The Substitute Form W-9 linked below was developed to comply with Internal Revenue Service (IRS) regulations and Minnesota statutes. Information collected assists Hennepin County in paying providers and vendors for their goods and services and reporting those payments to the IRS when required.

Each of the county's contractors, as a payee, is required by law to provide Hennepin County, as the payer, a correct Taxpayer Identification Number (TIN). A TIN is either a Social Security Number or an Employer Identification Number (EIN).

The information is shared with only the IRS. The Minnesota Government Data Practices Act classifies the Social Security Number as private. Unless otherwise provided by law, the home address is also private.

Use the Contact information if you have any questions.

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Instructions

  1. A new form is required from contractors who have not previously provided one and whenever previously provided contractor information has changed (for example, the taxpayer identification number, business name, tax status, or affirmative action classification). Exceptions: Forms are not required from the State of Minnesota, the University of Minnesota, other counties, or cities.
  2. Hennepin County staff can determine if a contractor has already submitted a form by referring to report RF75AH01, Vendors With Valid W-9 Information.
  3. Page 2 requests affirmative action information which Hennepin County uses internally to monitor and report on participation in county contracting.
  4. Each form must be complete, including the county's contract number and a signature. Note that without a contract number, the county may not be able to match a contractor's Substitute Form W-9 to the county's contract approval documentation; as a result, payments to the contractor may be delayed.
  5. Contractors are to print and complete the form, sign it, and mail, fax, or email a scanned image of it to Hennepin County.
  • Mail to either:
    Hennepin County Accounts Payable
    A1301 Government Center
    Minneapolis, MN 55487-0131
    - OR -
    to the county department that is responsible for the contract (the department must then forward it to General Accounting at mail code 131).
  • Fax to Hennepin County Accounts Payable at 612-348-9991.
  • E-mail using the Contact Information e-mail address provided at right to e-mail a scanned image of the signed form.