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w-g Request for Taxpayer
<br />ldentification Number and Gertification
<br />) Go to www.irs.gavlFormW9lor in$ructions and lhe latest informatign,
<br />Give Form to the
<br />requester, Do not
<br />send to the lRS.
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<br />O-9
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<br />IDa
<br />Form
<br />(Rev. Octob€r 2018)
<br />Departm6nt of the Treasury
<br />lntomal Revenue Service
<br />on your on
<br />Kittitas County Chamber of Commerce
<br />2 Brsinsss nam€/dlsregarded eniity name, if diffBrent from above
<br />4 Exemplions (codes apply only to
<br />c€rtain €ntities, not individualsi see
<br />instructions on page 3):
<br />Exempt payse code (if any) 5
<br />Ex€mption from FATCA reporiing
<br />code (if any)
<br />(Aeplos lo ecounlt frnlained autudo lha U.S.)
<br />name
<br />7 List number(s) here (optional)
<br />Enter your TIN in the appropriale box. The TIN provided must match the name given on line 1 to avoid
<br />backup withholding" For individuals, this is generally your social security number (SSN). However, for a
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
<br />entities, it is your employer identilication number (ElN)" lf you do not have a number, see How to get a
<br />Il l, later.
<br />Note: lf the account is in more than one name, see the instructions for line '1. Also see What Name and
<br />Number To Give the Requesterlor guidelines on whose number to enter.
<br />Under penalties of periury, I certify that:
<br />1. The number shown on this form is my correct taxpayer idsntitication number {or I am waiting for a number to be issued to me); and
<br />2. I am not subject to backup withholding because: {a) I am exempt lrom backup withholding, or (b) I have not been notified by the lnternal Fevenue
<br />Service (lR$) that I am subject to backup withholding as a result of a failure to repon all interest or dividends, or (c) the IRS has notified me lhat I am
<br />no longer sublect 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) €ntered on this form {if any) indicating that I am exempt from FATCA repofting is correct.
<br />Certificaiion instructions. You must cross out item 2 above lf you have been notified by the IRS that you are cunently subject to backup withholding because
<br />you have failed to all interest and dividends on your tax return. For real estate transactions, iiem 2 does not apply. For mortgage interesl paid,
<br />acquisition or of secured property, cancellation of debt, contribuiions to an individual retirem€nt anangemeni (lRA), and generally, payments
<br />oth€r than interest and you ar€ not required to s,gn the cerlification, but you must provide your conect TlN. See the instructions for Part ll, later,
<br />or
<br />Here
<br />General ns
<br />Section references are to ihe lnternal Revenue Code unless otherwise
<br />noted.
<br />Future deyelopments. For the latest in{ormation about developments
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, ga lo www.its.gov/FormW9.
<br />Purpose of Form
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />information retum with the IBS must obtain your conect taxpayer
<br />identification number (l-lN) which rnay be your social security number
<br />(SSN), individual taxpayer identification number (lTlN), adoption
<br />taxpayer identilication 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 retum. Examples ol information
<br />returns include, but are not limited to, the following.
<br />r Form 1099-lNT {inlerest earned or paid)
<br />Date >
<br />e Form 1099-DlV (dividends, including those {rorn stocks or mutual
<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 />c Form 1099-K {merchant card and third party network transactions)
<br />r Form 1098 (home mortgage inter€st), '1098-E (student loan interest),
<br />1098-T (tuition)
<br />. Form 1099-C (canceled debt)
<br />. Form 1 099-A {acquisition or abandonment of secured property)
<br />Use Form W-9 only if you are a U.S, person (including a resident
<br />alieni, to provide your correct TlN,
<br />lf you do nat return Farm W-9 to the requestet with a TlN, you might
<br />6e sublect to backup withholding. See What is backup withholding,
<br />later,
<br />Cla %t 7b
<br />3 Check appropriato box for federal tax classifjcation o{ ths person whose name is entered on lins 1 . Check oniy one of the
<br />tollowing seven boxes.
<br />I lndividuaysole propriotor or n C Corporation fJ S Gorporation n Parlnership I TrusUestate
<br />single-member LLC
<br />f] Limitea liabitity company. Ent€r iha tax classification {C=C corporation, S=S conoration, P=Partnership) >
<br />-
<br />Noter Check the appropriato box in the line above for th€ tax classification oi ihe single-member own6r" Do not check
<br />LLC if the LLC is classified as a single-rnember LLC that is disregardgd from th6 ownsr unless the owner of the LLC is
<br />anolher LLC that is not disregarded lrom the owner for U,S, federal tax purposes. Otherwjse, a single-member LLC
<br />is disregarded from lhe owner should check the appropriate box for the tax classitication of its owner,
<br />Other 501c6
<br />5 Address {number, street, and apt. or suite no,) Ee€ instructions.
<br />609 N Main St
<br />6 City, state, and ZIP code
<br />Ellensburg, WA 98926
<br />ldentification NumberPart I
<br />9 1 0 2 I 0 4 3 0
<br />Part ll
<br />u.s.tfr
<br />Cat. No.10231X rorm W-9 lRev. 10-2018)
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