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ITIN›Acceptance Agents’ Guide for Individual Taxpayer Identification Number

Exhibit E Sample Letter from Withholding Agent

0125 Publ 4520 (PDF) · 2026-10-03 edition · updated 2026-10-04 · United States

(To Be Used as a Guide for Providing Required Information)

(Written on Official Letterhead of Withholding Agent)

TO: IRS

ITIN POLICY SECTION

To Whom it May Concern:

This is to certify that _________________________________________________

Name of Account Holder

has an account with this organization which will be generating income during the current tax year that is subject to IRS information reporting requirements and/or withholding of Federal income tax. The applicant, therefore, is requesting an ITIN to provide to us for our IRS reporting, withholding and distribution procedures.

Sincerely,


Date of Signature Signature of Official


Printed Name of Official

44 Acceptance Agents Guide

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