Supplier Registration Form (USA)
Please enter the Setup ID that you received in your email.
Required to be setup in the Texas Instruments database.
* indicates required data
Legal Name of Company (as reported to IRS) *

Federal Tax Id OR Social Security Number
-
DBA DUNS # (no dashes)
Physical Address Remit to address (pay to)
Address * Address *
PO Box
City * City *
State * State *
Zip * Zip *
Area Code & Phone * -- Area Code & Phone * --
Fax Fax
Bank Information for electronic payment requires completion of a separate EFT Form.
Click here to download.
Email *
Email address to receive purchase order *
Web Address (URL)
The supplier represents and certifies that it is a:
Business Size * Business Type * Business Activity * Business Category
(Check one)  (Check one) (Check one) (Check all that apply)
Large 
Small  
Small Disadvantaged

(definitions)

 

Corporation  
Partnership 
Sole Proprietor 
Individual 
Trust/Estate 
Government Agency
LLC
Real Estate Rental/Lease      
Equipment Rental/Lease 
Medical/Health Care
Merchandise (goods only)
Merchandise Services
Legal Firm/Attorney/Lawyer
Royalties
Service Only
Consultant/Professional Fees 
Donation/Charitable Contribution 
Woman Owned
Manufacturer 
Distributor 
Non-Profit Organization 

(definitions)

Company Full Time Staff (not contractor) size: *

Including yourself, does the sole proprietorship, LLC, C Corporation, S Corporation, partnership or third party have a total of 7 or more (a) other partners, members, shareholders, or stockholders and/or (b) W-2 employees? For example, if you own an LLC and have 6 employees employed by the LLC, then the answer is "Yes". For example, if you have a partnership and only have 1 other partner but no other employees, then the answer is "No".

< 6 people
> 6 people
Business Classification -
Certification Requirement:

Proof of third party certification is required in order for a business entity to be classified as a minority (MBE) or woman-owned (WBE) supplier in the Texas Instruments database. You must confirm your MBE or WBE status with a certification number and expiration date for one of the agencies listed below. If the agency that provided your MBE or WBE certification is not listed, please enter the certification number, expiration date and agency name in the space denoted as "Other".

Certifying Agency Name Certification Number Certification Expiration Date
MMDDYYYY
DFWMBC - DFW Minority Business Council
NCTRCA - North Central Texas Reg Certif
NMSDC - National Minority Supplier Dev
WBCS - Women's Business Council SW
WBENC - Women's Business Enterprise Na
Other - please specify name of Agency below
Agency Name
Click here for Texas Instruments Supplier Diversity requirements.

The supplier represents that its qualifying ownership falls within at least one of the following categories.ne of the following categories.

Minority Business Representation *

Asia-Pacific American
- U.S. Citizen with origins from Japan, China, the Philippines, Vietnam, Korea, Samoa, Guam, the U.S. Trust Territory of the Pacific Islands (Republic of Palau), the Northern Mariana Islands, Laos, Kampuchea (Cambodia), Taiwan, Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Republic of the Marshall Islands, or the Federated States of Micronesia, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru

Black American - U.S. Citizen

Combined Ethnic group Ownership - Two or more minority groups

Hispanic American
- U.S. Citizen with origins from South America, Central America, Mexico, Cuba, the Dominican Republic, Puerto Rico, Spain, or Portugal

Historical Black College and University/Minority Institute

Individual/concern
currently certified for participation in the Minority Small Business and Capital Ownership Development Program under section 8(a) of the Small Business Act (15 U.S.C. 637(a))

Native American
- American Indians, Eskimos, Aleuts, or Native Hawaiians, including Indian tribes or native Hawaiian organizations

Subcontinent Asian (Asian-Indian American)
- U.S. Citizen with origins from India, Pakistan, Bangladesh, Sri Lanka, Bhutan, the Maldives Islands, or Nepal

None of the above

Required Tax Documentation Required Tax Documentation

In accordance with TI practice and policies, prior to initial payment, Payee will provide TI with valid US tax documentation declaring status of beneficial owner of any income generated by the requested payment. Please review A, B, and C below and respond accordingly.

A. If Payee is a US resident, corporation, or otherwise beneficially owned by a US entity:

  • Payee must provide a valid (authorized signature required), US Form W-9 (or other appropriate US tax declaration form) (W-9, Instructions) and submit to TI via email at simthelp@ti.com
Email
(Preferred method)		 Mail
(Use this option only if you don't have
access to Email)
simthelp@ti.com
Texas Instruments
Supplier Information Management
US Tax Declaration
13570 N Central Expwy     MS  3913
Dallas, Texas 75243
B. If Payee is a non-US or foreign resident, corporation, or otherwise beneficially owned by a non-US or foreign entity (choose from the taxpayer type that best fits your situation):

  • Nonresident Aliens, nonresident individuals
    		 W-8BEN , Instructions
      8233 (if applicable)
      		 8233, Instructions
      • Foreign Corporations
        		 W-8BEN-E, Instructions
        • Foreign Partnerships *
          		 W-8IMY, Instructions
          • Foreign Governments
            		 W-8EXP, Instructions
            • Foreign Grantor Trusts **
              		 W-8BEN-E, Instructions
              • Certain foreign trusts and foreign estates
                		 W-8IMY, Instructions
                • Foreign tax-exempt organizations (including private foundations)
                  		 W-8EXP, Instructions
                  • Nominees
                    		 W-8 used by beneficial owner

                    * A partnership may substitute its own form for the official version of Form W-8 to ascertain the identity of its partners.

                    ** A domestic grantor trust must provide a statement as shown in Sec. 1.1446-1(c)(2)(ii)(e) and documentation for its grantor.

                    C. If TI is licensing intellectual property (IP) rights from your company AND that IP is registered in Germany, TI may be required to withhold on payments made to your company regardless of whether your company has any tax connection to Germany. Please answer the below questions to determine if this withholding applies. If you have any questions, please email german_royalty_compliance@list.ti.com

                    1. Is TI licensing intellectual property (IP) rights from your company? If yes, proceed to (2). If no, please notify TI accordingly at german_royalty_compliance@list.ti.com and no further action is required.
                    2. Is the IP right in question registered in a German public register (e.g., with the German Patent and Trademark Office)? If yes, proceed to (3). If no, please notify TI accordingly at german_royalty_compliance@list.ti.com and no further action is required.
                    3. Please provide a properly issued certificate of exemption that indicates the applicable tax treaty providing relief from German withholding. If you do not have a certificate of exemption, please email german_royalty_compliance@list.ti.com.

                    Environmental, Safety, & Health *
                    Certify Compliance
                    Do Not Certify Compliance
                    Additional Questions *
                    Are any supplier’s owners, officers, or employees (in positions of influence) current TI Employees or have a close family or domestic Relationships with current TIers, in position of influence.? * Yes No
                    Are any supplier’s owners, officers, or employees (in positions of influence) former TI Employees ? * Yes No
                    If yes (current/former employees, and close family domestic relationships of current employees), please give Names and Employment dates.
                    Special Instructions
                    I certify under penalty of perjury that the Tax Identification Number I have provided is correct
                    Name
                    Title
                    Area Code & Phone Number
                    Please verify your information before clicking the submit button.

                    Please remember to send the appropriate Tax document (W8 or W-9 form).

                    The Legal Name submitted on this form should match the name on the Company Name on the Tax document.

                    TEXAS INSTRUMENTS INCORPORATED * SUPPLIER INFORMATION MANAGEMENT
                    P O BOX 650311 * M/S 3913 * DALLAS TX 75265-0311
                    email:simthelp@ti.com
                    20081117