Remittance & Tax Information
Payment & W-9 — 1099Reps
Florida Market Expansion Pilot · Prepared for Egg Medical
01Taxpayer Information (Form W-9)
Name (as shown on income tax return)
1099REPS, Inc.
Business name / DBA
1099reps.com
Federal tax classification
S Corporation
Employer Identification Number (EIN)
41-5078981
Entity type
Corporation (U.S.)
Address
940 Sweet Water Lane, Unit 415 · Boca Raton, FL 33431
A signed IRS Form W-9 (Rev. 10-2018) is furnished on request; the information above matches that form. 1099Reps is a U.S. person not subject to backup withholding.
02Payment by ACH / Wire
Beneficiary / Account holder
1099REPS, Inc.
Bank name
Column N.A.
Routing number (ABA)
121145433
Account number
744505826665375
Account type
Business Checking
Bank address
1 Letterman Dr, Bldg A, Ste A4-700, San Francisco, CA 94129
Reference / Memo: EGG MEDICAL — FL PILOT
Remit advice: support@1099reps.com
On the bank-name field use Column N.A. (Mercury's partner bank that holds ABA 121145433) — not "Mercury" — to avoid bank-name validation holds. ACH credits route by routing + account number.
1099Reps · Commercial Growth Partner
Lawrence Razzano
(336) 300-5622
support@1099reps.com