SAMPLE CERTIFICATION FOR CHANGE TO FIRM TAX IDENTIFICATION NUMBER*
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Please follow the sample below, date and sign, and submit along with an IRS W-9 Form to the Administrative Office of the Courts at the address below with a courtesy copy to CCAP.
I certify (or declare) that all payments awarded by the court to [name of counsel] for services performed and expenses incurred while under appointment of the court are the income of the firm and are not the income of the individual attorney. As such, for tax purposes, the income may be reported under employer identification number [EIN] of the firm which is [insert firm's EIN]. This firm is [incorporated / unincorporated]. The effective date is [insert date]. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
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Return completed declarations and an IRS W-9 Form to:
Dora E. Acosta, Staff Accountant
Financial Division – Accounting Unit
Judicial Council of California
Accounting Office, 7th Floor
455 Golden Gate Avenue
San Francisco, CA. 94102-3660
cc: CCAP
2407 J Street, Suite 301
Sacramento, CA 95816
* The tax ID number is the number under which a person is paid, and it is the number for tax reporting purposes. For the self-employed who are not corporations, the Social Security Number (SSN) is used as the tax ID. For those working for and receiving payment through a corporation that has a Federal Tax ID number, that number is used as the individual's tax ID rather than the person's Social Security Number.