Complete Form SS-4 for TCLH Industries. The company was formed on December 1, 2019, as a corporation (which files Form 1120S and was incorporated in North Carolina) by Michael Sierra (CEO; SSN 232- 32-3232) and David Alexander (President; SSN 454-54-5454). Day-to-day operations, such as the filing and signing of federal and state forms, are handled by the CEO, whose phone number and fax number are 919-555-7485 and 919-555-2000, respectively. The company is located at 202 Whitmore Avenue, Durham, NC 27701 (in Durham county), where it receives all mail. The company uses the calendar year as its fiscal year, and expects to employ four individuals (earning an expected average of $90,000/year) throughout the first 18 months of operations. Payroll is to be paid weekly on Thursdays, with the first pay date scheduled for Thursday, December 19, 2019 (for the one-week period ending the prior Sunday). The company does not assign a third-party designee. Notes: The type of business should be entered as "Cleaning Product Manufacturer" and the principal line of products produced should be entered as "Manufacturing of Household Cleaning Products." . Open Directions in Popup Window Form SS-4 (Rev. December 20XX) Department of the Treasury Internal Revenue Service Type or print clearly. 8a 8c 9a 1 2 4a 4b 6 Application for Employer Identification Number (For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others.) Go to www.irs.gov/FormSS4 for instructions and the latest information. See separate instructions for each line. Keep a copy for your records. Legal name of entity (or individual) for whom the EIN is being requested Trade name of business (if different from name on line 1) Mailing address (room, apt., suite no. and street, or P.O. box) City, state, and ZIP code (if foreign, see instructions) County and state where principal business is located 7a Name of responsible party Is this application for a limited liability company (LLC) (or a foreign equivalent)? If 8a is "Yes," was the LLC organized in the United States? Yes Partnership Corporation (enter form number to be filed) 3 5a 5b No Executor, administrator, trustee, "care of name Street address (if different) (Do not enter a P.O. box.) 7b EIN City, state, and ZIP code (if foreign, see instructions) 8b OMB No. 1545-0003 SSN, ITIN, or EIN Type of entity (check only one box). Caution. If 8a is "Yes," see the instructions for the correct box to check. Sole proprietor (SSN) Estate (SSN of decedent) Plan administrator (TIN) Trust (TIN of grantor) If 8a is "Yes," enter the number of LLC members Yes No 9b 10 11 13 15 16 17 18 Corporation (enter form number to be filed) Personal service corporation Church or church-controlled organization Other nonprofit organization (specify) Other (specify) If a corporation, name the state or foreign country (if State applicable) where incorporated 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) Date business started or acquired (month, day, year). See instructions. MM/DD/YYYY If no employees expected, skip line 14. Agricultural Household Highest number of employees expected in the next 12 months (enter -0- if none). Other Third Party Designee Trust (TIN of grantor) National Guard Farmers' cooperative REMIC Group Exemption Number (GEN) if any Foreign country 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) Has the applicant entity shown on line 1 ever applied for and received an EIN? If "Yes," write previous EIN here Address and ZIP code 12 14 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) MM/DD/YYYY Check one box that best describes the principal activity of your business. Transportation & warehousing Finance & insurance Construction Rental & leasing Manufacturing Real estate Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided. Closing month of accounting year If you expect your employment tax liability to be $1,000 or less in a full calendar year and want to file Form 944 annually instead of Forms 941 quarterly, check here. (Your employment tax liability generally will be $1,000 or less if you expect to pay $4,000 or less in total wages.) If you do not check this box, you must file Form 941 for every quarter. State/local government Federal government/military Indian tribal governments/enterprises Michael Sierra Signature Date 12/01/2019 For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Health care & social assistance Accommodation & food service Other (specify) Yes 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) No 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 ( Wholesale-agent/broker Wholesale-other Retail Designee's telephone number (include area code) (_) Designee's fax number (include area code) ) Applicant's telephone number (include area code) Applicant's fax number (include area code) ( Cat No 16055N Form SS-4 (Rev. 1-20XX)