Important Tax Notice Action Is Required
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1 Important Tax Notice Action Is Required [Name] [Address1] [Address2] [Country] Account Number: <account> Tax Identification Number: <TIN #> Dear [Name], The Internal Revenue Service (IRS) has notified us that the combination of your name and Tax Identification Number (TIN) we used to report your 2011 taxable income does not match its records or the records of the Social Security Administration (SSA). We want to be sure you have the information you need to avoid federal tax withholding and possible penalties. What you need to do: 1. Please review the name and TIN printed above, as they appear on our records. 2. Review the enclosed list of scenarios to determine which one applies to you, and take the appropriate course of action for that specific situation. 3. Please note that you must complete, sign, detach, and mail us the Substitute Form W-9 below in the enclosed self-addressed envelope, or fax it to regardless of any additional action that is required. We need to receive the form by December 5, 2012 (See below.) o o If your Account Name and/or TIN (Social Security Number or Employer Identification Number) is different from the one appearing above, please provide the corrected information on the appropriate lines of the Substitute Form W-9. If your Account Name and/or TIN appearing above are accurate, you must still complete and mail the attached Substitute Form W-9. What you need to know: It is extremely important that we receive an accurate, completed and signed Substitute Form W-9 from you by December 5, Otherwise, Internal Revenue Code section 3406(a)(1)(B), will require us to begin federal backup withholding at a rate of 28% on all taxable dividends, interest, sales proceeds, and other reportable distributions credited to your account after that date. You may also be subject to an IRS penalty of $50 for providing an inaccurate name/tin and for failing, upon notification, to provide amended information. California residents who are subject to federal backup withholding on their account will have an additional 7% withholding at the state level on their gross sales proceeds, long-term capital gains distributions, cash liquidation transactions, royalties, and substitute payments, for a total of 35% withholding. Maine residents who are subject to federal withholding will have an additional 5% withheld at the state level on their sales transactions, interest, and dividends, for a total of 33% withholding. If you have any questions relating to this notice, please contact your Advisor, or call TD Ameritrade Institutional at Thank you for your attention to this matter. Sincerely,
2 John V. Tovar Managing Director, Brokerage Services TD Ameritrade Institutional TD Ameritrade Institutional does not provide tax advice. We suggest you consult with a tax-planning professional with regard to your personal circumstances. TD Ameritrade Institutional, Division of TD Ameritrade, Inc., member FINRA/SIPC/NFA. TD Ameritrade is a trademark jointly owned by TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank TD Ameritrade IP Company, Inc. All rights reserved. Used with permission. TDAI 5498 L 11/ Name Substitute Form W-9 - Request for Taxpayer Identification Number and Certification Business Name, if different from above Address (number, street, and apt. or suite no.) City, State, and ZIP Code Social Security Number Employer Identification Number Account Number: <account #> Check appropriate box for federal tax classification (required): Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate Exempt payee Limited liability company. Enter tax classification (C=C corporation, S=S corporation, P=partnership): Other - Please Specify: Certification 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), 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 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 (defined in the Instructions to Form W-9, available at Certification Instructions - You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. Sign Here Signature Date
3 Important Tax Notice Action is Required Second Notice [Name] [Address1] [Address2] [Country] Account Number: <account #> Tax Identification Number: <TIN #> Dear [Name], The Internal Revenue Service (IRS) recently notified us that the combination of your name and Tax Identification Number (TIN) we used to report your 2011 taxable income does not match its records or the records of the Social Security Administration (SSA). You will find your name and tax identification number above as they appear on our records. You may remember that TD Ameritrade Institutional was notified of this discrepancy once before during the past three years. At that time, you may have responded to our initial notice and signed a Substitute Form W-9 updating your TIN. However, the IRS