Subcontractor Information Form

Scott's Concrete Pumping — Please complete this form so we can keep your information on file for 1099 purposes. Takes about 5 minutes.

Are you an Individual or a Business?

👤 Individual / Sole Proprietor

🏢 Business / Company

Name & Contact

Legal Name (as shown on your tax return) *

Business Name / DBA (if different from legal name)

Federal Tax Classification *

Phone *

Email *

Address

Street Address *

Suite / Apt / Unit

City *

State *

ZIP *

Taxpayer Identification Number

🔒 Your TIN is encrypted at rest and only accessible to the payroll administrator. It is used solely for IRS 1099-NEC filing.

TIN Type *

TIN *

Certification & E-Signature

Under penalties of perjury, I certify that: (1) The number shown on this form is my correct taxpayer identification number, (2) I am not subject to backup withholding, and (3) I am a U.S. citizen or other U.S. person.

Type your full legal name as your electronic signature *

Signed electronically on October 14, 2026

Subcontractor Information Form