Please complete all of the information below for the company requesting the W-9 form/FEIN. Failure to complete all
of the information below could result in a delay. Email completed form to 1099report@wal-mart.com or FAX the
form to: 866-635-3885.
*W-9s for credit card payments cannot be obtained through this method. Please see details below this chart if your request is
regarding a Walmart or Sam’s Club Credit Card.
Answer
Do you need a W-9 or FEIN?
Company's Name (Who will be
getting the W-9?):
Company's Address:
Company's City:
Company's State:
Company's Zip:
Company's Contact Name:
Company's Contact Number:
Company's Email Address:
Company's Fax Number:
Is it for a Walmart Store/Sam's
Club, DC or other?
OR Which W-9 is needed (if you
know)?
Walmart Store/Sam’s Club
Number:
Walmart Store/Sam’s Club
Location:
Reason for Request
(Please be very specific and
detailed in your response. Failure to
provide enough detail may result in
a delay or denial of the request.)
Note: Once a properly completed form has been submitted, please allow up to 2 weeks to receive it, due to the
volume of requests.
For Walmart or Sam’s Clubs Credit Cards:
 Walmart Credit Card:
 Sam’s Club MasterCard:
 Sam’s Club Private Label Credit Card:
877-294-1086
866-220-2760
800-203-5764