Substitute IRS Form W-9

Complete, sign, date, and submit for prize processing

Substitute Form W-9
(Rev. December 2019) Kayak Bass Fishing, LLC

Request for Taxpayer Identification Number and Certification

▶ Go to for instructions and the latest information regarding the IRS Form W-9

This Form is sent to KBF and not to the IRS.

  • Secure Web PagePurpose of Form

    If you receive from Kayak Bass Fishing, LLC (KBF) various types of income, prizes, awards, or gross proceeds equaling $600 or more in a calendar year, KBF submits to the Internal Revenue Service a Form 1099-MISC, and you will receive copies of that form by January 31 to use in preparing your federal and state income tax returns.

    The requester—in this case, KBF—requests that you provide your correct taxpayer identification number (TIN) using an IRS Form W-9 or a Substitute Form W-9. Your TIN may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN).

    Use this Substitute Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not submit to KBF a Substitute Form W-9 with a TIN, you might be subject to backup withholding. (See What is Backup Withholding in IRS Form W-9 General Instructions.)

    Note: If you are a U.S. person and a requester provides you a form other than the IRS Form W-9 to request your TIN, the IRS requires you to use the requester’s form if it is substantially similar to the IRS Form W-9.

    By signing and submitting the form below, you:

    1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),
    2. Certify that you are not subject to backup withholding, or
    3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income, and
    4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. (See What is FATCA reporting in IRS Form W-9 General Instructions.)
  • Enter your name as shown on your income tax return. Required.
  • This Substitute IRS Form W-9 will be emailed in a secure, digitally-encrypted format to KBF and a copy will come to the email address you enter here.
  • Business name/disregarded entity name, if different from above
  • Click on the appropriate button for federal tax classification of the person whose name is entered on line 1. Click only one of the following seven buttons.
  • If the "Limited Liability Company" button is selected above, enter the tax classification (C=C corporation, S=S corporation, P=Partnership) here. Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner.
  • Generally, individuals (including sole proprietors) are not exempt from backup withholding. If that's you, skip this section. Exemption codes apply only to certain entities, not individuals. See page 3 of the IRS Form W-9 instructions.
  • Enter the address to which an IRS Form 1099 should be mailed. This is the same address as you use in filing Federal Income Tax Returns.
  • Part I Taxpayer Identification Number (TIN)

    Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.
    Note: If the account is in more than one name, see IRS Form W-9 Instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.

  • For individuals, your social security number (SSN) is required in this format: 999-99-9999
  • For entities, your Employer Identification Number (EIN) is required in this format: 99-9999999
  • Under penalties of perjury, I certify that:
  • Certification Instructions

    Generally, KBF Prize recipients mark Boxes 1, 2, and 3.

    Box 2: You must not check Box 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.

    Box 4: Do not check Box 4 unless a participating foreign financial institution is required to report you as a United States person holding an account with it.

    For definition of a US person and additional guidance on Part II, see IRS Form W-9 Instructions.

  • Digital Signature of U.S. person. Type your full, legal name with a slash (/) before and after, like this: /John E Doe/
  • The date you are signing this form; NOT your Date of Birth.