Grant Application 2010 - BMI.com

320 W. 57 th StreetNew York, NY 10019Grant Application 2010Name of organization:____________________________________________________________________(please give exact name as listed on your most recent IRS 990 Form)Address:_______________________________________________________________________________Tax identification number: _____________________________Telephone: ___________________________ E-mail:_____________________________By checking this box, you confirm that the organization listed above is designated as a501(c)3 by the Internal Revenue Service. All applications must have this confirmation.Describe the work of your organization giving specific details of your involvement with contemporarycomposers and contemporary music. If your organization presents performances, attach a separate listor concert programs showing all repertoire for the most recent season.Amount of grant requested: ______________Name of individual who will be your liaison to the Foundation: ___________________________________________________________________________ _________ _____________________ ______________(signature) (title) (date)THE FOLLOWING MUST BE ATTACHED TO THE APPLICATION:copy of your budget for the current year and the forthcoming year (If applying for a special project,attach a budget for the project also).a fully completed W-9 Formlist of repertoire or concert programs for the most current season (required only if you presentconcerts).Applications received without this information will not be considered. 11/0 8

Form W-9 Request for Taxpayer(Rev. December 2000)Identification Number and CertificationDepartment of the TreasuryInternal Revenue ServiceName (See Specific Instructions on page 2.)Give form to therequester. Do notsend to the IRS.Please print or typeBusiness name, if different from above. (See Specific Instructions on page 2.)Check appropriate box: Individual/Sole proprietor Corporation Partnership Other Address (number, street, and apt. or suite no.)Requester’s name and address (optional)City, state, and ZIP codePart I Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. Forindividuals, this is your social security numberSocial security number(SSN). However, for a resident alien, soleproprietor, or disregarded entity, see the Part I– –instructions on page 2. For other entities, it is youremployer identification number (EIN). If you do notorhave a number, see How to get a TIN on page 2.Employer identification numberNote: If the account is in more than one name, seethe chart on page 2 for guidelines on whose number –to enter.Part III CertificationList account number(s) here (optional)For U.S. Payees Exempt FromBackup Withholding (See theinstructions on page 2.)Under penalties of perjury, I certify that:1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the InternalRevenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS hasnotified me that I am no longer subject to backup withholding, and3. I am a U.S. person (including a U.S. resident alien).Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backupwithholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirementarrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you mustprovide your correct TIN. (See the instructions on page 2.)SignHereSignature ofU.S. person Purpose of FormA person who is required to file an informationreturn with the IRS must get your correcttaxpayer identification number (TIN) to report, forexample, income paid to you, real estatetransactions, mortgage interest you paid,acquisition or abandonment of secured property,cancellation of debt, or contributions you madeto an IRA.Use Form W-9 only if you are a U.S. person(including a resident alien), to give your correctTIN to the person requesting it (the requester)and, when applicable, to:1. Certify the TIN you are giving is correct (oryou are waiting for a number to be issued),2. Certify you are not subject to backupwithholding, or3. Claim exemption from backup withholding ifyou are a U.S. exempt payee.If you are a foreign person, use theappropriate Form W-8. See Pub. 515,Withholding of Tax on Nonresident Aliens andForeign Corporations.Note: If a requester gives you a form other thanForm W-9 to request your TIN, you must use therequester’s form if it is substantially similar to thisForm W-9.What is backup withholding? Persons makingcertain payments to you must withhold and payto the IRS 31% of such payments under certainconditions. This is called “backup withholding.”Payments that may be subject to backupwithholding include interest, dividends, brokerand barter exchange transactions, rents,royalties, nonemployee pay, and certainpayments from fishing boat operators. Realestate transactions are not subject to backupwithholding.If you give the requester your correct TIN,make the proper certifications, and report allyour taxable interest and dividends on your taxreturn, payments you receive will not be subjectto backup withholding. Payments you receivewill be subject