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.",, lllf'9
<br />(Rev. Octobor2018)
<br />Departm€nt ot lh6 Treasury
<br />lnternal Revenue Seruice
<br />Request for Taxpayer
<br />ldentification Number and Certification
<br />) Go to www.irs,govlFormWglor instructions and the latest intormation.
<br />Give Form to the
<br />requester. Do not
<br />send to the lRS,
<br />4 Exemptions (codes apply only to
<br />certain entlties, not individuals: see
<br />instructions on page 3):
<br />Exempt payee code (if any) 3
<br />Exemption from FATCA reporting
<br />code (if any) C
<br />(Applios rc aeMnts maktained outsids the U.S)
<br />on your lncome
<br />of Kittitas
<br />2 Business
<br />7 List account number(s) here
<br />is required on this line:
<br />entity name, it
<br />d
<br />o6)a!o-
<br />Eo
<br />ocoo>i:€o
<br />o<
<br />2o
<br />o.o
<br />ooo.o
<br />d)
<br />o)(/)
<br />name
<br />Number
<br />Enter your TIN in.the appropriate box. The TIN provided must match the name given on
<br />backup withholding. For individuals, this is generally your social security number (ssN).
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for part l, later.
<br />entities, it is your employer identification number (ElN). lf you do not have a number, seeI/M later,
<br />line 1 to avoid
<br />However, for a
<br />For other
<br />How to get a
<br />or
<br />Note: lf the account is in m ore than one name, see the instructions for lino I . Also see What Name and
<br />Number To Give the Fequoster for guidelines on whose number to enter.
<br />Under penalties of perjury, I 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 lnternal RevenueService (lRS) that I am subject.to.bqgl rp withholding as a resuit of a failure to report all inibresi or dividends, or (c) the IRS iras notified me that I amno longer subject to backup withholding; and
<br />3. I am a U,S. citizen or other U.S. person (defined below); and
<br />4. The FATCA code(s) entered on this form (ifany) indicating that I am exempt from FATCA reporting is correct.
<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 becauseyou have failed to report all interest and
<br />acquisition or abandonment of securod
<br />dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
<br />property, cancellation of debt, contributions to an individual retirement arrangement (lRA), and generally, payments
<br />must provide your correct TlN. See the instructions for Part ll, later.othsr than interest and dividends, you are not required to sign the but you
<br />Sign
<br />Here
<br />General ln ns 1099-DlV (dividends, including those from stocks or mutual
<br />Section references are to the lnternal Revenue Code unless otherwise
<br />noted.
<br />Future developments, For the latest information about developments
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, go 10 www.irs.govlFormWg.
<br />Purpose of Form
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />information return with the IRS must obtain your correct taxpayer
<br />identification number [lN) which may be your social security number
<br />(SSN), individual taxpayer identitication number (lTlN), adopiion
<br />taxpayer identification number (ATIN), or employer identification number
<br />(ElN), to report on an information return the amount paid to you, or other
<br />amount reportable on an information return. Examples of information
<br />returns include, but are not limited to, the following.
<br />. Form 1099-lNT (interest earned or paid)
<br />. Form 1099-MISC (various types of income, prizes, awards, or gross
<br />proceeds)
<br />. Form 1099-8 (stock or mutual fund sales and certain other
<br />transactions by brokers)
<br />. Form 1099-S (proceeds from real estate transactions)
<br />. Form 1099-K (merchant card and third party network transactions)
<br />. Form 1098 (home mortgage interest), 1 098-E (student loan interest),
<br />1098-T (tuition)
<br />o Form 1099-C (canceled debt)
<br />. Form 1099-A (acquisition or abandonment of secured property)
<br />Use Form W-9 only if you are a U.S. person (including a resident
<br />alien), to provide your conect TlN.
<br />lf you do not return Form W-9 to the requester with aTlN, you might
<br />be subject to backup withholding. See What is backup withholding,
<br />later.
<br />3 Check appropriate box for federal tax classificatlon of the person whose nam6 is ent€red on line 1 . Check only one of thofollowing seven boxes.
<br />n lndividual/soleproprieloror fl CCorporation n Scorporation n Pa*nersnip ! Trust/estate
<br />single-member LLC
<br />fl uimiteo tiaoitity company. Enter the tax classilication (c-c corporatiori, s=s corporation, p=partnership) > _
<br />Other
<br />apt. or sult6 no.) Sec5 Address (number, street,
<br />Ave
<br />6 City, state, and ZIP
<br />wA 98926
<br />numbor
<br />Part I
<br />number
<br />I 1 6 0 0 1 3 4 I
<br />Part ll
<br />Signature of
<br />U.S. pemon )Daie >
<br />Cat. No. 10231X Form W-9 (Rev. l0-2019)
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