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PATH E N TME D I C A LHI S T O Date Patients Name Date of Birth Age Referring Physician Primary Care Physician Reason for today's visit P LEASE C HECK A LL T HAT A APPLY No Pertinent Past Medical

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What is i e n t?

i e n t stands for Individual Taxpayer Identification Number.

Who is required to file i e n t?

Non-U.S. residents and individuals who are not eligible for a Social Security Number but have a U.S. tax filing requirement.

How to fill out i e n t?

You can fill out Form W-7 and submit it along with required documentation to the Internal Revenue Service.

What is the purpose of i e n t?

The purpose of i e n t is to provide individuals without Social Security Numbers a way to meet their tax filing requirements.

What information must be reported on i e n t?

Personal information such as name, date of birth, and foreign status, along with supporting documentation to verify identity and foreign status.

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