to backup withholding if:1. You do not furnish your TIN to therequester, or2. You do not certify your TIN when required(see the Part III instructions on page 2 fordetails), or3. The IRS tells the requester that youfurnished an incorrect TIN, or4. The IRS tells you that you are subject tobackup withholding because you did not reportall your interest and dividends on your tax return(for reportable interest and dividends only), orPart IIDate 5. You do not certify to the requester that youare not subject to backup withholding under 4above (for reportable interest and dividendaccounts opened after 1983 only).Certain payees and payments are exemptfrom backup withholding. See the Part IIinstructions and the separate Instructions forthe Requester of Form W-9.PenaltiesFailure to furnish TIN. If you fail to furnish yourcorrect TIN to a requester, you are subject to apenalty of $50 for each such failure unless yourfailure is due to reasonable cause and not towillful neglect.Civil penalty for false information with respectto withholding. If you make a false statementwith no reasonable basis that results in nobackup withholding, you are subject to a $500penalty.Criminal penalty for falsifying information.Willfully falsifying certifications or affirmationsmay subject you to criminal penalties includingfines and/or imprisonment.Misuse of TINs. If the requester discloses oruses TINs in violation of Federal law, therequester may be subject to civil and criminalpenalties.Cat. No. 10231XForm W-9 (Rev. 12-2000)

Form W-9 (Rev. 12-2000) Page 2Specific InstructionsName. If you are an individual, you mustgenerally enter the name shown on your socialsecurity card. However, if you have changedyour last name, for instance, due to marriagewithout informing the Social SecurityAdministration of the name change, enter yourfirst name, the last name shown on your socialsecurity card, and your new last name.If the account is in joint names, list first andthen circle the name of the person or entitywhose number you enter in Part I of the form.Sole proprietor. Enter your individual nameas shown on your social security card on the“Name” line. You may enter your business,trade, or “doing business as (DBA)” name on the“Business name” line.Limited liability company (LLC). If you are asingle-member LLC (including a foreign LLC witha domestic owner) that is disregarded as anentity separate from its owner under Treasuryregulations section 301.7701-3, enter theowner’s name on the “Name” line. Enter theLLC’s name on the “Business name” line.Caution: A disregarded domestic entity that hasa foreign owner must use the appropriateForm W-8.Other entities. Enter your business name asshown on required Federal tax documents onthe “Name” line. This name should match thename shown on the charter or other legaldocument creating the entity. You may enter anybusiness, trade, or DBA name on the “Businessname” line.Part I—Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box.If you are a resident alien and you do nothave and are not eligible to get an SSN, yourTIN is your IRS individual taxpayer identificationnumber (ITIN). Enter it in the social securitynumber box. If you do not have an ITIN, seeHow to get a TIN below.If you are a sole proprietor and you have anEIN, you may enter either your SSN or EIN.However, the IRS prefers that you use your SSN.If you are an LLC that is disregarded as anentity separate from its owner (see Limitedliability company (LLC) above), and are ownedby an individual, enter your SSN (or “pre-LLC”EIN, if desired). If the owner of a disregardedLLC is a corporation, partnership, etc., enter theowner’s EIN.Note: See the chart on this page for furtherclarification of name and TIN combinations.How to get a TIN. If you do not have a TIN,apply for one immediately. To apply for an SSN,get Form SS-5, Application for a Social SecurityCard, from your local Social SecurityAdministration office. Get Form W-7, Applicationfor IRS Individual Taxpayer IdentificationNumber, to apply for an ITIN or Form SS-4,Application for Employer Identification Number,to apply for an EIN. You can get Forms W-7 andSS-4 from the IRS by calling 1-800-TAX-FORM(1-800-829-3676) or from the IRS’s Internet WebSite at www.irs.gov.If you do not have a TIN, write “Applied For”in the space for the TIN, sign and date the form,and give it to the requester. For interest anddividend payments, and certain payments madewith respect to readily tradable instruments,generally you will have 60 days to get a TIN andgive it to the requester before you are subject tobackup withholding on payments. The 60-dayrule does not apply to other types of payments.You will be subject to backup withholding on allsuch payments until you provide your TIN to therequester.Note: Writing “Applied For” means that you havealready applied for a TIN or that you intend toapply for one soon.Part II—For U.S. Payees Exempt From BackupWithholdingIndividuals (including sole proprietors) are notexempt from backup withholding. Corporationsare