SECTION 4. FORMAT FOR

MAKING THE REQUIRED CERTIFICATIONS

.01 Required certifications clearly set forth . For a payor to be treated as having provided a taxpayer with a valid substitute Form W–9, the required certifications must be clearly set forth. The Service will treat the required certifications as being clearly set forth only if they meet the provisions of section 4.02 or 4.03 of this revenue procedure.

.02 Separate signature for required certifications . A substitute Form W–9 is valid if a separate signature line is provided just for the required certifications.

.03 Single signature for required certifications and other provisions . A substitute Form W–9 is valid if:

(1) a single signature line is provided for the required certifications as well as other provisions unrelated to the required certifications;

(2) the language of the required certifications is highlighted, boxed, printed in bold-face type, or presented in some other manner that distinguishes and causes the language to stand out from all other information contained on the substitute Form W–9; and

(3) the following statement is provided in the same manner prescribed in section 4.03(2) and appears immediately above the single signature line on the substitute Form W–9: ‘‘The

Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.’’