Practice Set 1A Exercise 3 Completed 2 Out of 6 CALENDAR CALCULATOR CHECK MY WORK SAVE ASSIGNMENT BACK TO ASSIGNMENTS Open Directions in Popup Window Form SS-4 (Rev. December 20XX) Department of the Treasury Internal Revenue Service Go to www.irs.gov/FormSS4 for instructions and the latest information. See separate instructions for each line. Keep a copy for your records. Application for Employer Identification Number (For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, Indian tribal entities, certain individuals, and others.) Legal name of entity (or individual) for whom the EIN is being requested Adam Spruce Trade name of business (if different from name on line 1) Adam's Diner Executor, administrator, trustee, “care of” name Mailing address (room, apt., suite no. and street, or P.O. box) 95 Main Street Street address (if different) (Do not enter a P.O. box.) City, state, and ZIP code (if foreign, see instructions) Atlanta, GA 30311 City, state, and ZIP code (if foreign, see instructions) SSN, ITIN, or EIN 777-77-7777 9a Type of entity (check only one box). Caution. If 8a is "Yes," see the instructions for the correct box to check. PSa 1-4 Complete Form SS-4 Complete Form SS-4 for a newly formed company. Adam’s Diner is a new eatery that was formed as a sole proprietorship by its owner, Adam Spruce (SSN 777-77-7777), on January 18, 2021, and serves only locally sourced foods. As a result of having started a new business, the company files Form SS-4 so that it may begin distributing payroll checks as of January 22, 2021. The diner is located at 95 Main Street, Atlanta, GA 30311 (it is in Fulton county and is the only address associated with the business), and both its telephone and fax number are 478-555-8129. The company uses the calendar year as its fiscal year, and expects to employ four people (earning an average of $19,900/year) throughout the first 12 months of operations. Payroll is to be paid weekly on Fridays, with the first pay date scheduled for Friday, January 22, 2021. Form SS-4 is completed on the date of formation of the company. The company does not assign a third-party designee. Notes: • The type of business should be entered as "Small Eatery" and the principal line of products produced should be entered as "Diner food sold in small eatery". OMB No. 1545-0003 EIN 1 2 3 4a 5a 4b 5b 6 County and state where principal business is located Fulton County, GA 7a Name of responsible party Adam Spruce 7b 8a Is this application for a limited liability company (LLC) (or a foreign equivalent)? . . . . . . . . . . Yes No 8b If 8a is “Yes,” enter the number of LLC members . . . . . 8c If 8a is “Yes,” was the LLC organized in the United States? . . . . . . . . . . . . . . . . . . . . . . . Yes No Student: eLab https://lti.labyrinthelab.com/user_hw_assigmnent_questions.php?q=V... 1 of 3 8/28/2022, 8:18 PM Sole proprietor (SSN) Corporation (enter form number to be filed) Other nonprofit organization (specify) Estate (SSN of decedent) Plan administrator (TIN) Trust (TIN of grantor) Group Exemption Number (GEN) if any 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) Banking purpose (specify purpose) Changed type of organization (specify new type) Created a trust (specify type) Created a pension plan (specify type) 17 Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided. Diner food sold in small eatery 18 Has the applicant entity shown on line 1 ever applied for and received an EIN? If “Yes,” write previous EIN here Third Party Designee Designee's telephone number (include area code) ( ___ ) Des