exempt from backup withholding for certainpayments, such as interest and dividends. Formore information on exempt payees, see theseparate Instructions for the Requester ofForm W-9.If you are exempt from backup withholding,you should still complete this form to avoidpossible erroneous backup withholding. Enteryour correct TIN in Part I, write “Exempt” inPart II, and sign and date the form.If you are a nonresident alien or a foreignentity not subject to backup withholding, givethe requester the appropriate completed FormW-8.Part III—CertificationTo establish to the withholding agent that youare a U.S. person, or resident alien, sign FormW-9. You may be requested to sign by thewithholding agent even if items 1, 3, and 5below indicate otherwise.For a joint account, only the person whoseTIN is shown in Part I should sign (whenrequired).1. Interest, dividend, and barter exchangeaccounts opened before 1984 and brokeraccounts considered active during 1983. Youmust give your correct TIN, but you do not haveto sign the certification.2. Interest, dividend, broker, and barterexchange accounts opened after 1983 andbroker accounts considered inactive during1983. You must sign the certification or backupwithholding will apply. If you are subject tobackup withholding and you are merely providingyour correct TIN to the requester, you mustcross out item 2 in the certification beforesigning the form.3. Real estate transactions. You must signthe certification. You may cross out item 2 of thecertification.4. Other payments. You must give yourcorrect TIN, but you do not have to sign thecertification unless you have been notified thatyou have previously given an incorrect TIN.“Other payments” include payments made in thecourse of the requester’s trade or business forrents, royalties, goods (other than bills formerchandise), medical and health care services(including payments to corporations), paymentsto a nonemployee for services, payments tocertain fishing boat crew members andfishermen, and gross proceeds paid to attorneys(including payments to corporations).5. Mortgage interest paid by you,acquisition or abandonment of securedproperty, cancellation of debt, qualified statetuition program payments, IRA or MSAcontributions or distributions, and pensiondistributions. You must give your correct TIN,but you do not have to sign the certification.Privacy Act NoticeSection 6109 of the Internal Revenue Coderequires you to give your correct TIN to personswho must file information returns with the IRS toreport interest, dividends, and certain otherincome paid to you, mortgage interest you paid,the acquisition or abandonment of securedproperty, cancellation of debt, or contributionsyou made to an IRA or MSA. The IRS uses thenumbers for identification purposes and to helpverify the accuracy of your tax return. The IRSmay also provide this information to theDepartment of Justice for civil and criminallitigation, and to cities, states, and the District ofColumbia to carry out their tax laws.You must provide your TIN whether or not youare required to file a tax return. Payers mustgenerally withhold 31% of taxable interest,dividend, and certain other payments to a payeewho does not give a TIN to a payer. Certainpenalties may also apply.What Name and Number ToGive the RequesterFor this type of account:1. Individual2. Two or moreindividuals (jointaccount)3. Custodian account ofa minor (Uniform Giftto Minors Act)4. a. The usualrevocable savingstrust (grantor isalso trustee)b. So-called trustaccount that is nota legal or valid trustunder state law5. Sole proprietorshipFor this type of account:Give name and SSN of:The individualThe actual owner of theaccount or, if combinedfunds, the first individualon the account 1The minor 2The grantor-trustee 1The actual owner 1The owner 3Give name and EIN of:6.7.Sole proprietorshipA valid trust, estate, orpension trustThe owner 3Legal entity 48. CorporateThe corporation9. Association, club, The organizationreligious, charitable,educational, or othertax-exemptorganization10. PartnershipThe partnership11. A broker or registered The broker or nomineenominee12. Account with the The public entityDepartment ofAgriculture in the nameof a public entity (suchas a state or localgovernment, schooldistrict, or prison) thatreceives agriculturalprogram payments1List first and circle the name of the person whosenumber you furnish. If only one person on a jointaccount has an SSN, that person’s number must befurnished.2Circle the minor’s name and furnish the minor’s SSN.3You must show your individual name, but you may alsoenter your business or “DBA” name. You may use eitheryour SSN or EIN (if you have one).4List first and circle the name of the legal trust, estate,or pension trust. (Do not furnish the TIN of the personalrepresentative or trustee unless the legal entity itself isnot designated in the account title.)Note: If no name is circled when more than onename is listed, the number will be considered tobe that of the first name listed.