has indicated that a discrepancy still exists. As a result, Section 3406 of the Internal Revenue Code requires us to withhold 28% of all reportable dividends, interest, and sales proceeds credited to your account after December 5, You may also be subject to an IRS penalty of $50 for providing inaccurate name/tin and for failing, upon notification, to provide amended information. California residents who are subject to federal backup withholding on their account will have an additional 7% withholding at the state level on their gross sales proceeds, long-term capital gains distributions, cash liquidation transactions, royalties, and substitute payments, for a total of 35% withholding. Maine residents who are subject to federal withholding will have an additional 5% withheld at the state level on their sales transactions, interest, and dividends, for a total of 33% withholding. Unfortunately, we are unable to correct this matter by accepting an updated Substitute Form W-9 from you. However, you can prevent the backup withholding from occurring by following the instructions listed below. What you need to do if your TIN is a Social Security Number (format: ) 1. Visit your local Social Security Administration (SSA) office to obtain a printout showing your legal name and Social Security Number as it is listed in the SSA system. 2. Send this printout to TD Ameritrade Institutional in the enclosed envelope or fax it to us at Please be sure your account number is listed on the printout. 3. If your name, as it is listed on the form from the SSA office, is different from the name listed on your TD Ameritrade Institutional account, you will need to update your account to match the SSA's information. Please contact your Advisor for information on what is needed to update your name on your account. What you need to do if your TIN is an Employer Identification Number (format: ) 1. Write to the IRS Center (Attention: Entity Section) where you file your income tax return, and ask the IRS to send you IRS Letter 147-C. We have provided a list of the Regional IRS Service Center locations below. 2. Enclose a copy of this notice in your letter to the IRS Center. 3. When you receive Letter 147-C, please send it to us, with a copy of this notice, in the enclosed envelope.
4 How to request Letter 147-C: Write to the Internal Revenue Service Center, Entity Section, using the city corresponding to your location listed in the table below. A street address is not required. If you live in: Use this address for the IRS Service Center: Florida, Georgia, North Carolina, South Carolina, West Virginia Atlanta, GA New Jersey, New York (New York City and counties of Nassau, Rockland, Suffolk, and Westchester) Holtsville, NY New York (all other counties), Massachusetts, Michigan, Rhode Island Andover, MA Connecticut, Delaware, Maine, New Hampshire, Vermont Philadelphia, PA Illinois, Iowa, Kansas, Minnesota, Missouri, Oklahoma, Wisconsin Kansas City, MO District of Columbia, Indiana, Maryland, Ohio, Pennsylvania Cincinnati, OH Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Tennessee, Virginia Memphis, TN Arizona, Colorado, Idaho, Montana, New Mexico, Texas, Wyoming Austin, TX Nebraska, North Dakota, South Dakota, Washington, Utah Ogden, UT Alaska, California, Hawaii, Nevada, Oregon Fresno, CA All APO and FPO addresses, American Samoa, non-permanent residents of Guam or the Virgin Islands, Puerto Rico, a foreign country Philadelphia, PA If you have any questions relating to this notice, please contact your Advisor, or call TD Ameritrade Institutional at Thank you for your attention to this matter. Sincerely, John V. Tovar Managing Director, Brokerage Services TD Ameritrade Institutional TD Ameritrade does not provide tax advice. Please consult a tax-planning professional with regard to your personal circumstances. TD Ameritrade Institutional, Division of TD Ameritrade, Inc., member FINRA/SIPC/NFA. TD Ameritrade is a trademark jointly owned by TD Ameritrade IP Company, Inc. and The Toronto-Dominion Bank TD Ameritrade IP Company, Inc. All rights reserved. Used with permission. TDAI 5459 L 11/12
5 What to Do: Scenarios Involving Your Social Security Number Scenario Course of Action The Last Name and Social Security Number on this Notice are the same as the Last Name and Social Security Number that appear on your Social Security Card. Contact your local Social Security Administration (SSA) office to determine the discrepancy and resolve the issues with an SSA representative. Sign the enclosed Form W-9 and return it to TD Ameritrade Institutional in the envelope provided. The Social Security Number on this Notice is different from the Social Security Number on your Social Security Card, but the Last Name is the same. The Last Name on this Notice is different from the Last Name on your Social Security Card, but the Social Security Number is the