|
1 Namalhs shown on vour incomef4;ll Clar
<br />Buslness name/dlsrecarderAlhriq2
<br />tax classification of the person whose name is entered on lin6 1, Check only one of the
<br />! lndivioual/soleproprietoror n CCorporation ffscorporation ! partnership n Trusvestate
<br />single-member LLC
<br />fl timiteC liability company. Enier the tax classificalion (C=C corporation, S=S corporation, p=paftnership) >_
<br />Other instructions) >
<br />3 Check appropriate box
<br />following seven boxes.
<br />account number(s) here7
<br />Social
<br />Part
<br />.*'' lltf-s
<br />(Rav. October2018)
<br />Deparlm€nt of the Treasury
<br />lnternal BEvenue Serulce
<br />Request for Taxpayer
<br />ldentification Number and Gertification
<br />) Go to www,irs,govlFormW9 for instructions and the latest inlormation.
<br />Requester's name
<br />Give Form to the
<br />requester. Do not
<br />send to the lRS.
<br />ZA
<br />stocks or mutual
<br />(al entlty Bame,,rf 6o$ctA
<br />on not
<br />TIN provided must match the name given on line 1 to avoid
<br />generally your social security number {SSN). However, for a
<br />6 lrj
<br />moo)do-co.u,IDEcLo>E
<br />ol
<br />lo
<br />o(lr
<br />'6
<br />o
<br /><Loooa
<br />4 Exemptions (codes apply onlyto
<br />certain entities, not individuals; see
<br />instructlons on page 3):
<br />Exempt payee code (if any)
<br />Exemption from FATCA r€porting
<br />code (if any)
<br />(Applhs lo accounls mainl ainad outsda the U.S)
<br />Gounty Auditor's Office
<br />w. sth sre 105
<br />WA
<br />Enter your TIN in the
<br />backup withholding.
<br />appropriate box. The
<br />For individuals, this is
<br />resident alien, sole proprietor, or disregarded entity,
<br />entities, it is your employer identification number (El
<br />I/N, later.
<br />see the instructions for Part l, later. For other
<br />N). lf you do not have a number, see How to get a
<br />or
<br />Note: lf the account is in more than one name, see the instructions for lino 1. Also see What Name andNumber To Give the Reguester for guidelines on whose number to enter.
<br />on
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this form is my correct taxpayer identilication number (or I am waiting for a number to be issued to me); and2' 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 backup withholding as a resuit of a lailure to report all inieresi ir 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 (detined below); and
<br />4. The FATCA code(s) entered on this form (if any) 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 because
<br />not apply, For mortgage interest paid,and dividends on your tax For esiate lransactions, item 2 does
<br />prcperty, cancellation debt,to an individual retirement anangement (lHA), and payments
<br />other than interest and dividends,you must provide your correct TlN. See for ll, later.
<br />Sign
<br />Here
<br />General lnstructions
<br />Section references are to the lnternal Revenue Code unless otheruise
<br />noted.
<br />Future developments. Forthe latest information about developments
<br />related to Form W-9 and its instruclions, such as legislation enicted
<br />after they were published, go lo www.irs.govlFormWg.
<br />Purpose of Form
<br />. Form 1099-DlV (dividends. including
<br />funds)
<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 1099-5 (proceeds from real estate transactions)
<br />o Foim 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 />. Form 1 099-C (canceled debt)
<br />'Form 1099-4 (acquisition or abandonmsnl of secured property)
<br />Use Form W-9 only if you are a U.S. person (including a resident
<br />alien), to provide your correct TlN.
<br />lf you do not return Form W-9 to the requester with a TlN, you might
<br />be subject to backup withholding. See What is backup withholding,
<br />later.
<br />An individual or €ntity (Form W-9 reguestei who is required to file an
<br />information return with the IRS must obtain your correct taxpayer
<br />identification number fflN) which may be your social security number
<br />(SSN), individual taxpayer identificatiirn nrimber (lTlN), adopiion
<br />taxpayer identlfication 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 lnformation return. Examples of intormation
<br />returns include, but are not limited to, the following.
<br />. Form 1 099-lNT (interest earned or paid)
<br />number
<br />Part ll
<br />Signature ol
<br />U.S. person )Date >
<br />Cat. No.10231X Form W-9 (Rev. 10-2018)
|