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Step 1  Enter your information:
Protection & Security
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  Please fill out this application to the best of your abilities. If there are questions you do not understand, please skip to the next question & an associate will contact you once it is submitted.
Main Information :
Legal name for whom the EIN is being requested:

(Individual Name, Corporation Name, LLC)
DBA/Trade Name
of Business:


(if different from name of line 1)
Address:
City:
County:
State:
Zip:
Phone:
Fax:
County & State where principal business is located:
Name of principal officer, general partner, grantor, owner, or trustor:
SSN, ITIN, or EIN:  safe
Entity Information :
Type of Entity:
Group Exemption Number:
Name of state or  foreign country  where incorporated: State:

Foreign country:

Reason for applying :
Choose Reason:
Date business was 
started or acquired:
Month, Day, Year:
Closing month of accounting year:
First date wages or  annuities were paid: If available | Month, Day, Year:
Principal Activity:
Please select that which best describes the principal activity of your business:
Principal line:

(i.e. merchandise sold, specific work, products produced, sevices provided)
Applicant History :
Has the applicant ever applied for an EIN for this or any other business?   
Applicant’s name and trade name shown on prior application: Legal Name:

Trade Name:
Approximate date  when, and city &  state where, the  application was filed:


Previous employer  identification number  if known:
Approximate date when filed:

City and state where filed:

Previous EIN:

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Tip : It's a good idea to enter a telephone number so we may reach you quickly in case we need further information.
Thank You!
'Name of Principle officer' only applies to LLC, LLP & Corporation entities.
'SSN, ITIN, or EIN' :
If Individual, Partner, or Husband & wife enter SSN. Corp, LLC's or LLP's Enter EIN or ITIN.
Partners or Husband and Wife, please enter only one person's name.
Questions that you do not understand, leave them blank. An associate will call you.