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If you fail to furnish your taxpayer identification number or social security number or if you provide an invalid number IRS law requires that we withhold taxes totaling 28 of all payments we make to you. SECTION A Remittance Address for Payments to You Individual or Company Name Address City State Contact Name Zip Code County Phone No Fax No Email address SECTION B Purchase Order Information NOT APPLICABLE FOR HEALTHCARE PROVIDERS SECTION C Identifying Number for the IRS Taxpayer...
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