Part I: provider identification
The dependent care provider's name, address, city, state and ZIP code, and taxpayer identification number, with a box to check if the number is a social security number.
W-10
Dependent Care Provider's Identification and Certification
- Agency
- IRS
- Revision
- Rev. October 2020
- Fillable fields
- 6
- Pages
- 1
- Official source
- IRS form page
- Checked
- October 21, 2026
Form W-10: Dependent Care Provider's Identification and Certification
Form W-10 is a way to get the correct name, address and taxpayer identification number (TIN) from each person or organization that provides care for your child or other dependent. The IRS page for the form says it may be used if you plan to claim a credit for child and dependent care expenses on Form 1040 or 1040-SR, or you receive benefits under your employer's dependent care plan.
In either case, the instructions say each care provider's correct name, address and TIN are shown on Form 2441, Child and Dependent Care Expenses. Form W-10 is one of the due diligence sources the instructions list for getting that information, along with a copy of the provider's social security card or a recently printed letterhead or invoice.
The care provider completes and signs Part I. The form says "Do NOT file Form W-10 with your tax return. Instead, keep it for your records." You can fill out Form W-10 free in your browser on this page and download the result without an account.
What's on Form W-10
Provider certification and signature
Under penalties of perjury, the provider certifies that the name, address and TIN shown are correct, then signs and dates.
Part II: person requesting the information
Name, street address, apartment number, city, state and ZIP code of the person requesting the Part I information.
Instructions
The purpose of the form, the penalty for failure to furnish a TIN, what happens if incorrect information is reported, the due diligence records, and which TIN each type of provider uses.
How to fill out Form W-10
- 1
Provider name and address
The provider enters its name and address, including number, street, apartment number, city, state and ZIP code.
- 2
Provider TIN
For individuals and sole proprietors the TIN is a social security number (SSN). A nonresident or resident alien who doesn't have and isn't eligible to get an SSN uses an ITIN. Other entities use an employer identification number (EIN).
- 3
SSN box
If the number entered is a social security number, the provider checks the box beside it.
- 4
No TIN yet
The instructions say providers without a TIN should apply for one immediately: Form SS-5 from the Social Security Administration for an SSN, Form W-7 for an ITIN, or Form SS-4 for an EIN.
- 5
Sign and date
The provider signs the certification under penalties of perjury and enters the date.
- 6
Part II
The instructions say to complete Part II only if the form is left with the dependent care provider to return later. The requester's name and address go here.
Why fill Form W-10 on indox
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- The official blank straight from the IRS, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes, penalties and due diligence
Do not file it
The form says not to file Form W-10 with your tax return and to keep it for your records. The provider's details are reported on Form 2441.
Penalty for failure to furnish TIN
Section 6109(a) requires a dependent care provider to give a valid TIN. The instructions say a provider who doesn't give a correct TIN is subject to a penalty for each failure unless due to reasonable cause, except a 501(c)(3) organization.
Incorrect information
The instructions say the credit or the exclusion for employer-provided dependent care benefits isn't allowed if incorrect provider information is reported on Form 2441 and due diligence can't be established to the IRS.
Due diligence records
A properly completed Form W-10, a copy of the provider's social security card, a recently printed letterhead or invoice with the name, address and TIN, or the employer's dependent care plan statement.
If the provider does not comply
The instructions say certain information is still reported on Form 2441, and point to the Instructions for Form 2441 for details.
Related forms
2441
Child and Dependent Care Expenses
72 fields, 2 pages
1040
U.S. Individual Income Tax Return
199 fields, 2 pages
1040-SR
U.S. Income Tax Return for Seniors
200 fields, 4 pages
W-7
Application for IRS Individual Taxpayer Identification Number
69 fields, 1 page
SS-4
Application for Employer Identification Number
89 fields, 2 pages
W-4
Employee's Withholding Certificate
48 fields, 5 pages
Who fills out Form W-10?
The person paying for care asks for it. The care provider completes and signs Part I, and the form goes back to the person who asked.
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Questions about Form W-10
Do I send Form W-10 to the IRS?
No. The form says not to file it with your tax return and to keep it for your records.
Who signs Form W-10?
The dependent care provider signs Part I, certifying under penalties of perjury that its name, address and taxpayer identification number are correct.
Is Form W-10 the only way to get a provider's TIN?
No. The instructions say Form W-10 or any of the other due diligence sources may be used, such as a copy of the provider's social security card or a recently printed letterhead or invoice showing the name, address and TIN.
What does a tax-exempt provider enter for the TIN?
The instructions say a 501(c)(3) organization exempt under section 501(a) isn't required to supply its TIN. It completes the name and address lines and writes "tax-exempt" in the space for the TIN.
What if the provider will not give the information?
The instructions say certain information is still reported on Form 2441, and point to the Instructions for Form 2441 for details.
When is Part II filled in?
The instructions say to complete Part II only if the form is left with the dependent care provider to return later.