Harbor Compliance - EIN Order Form

Contact Information for the IRS

The IRS requires the contact information for a “responsible party”. This person is an owner or manager. For a nonprofit, use the principal officer.
Responsible Party is an:

IndividualEntity
Responsible Party Name*

First NameLast Name
Responsible Party Legal Name
The legal name of the entity serving as responsible party.
Calculated Responsible Party Name
Responsible Party's SSN or ITIN *
Provide the 9-digit Social Security Number (SSN) or Individual Tax Identification Number (ITIN).Your sensitive information is secured.
Responsible Party's EIN *
Provide the 9-digit Employer Identification Number (EIN).Your sensitive information is secured.
Responsible Party's SSN, ITIN, or EIN

Employees
Highest number of AGRICULTURAL employees expected in the next 12 months*
Highest number of HOUSEHOLD employees expected in the next 12 months*
Highest number of OTHER employees expected in the next 12 months*
Total Employees
First date wages or annuities were paid*

MonthDayYear
Enter the date on which the business began to pay wages or annuities. For foreign applicants, this is the date you began to pay wages in the United States.
Do you expect your employment tax liability to be $1,000 or less in a full calendar year? Your employment tax liability will generally be $1,000 or less if you expect to pay $5,000 or less in total wages subject to social security and Medicare taxes and federal income tax withholding.*

NoYes
Because you expect your employment tax liability to be $1,000 or less in a full calendar year, you're eligible to file Form 944 annually (once each year) instead of filing Form 941 quarterly (every 3 months). How do you prefer to file?*

Quarterly (Form 941)Annually (Form 944)
Designee’s name
Designee's Address and ZIP code
Designee’s telephone number (include area code)
Designee’s fax number (include area code)

Your Contact Information
Name*

First NameMiddle NameLast NameSuffix
Title*
Name and title
Email*
Phone Number*
Phone Number Value
Fax Number
Fax Number Value
Please check the box:*

I understand that I am authorizing Harbor Compliance to apply for and receive an EIN on my behalf, and to answer questions from the IRS about completion of the SS-4 application form.
Signature*

Clear
To meet IRS requirements, we must store a copy of the completed IRS Form SS-4 in our files. We will create the form and apply your signature to it, including the section appointing us as a third party designee solely for the purpose of obtaining your EIN.
Date

MonthDayYear
Date
Order Summary
Calculated Total
Total

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Order an Employer Identification Number (EIN)