same on both. Note: This can occur when a name change has occurred due to marriage, divorce, adoption, etc., and the change has not been reported to either TD Ameritrade Institutional or the Social Security Administration. Enter your Social Security Number, as it appears on your Social Security Card, on the enclosed Form W-9, then sign and return the form to TD Ameritrade Institutional in the envelope provided. No contact with the SSA is necessary. A TD Ameritrade Institutional representative will update our records for future processing. If the Last Name on this Notice is correct: Contact your local Social Security Administration (SSA) office to correct the name on their records. Sign the enclosed Form W-9 and return it to TD Ameritrade Institutional in the envelope provided. If the Last Name is correct on your Social Security Card but is incorrect on this Notice: Enter the name that is on your Social Security Card, along with all of the other applicable information, on the enclosed Form W-9. Then sign and return the form to TD Ameritrade Institutional in the envelope provided. A TD Ameritrade Institutional representative will update our records for future processing. Both the Last Name and Social Security Number on this Notice are different from the Last Name and Social Security Number on your Social Security Card. Enter the name and Social Security Number from your Social Security Card on the enclosed Form W-9, then sign and return the form to TD Ameritrade Institutional in the envelope provided. A TD Ameritrade Institutional representative will update our records for future processing. You are not a U.S. taxpayer and do not have a Social Security Number. Send us a completed original Form W-8BEN (available at in the envelope provided, along with a copy of your current passport or visa, and a letter explaining why you have a U.S. mailing address (if you have provided one for your account).
6 What to Do: Scenarios Involving Your Employee Identification Number Scenario Course of Action The Name and Employee Identification Number on this Notice agree with your records. Contact your local Internal Revenue Service (IRS) office to determine the discrepancy and resolve the issues with an IRS representative. Sign the enclosed Form W-9 and return it to TD Ameritrade Institutional in the envelope provided. The Employee Identification Number on this Notice is different from your records, but the Name is the same. Enter the correct Employee Identification Number on the enclosed Form W-9, then sign and return the form to TD Ameritrade Institutional in the envelope provided. No contact with the IRS is necessary. A TD Ameritrade Institutional representative will update our records for future processing. If the Name on this Notice is correct: The Name on this Notice is different from the Name of your Trust, Organization or other Entity, but the Employee Identification Number is the same on both. Both the Name and Employee Identification Number on this Notice are incorrect. You have never been assigned an Employee Identification Number or you do not know your Employee Identification Number. You believe your organization is EXEMPT from Form 1099 reporting and federal backup withholding. Contact your local Internal Revenue Service (IRS) office to correct the name on their records. Sign the enclosed Form W-9 and return it to TD Ameritrade Institutional in the envelope provided. If the Name on this Notice is incorrect: Enter the correct name on the enclosed Form W-9, then sign and return the form to TD Ameritrade Institutional in the envelope provided. A TD Ameritrade Institutional representative will update our records for future processing. Enter the correct name and Employee Identification Number on the enclosed Form W-9, then sign and return the form to TD Ameritrade Institutional in the envelope provided. A TD Ameritrade Institutional representative will update our records for future processing. Contact your local Internal Revenue Service (IRS) office and find out how to obtain a new Employee Identification Number or ask to obtain your already assigned Employee Identification Number. When you receive your Employee Identification Number, record this information on the enclosed Form W-9, then sign and return it to TD Ameritrade Institutional in the envelope provided. A TD Ameritrade Institutional representative will update our records for future processing. Complete the enclosed Form W-9, including Part II, For Payees Exempt From Backup Withholding, then sign and return it to TD Ameritrade Institutional in the envelope provided. You may need to provide other documentation (Corporate Resolution, Trust Agreement, Charter, etc.) to qualify for such an exemption. A TD Ameritrade Institutional representative will update our records for future processing. TDAI 7030 L 11/12
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