Toni Prevosti is opening a new business, Prevosti Farms and Sugarhouse, which is a small company that will harvest, refine, and sell maple syrup products. In subsequent chapters, students will have the opportunity to establish payroll records and complete payroll information for Prevosti Farms and Sugarhouse. Toni has decided that she needs to hire employees for the business to grow. Complete the application for Prevosti Farms and Sugarhouse s Employer Identification Number (Form SS-4) with the following information: Prevosti Farms and Sugarhouse is located at 820 Westminster Road, Bridgewater, Vermont, 05520 (which is also Ms. Prevosti s home address), phone number 802-555-3456. Bridgewater is in Windsor County. Toni, the responsible party for a Limited Liability Company with one member, has decided that Prevosti Farms and Sugarhouse, will pay its employees on a biweekly basis. Toni s Social Security number is 055-22-0443. The beginning date of the business is February 1, 20XX. Prevosti Farms and Sugarhouse will use a calendar year as its accounting year. Toni anticipates that she will need to hire six employees initially for the business, three of whom will be agricultural and three who will be office workers. The first date of wage disbursement will be February 13, 20XX. Toni has not had a prior EIN. Required: Form SS-4 (Rev. December 2017) Department of the Treasury Internal Revenue Service Type or print clearly. Application for Employer Identification Number (For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others.) Keep a copy for your records. See separate instructions for each line. 1 Legal name of entity (or individual) for whom the EIN is being requested Toni Prevosti 2 Trade name of business (if different from name on line 1) *************** Prevosti Farms and Sugarhouse 4a Mailing address (room, apt., suite no. and street, or P.O. box) 4b City, state, and ZIP code (if foreign, see instructions) :6 County and state where principal business is located 7a Name of responsible party 8a Is this application for a limited liability company (LLC) (or a foreign equivalent)? O O 8c If 8a is Yes, was the LLC organized in the United States? 9a Type of entity (check only one box). Caution. If 8a is Yes, see the instructions for the correct box to check. Sole proprietor (SSN) Partnership Corporation (enter form number to be filed) Personal service corporation Church or church-controlled organization Yes No 3 5b EIN 5a Street address (if different) (Do not enter a P.O. box.) Executor, administrator, trustee, care of name 7b SSN, ITIN, or EIN Estate (SSN of decedent) Plan administrator (TIN) Trust (TIN of grantor) National Guard Farmers cooperative OMB No. 1545-0003 City, state, and ZIP code (if foreign, see instructions) 8b If 8a is Yes, enter the number of LLC members... 2 Yes L State/local government Federal government/military No Oother nonprofit organization (specify) Other (specify) 9b If a corporation, name the state or foreign country (if applicable) where incorporated 10 Reason for applying (check only one box) Started new business (specify type) Hired employees (Check the box and see line 13.) Compliance with IRS withholding regulations Other (specify) 11 Date business started or acquired (month, day, year). See instructions. 13 Highest number of employees expected in the next 12 months (enter -0- if none). If no employees expected, skip line 14. Agricultural Household OREMIC Group Exemption Number (GEN) if any State 18 Has the applicant entity shown on line 1 ever applied for and received an EIN? Banking purpose (specify purpose) Changed type of organization (specify new type) Purchased going business Created a trust (specify type) Created a pension plan (specify type) Other 15 First date wages or annuities were paid (month, day, year). Note. If applicant is a withholding agent, enter date income will first be paid to nonresident alien (month, day, year) 16 Check one box that best describes the principal activity of your business. Construction Rental & leasing Manufacturing Transportation & warehousing Finance & insurance Real estate 17 Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided. Health care & social assistance Accommodation & food service Other (specify) OIndian tribal governments/enterprises Foreign country 12 Closing month of accounting year 14 If you expect your employment tax liability to be $1,000 or less in full calendar year and want to file Form 944 annually instead of Forms 941 quarterly, check here. (Your employment tax liability generally will be $1,00 or less if you expect to pay $4,000 or less in total wages.) If you do not che this box, you must file Form 941 for every quarter. Wholesale-agent/broker Wholesale-other Yes Retail No 18 Has the applicant entity shown on line 1 ever applied for and received an EIN? O If Yes , write previous EIN here Complete this section only if you want to authorize the named individual to receive the entity s EIN and answer questions about the completion of this form. Designee s name Designee s telephone number (include area code) Third Party Designee Address and ZIP code Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete. Name and title (type or print clearly) Date O 02/01/20XX Yes No Designee s fax number (include area code) Signature Toni Prevosti Cat. No. 16055N Form SS-4 (Rev. 12-2017) For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. THIS FORM IS A SIMULATION OF AN OFFICIAL U.S. TAX FORM. IT IS NOT THE OFFICIAL FORM ITSELF. DO NOT USE THIS FORM FOR TAX FILINGS OR FOR ANY PURPOSE OTHER THAN EDUCATIONAL, 2020 McGraw-Hill Education. Applicant s telephone number (include area code) Applicant s fax number (include area code)