W9 Exemption Form
if payee is not receiving payment for a 1099 trackable item please complete the following form, submit a signed copy and turn in to the business office. Once approved a new payee to be added to our system in a timely manner.
Please complete the following payee details in full:
Name
First Name Last Name
Address
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code
Please select one of the following options:
Payee is an employee, and payment is strictly for personal reimbursement Payee is a volunteer, and payment is strictly for personal reimbursement Payee is receiving benevolent funds for basic needs, and this gift is not taxable Other
Please specifiy:
Requested by: First Name Last Name Date
Approved by: First Name Last Name Date
Should be Empty:

W9 Exemption Form