Business Designation. (Check one box): Professional Corporation Nonprofit Corporation Limited Partnership Limited Liability Company Limited Liability Partnership Sole Proprietorship Corporation Partnership Other
Business Designation. Texas Corporation Out-of-State Corporation Foreign Corporation Limited Liability Company Other (Please Explain): Limited Partnership General Partnership Professional Association Financial Institution Sole Ow ner Individual Recipient Government Entity TX State Agcy/Universit Box 7 Box 8 Box 9 Box 10 State Charter Information: Sole Ownership Info: Partnership Information: Profit Status: State of Jurisdiction: Sole Ow ner Name and SSN: Partner 1 Name and SSN/EIN: Partner 2 Name and SSN/EIN: Profit File or Charter Number: Non-Profit Box 11 Box 12 Backup Withholding: * Please see IRS Website Certification: Exempt from Backup Withholding Under penalties of perjury, I certify that:
