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Form ROQUOSÌ IOr Taxpayer Give Form to the
<br />oRem men re Identification Number and Certification re udeste
<br />e
<br />not
<br />intemal Revenue Service
<br />Name (as silown on your Inconie tax retum)
<br />Laughing Horse Arts Foundation
<br />Business naine/disregarded entity name,li ditterent frorn at>ove
<br />D.B.A.Jazz in the Valley
<br />c Check appropriate box for federal tax classification:
<br />°O Individual/sole pmprietor C Corporation S Corporation Partnership Trust/estateoc
<br />Limited liability company.Enter the tax classification (C=C corporatlon,S=S corporation,P=partnership)O Exempt payee
<br />O Other (see inskuana)W
<br />Address (number,street,and apt,or suite no.)Requester's name and addræs (optional)
<br />P.O.Box 214 Kittitas County Auditor
<br />City,state,and ZIP code 205 West 5th Ave -Suite105
<br />EIIensburg,WA 98926 Ellensburg,WA 98926
<br />List account number(s)here (optional)
<br />Enter your TIN in the appropriate box.The TIN provided must match the name given on the "Name"line Social securfty number
<br />to avold backup withholding.For individuals,this is your social security number (SSN).However,for a
<br />resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other -
<br />entities,it Is your employer identification number (EIN).If you do not have a number,see How to get a .
<br />TIN on page 3.
<br />Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identificahon number
<br />number to enter.
<br />91 -1211173
<br />Certification
<br />Under penalties of perjury,l certify that:
<br />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),and
<br />2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or (b)I have not been notified by the Internal Revenue
<br />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 has notified me that I am
<br />no longer subject to backup withholding,and
<br />3.I am a U.S.citizen or other U.S.person (defined below).
<br />Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
<br />because you have failed to report all interest and dividends on your tax retum.For real estate transactions,item 2 does not apply.For mortgage
<br />interest paid,acquisition or a nment of secured property,cancellation of debt,contributions to an individual retirement arrangement (IRA),and
<br />generally,payments other th rest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the
<br />ctions on pa
<br />Date>¯OO Í
<br />General Instructions Note.If a requester gives you a form other than Form W-9 to request
<br />your TIN,you must use the requester's form If it is substantially similar
<br />Section references are to the Intemal Revenue Code unless herwise to this Form W-9.
<br />noted Definition of a U.S.person.For federal tax purposes,you arePurposeofFormconsideredaU.S.person if you are:
<br />A person who is required to file an information return with the IRS must •An individual who is a U.S.citizen or U.S.resident alien,
<br />obtain your correct taxpayer identification number (TIN)to report,for •A partnership,corporation,company,or association created or
<br />example,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the United States,
<br />you paid,acquisition or abandonment of secured property,cancellation •An estate (other than a foreign estate),or
<br />of debt,or contributions you made to an IRA.•A domestic trust (as defined in Regulations section 301.7701-7).
<br />Use Form W-9 only if you are a U.S.person (including a resident
<br />alien),to provide your correct TIN to the person requesting it (the Special mies for partnerships.Partnerships that conduct a trade or
<br />requester)and,when applicable,to:business in the United States are generally required to pay a withholding
<br />tax on any foreign partners'share of income from such business.
<br />1.Certify that the TIN you are giving is correct (or you are waiting for a Further,in certain cases where a Form W-9 has not been received,anumbertobeissued),partnership is required to presume that a partner is a foreign person,
<br />2.Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a
<br />3.Claim exemption from backup withholding if you are a U.S.exempt partner in a partnership conducting a trade or business in the United
<br />payee.If applicable,you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S.
<br />allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership Income.
<br />is not subject to the withholding tax on foreign partners'share of
<br />effectively connected income.
<br />Cat.No.10231X Form W-9 (Rev.12-2011)
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