funds withheld can only be refunded by the IRS. IF YOU ARE AN INDIVIDUAL
OR A
SOLE-PROPRIETOR, PAYMENTS MUST BE MADE AND REPORTED UNDER YOUR NAME.
PLEASE PRINT THE NAME THAT NEEDS TO BE REPORTED. If you have any questions regarding this issue,
please contact the IRS. NOTE: Merchandise and reimbursements will not be separated from reportable dollars.
Your Tax Identification Number is a nine digit number assigned by the either the Social Security Administration or the IRS.
If you do not have a Federal Employer Identification number (FEIN), you will need to use your Social Security Number (SSN).
Please complete the appropriate section below. Then fill out the last section and return this form. Thank you.
 Individual?
YOUR NAME _____________________________________________________________
Social Security Number (SSN) __ __ __ - __ __ - __ __ __ __
 Sole Proprietor?
YOUR NAME ______________________________________________________________
BUSINESS NAME _____________________________________________________________
SSN __ __ __ - __ __ - __ __ __ __ OR FEIN__ __ - __ __ __ __ __ __ __
(This is either your Social Security Number OR your Federal Employer ID Number)




Partnership?
Incorporated Attorney or Legal Firm?
LLC (Limited Liability Company)?
LLP (Limited Liability Partnership)?
 Corporation/Incorporated?
 Non-Profit?
 Government Agency?
FEIN __ __ - __ __ __ __ __ __ __
(This is your Federal Employer ID number)
FEIN __ __ - __ __ __ __ __ __ __
(This is your Federal Employer ID number)
Print Name: __________________________________________________
Title: ___________________
Date: ____________
Signature:_____________________________________________________ Phone number: _____________________________
Please fax back to: 1099 Administrator (503) 696-3329, or as an alternate (503) 696-3060. THANK YOU
For inquiries regarding this Form, please contact the Customer Service Center at (503) 264-7851.
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