APPLICATION
for Employer Identification Number in the USA, Form SS-4
1. The full name of the company
2.  
3.  
4.  
5. _________________________________________________________________ 
2. Does the trade name differ from that stated above in paragraph 1:
Yes__________No___________
If Yes, please specify your trade name:
_______________________________________________________
_______________________________________________________
_______________________________________________________ 
3. If you do not use our office services, please specify:
3a. P.O. Box, street, house and suite number in the USA
_______________________________________________________
_______________________________________________________
_______________________________________________________ 
3b. City, state and zip code in the USA 
_______________________________________________________
_______________________________________ 
4. If you do not use our office services, please specify:
4a. Street, house and suite number 
_______________________________________________________
______________________________________
4b. City, country, zip code
_______________________________________________________
_____________________________________ 
If you have no address in the USA we can offer you the following options:
a. postal services: USD 400 p.a.
b. the services of mail, telephone, fax (reception and transmission): USD 600 p.a.
c. the plan to purchase transactions management center: USD 1,800 p.a.
(further information is made available upon additional request)
5. If you do not use our office services, please specify:
The district and state where the principal business is located: _________________ 
 
 
 
 _____________________________________________________________________ 
 
6. Please state the full name, surname and the patronymic of the officer, partner 
7.  
8.  
9.  
10.  or owner, his/her social security number: ________________________________
11. _______________________ 
ATTENTION: if this person lives in any other country and has no social security 
 
number, please send us:
#1 - a copy of his/her passport
#2 - the letter of the letterhead of your company containing the following:
[Quote]
Date
____________ 
____________ 
 
Dear Sirs,
Please find enclosed the copy of my passport as an attachment to the application for taxpayer ID.
 
 Pursuant to paragraph 7, the social security number cannot be supplied because the person in 
 
question is neither resident or inhabitant of the USA.
Sincerely,
(signature)
(name, surname)
(position)
[Unquote]
7. The planned date of the commencement of business
________________________________________________________________
______________________________
8. The final month of the company’s fiscal year
_________________________________________________________________
_____________________________ 
usually December, but may be any other month.
9. Will you employ hired staff within the next 12 calendar months?
Yes____________No_____________
If Yes, please state the month, day and year salaries start to be paid:
________________________________________________________________
______________________________ 
If Yes, please specify the largest number of employees proposed for the next 
 
12 months and areas in which they have been previously employed:
 
1. agriculture ______________________________________________________________
2. ___________________ 
 
3. had no relation to the agriculture ___________________________________________ 
 
4. had no previous employment_____________________________________________
Please specify in detail the objects of the company’s business (imports/exports, 
 
trade in real estate, etc.)
_________________________________________________________________
_________________________________________________________________
__________________________________________________________
Is your business associated with manufacturing?
Yes_____________No______________
If Yes, please specify the principal products and raw materials:
__________________________________________________________________
__________________________________________________________________
________________________________________________________ 
13. Will products or services be sold?
WholesaleRetailOther 
Will not be sold_______________________________________________________________
__________________
14a. Have you applied for the EID earlier?
Yes_______________No_______________
14b. If Yes, please state your permanent name: _____________________________ 
trade name ___________________________________________________________ 
14c. The name and position (i.e. owner, president, vice-president, etc.) of the person 
 
signing this application
___________________________________________________________________
___________________________________________________________________
______________________________________________________
If you do not use office services we offer, please specify the contact telephone number in
 
 case the Internal Revenue Service will need additional information in connection with your
 
 application: ________________________________________ 
Please note that the following documents should be attached to this application:
1. A signed copy of Form SS-4.
2. The application to obtain the taxpayer ID code.
3. A copy of the passport.
4. The letter to the Internal Revenue Service.
___________________________
(signature, date)