Chapter Non-Employee Compensation Form


This information is required by the IRS, even if your chapter paid $0 to non-employees, for the calendar year that ends on December 31 — and must be submitted online by December 31. Most chapters do not incur this type of expenditure in December; therefore, are encouraged to submit the form after their last event for the calendar year. It is important for chapters to collect W9 Forms from speakers, etc., throughout the year and save them in order to complete the Non-Employee Compensation Form at the end of the year.

If you have more than 5 payments, additional forms should be submitted. You will receive a confirmation number for each submitted form. Review the FAQs to ensure you report everything needed.

Non-Employee Compensation Forms will be processed each year starting the first week of December.

Please Note: Be sure your internet browser is either Internet Explorer (version 9 or 10), or Firefox. Browsers that will not work are Google Chrome, Safari, and Internet Explorer 11. If using Internet Explorer, version 9 or 10, turn on "Compatibility View" on the browser.


Chapter Information:

Chapter Name: *
(Please spell out the full chapter name)
Chapter Financial Code: *
(4-digit number that begins with 4_ _ _)
Has your chapter made payments for services in the calendar year ending 12/31?: *
If no, skip the payment section and proceed to the bottom of the form.

1st Payment

Name:
Address:
City:
State:
Zip:
Social Security # or Federal ID #:
Service Provided:
Date Service Provided:
(mm/dd/yyyy)
Total Amount of Payment:
(Not including travel, hotel or meal expenses)

2nd Payment

Name 2:
Address 2:
City 2:
State 2:
Zip 2:
Social Security # or Federal ID # 2:
Service Provided 2:
Date Service Provided 2:
(mm/dd/yyyy)
Total Amount of Payment 2:
(Not including travel, hotel or meal expenses)

3rd Payment

Name 3:
Address 3:
City 3:
State 3:
Zip 3:
Social Security # or Federal ID # 3:
Service Provided 3:
Date Service Provided 3:
(mm/dd/yyyy)
Total Amount of Payment 3:
(Not including travel, hotel or meal expenses)

4th Payment

Name 4:
Address 4:
City 4:
State 4:
Zip 4:
Social Security # or Federal ID # 4:
Service Provided 4:
Date Service Provided 4:
(mm/dd/yyyy)
Total Amount of Payment 4:
(Not including travel, hotel or meal expenses)

5th Payment

Name 5:
Address 5:
City 5:
State 5:
Zip 5:
Social Security # or Federal ID # 5:
Service Provided 5:
Date Service Provided 5:
(mm/dd/yyyy)
Total Amount of Payment 5:
(Not including travel, hotel or meal expenses)

6th Payment

Name 6:
Address 6:
City 6:
State 6:
Zip 6:
Social Security # or Federal ID # 6:
Service Provided 6:
Date Service Provided 6:
(mm/dd/yyyy)
Total Amount of Payment 6:
(Not including travel, hotel or meal expenses)

7th Payment

Name 7:
Address 7:
City 7:
State 7:
Zip 7:
Social Security # or Federal ID # 7:
Service Provided 7:
Date Service Provided 7:
(mm/dd/yyyy)
Total Amount of Payment 7:
(Not including travel, hotel or meal expenses)

8th Payment

Name 8:
Address 8:
City 8:
State 8:
Zip 8:
Social Security # or Federal ID # 8:
Service Provided 8:
Date Service Provided 8:
(mm/dd/yyyy)
Total Amount of Payment 8:
(Not including travel, hotel or meal expenses)

9th Payment

Name 9:
Address 9:
City 9:
State 9:
Zip 9:
Social Security # or Federal ID # 9:
Service Provided 9:
Date Service Provided 9:
(mm/dd/yyyy)
Total Amount of Payment 9:
(Not including travel, hotel or meal expenses)

10th Payment

Name 10:
Address 10:
City 10:
State 10:
Zip 10:
Social Security # or Federal ID # 10:
Service Provided 10:
Date Service Provided 10:
(mm/dd/yyyy)
Total Amount of Payment 10:
(Not including travel, hotel or meal expenses)

Further Requests and Comments

Comments:
Your Name: *
Your Email: *
Your Phone Number:
(999-999-9999)

 

 

 

Revised 12/12/14

Submit
Your Feedback