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,","'llll-9 Request for Taxpayer
<br />ldentlflcatlon Number and Certlflcatlon
<br />Oo to wwsnr.govlFormW9lor inetructlong and tho lat€at informatlon'
<br />Glve form lo the
<br />request€r. Oo not
<br />send to the lRS.
<br />(Rav. March 2024)
<br />Oepanmont of the lreasury
<br />lnlernal R€vonue S€rvlce
<br />Belore
<br />General lnstructions
<br />Section 16l€ronces ale !o the lnternal Rovenue Code unloss otherwiso
<br />noted.
<br />Future developments. For the latsst information about developtnents
<br />relaled to Form W-9 and its lnstructions, such as legislation enacted
<br />afler they were published, ga la www.its.govlFormW9.
<br />What's New
<br />Line 3a has been modifisd to clarily how a disregarded entlty completeg
<br />this lin€. An LLC that is a disregarded entity should chock the
<br />appropriate box for the tax classification of its owner. Othemiso, i!
<br />should check lhe "LLC" box and enter its appropriate tax classitrcation,
<br />For related to lhs ol Form W'9, see of below
<br />! Name of entity/individual. An 6ntr1/ is requirBd. (For a sole proprielor or disregard€d ontity, 6nte.lhe o$,ner's tlamo on lino 1. and onter tho businoss/dlsragatdod
<br />entity's nome on line 2.)
<br />2 Business nam€/dlsregard€d antity nam€, if ditlorent |tom abovo.
<br />Bill Clarke at
<br />4 Exemplions (codes apply only lo
<br />codain ontitios, not lndividudl$;
<br />s6o lnstructlors on pag€ 3):
<br />Exempt payso codo (;f Bny)
<br />tUo)do-
<br />co.ooco'cl>'!vo
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<br />4tr
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<br />Exemplion from
<br />Compllanco Act
<br />cod6 (l{ any}
<br />Foreign
<br />TFATCA)
<br />Accounl Tax
<br />16porting
<br />(Applios to accounts maintaineet
<br />oulside ma United Saales/
<br />n6qu6st€r's narno and addtoss {optionaU
<br />7 List account numb6(3) b€r6 {oplional)
<br />Enter your TIN in the appropriate 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 />resldent allen, sole proprietof, or disregarded entity, se€ the instuclions {or Patt l, later. For other
<br />entities, it is your employer identification number (ElN). lf you do not havs a number, see How lo get a
<br />I/N, later.
<br />Note: lf the account is in more than ono namo, s€e the instruchons for tins 1. See also What Namo ond
<br />Number fo Give the Requesfer for guidelines on whoso numbsr to snler.
<br />Under Fenalties of perjury. I cerufi/ that:
<br />'1 . The number shown on this lorm is my correct taxpayer identrficatron number (or I arn waiting for a number to be issued to me); and
<br />2. I am not subject to backup wifhhoidlng because (a) I am exempt from backup withholding, or (b) I havo not been notified by lhe lnternal Flevenue
<br />Soruice (lRSj that I am subiect to backup wilhholding as a result oi a failure to report all interest or dividends, or (c) the IRS has notified rne that I am
<br />no longer subject to backup withholding; and
<br />3. I arn a U.S. citizen or other U.S. person {detined below}: and
<br />4. Th€ FATCA code(s) entered on this form (if any) rndicating that I am exempt from FAI-CA repoding is cotrect.
<br />C€rtilication ingtructiong. You 6ust cross out it€m 2 abov6 if you have been notilied by the IRS that you are currently subiecl lo backup withholding
<br />becauso you hav6 failed to report all interest anci dividends on your tax relurn. For real estate transactions, item 2 does not apply. For morlgage interest paid,
<br />acquisilion or abandonment ol secured propedy, cancellation of debt,to an individual r€tirement arrangernent (lRA), and, generally, payments
<br />other than lnlerest and are not to correct TlN. See tho instructions for Part ll later.
<br />Sign
<br />Here oate 01.01.2025
<br />or
<br />N6w iine 3b has be€n added to this form. A flow-through snllty is
<br />requlred to complete this line to indicate that it has direct or indirect
<br />forelgn pann6rs, owners, or beneficiaries when it plovid€s tho Form W-9
<br />to anothsr flow-through entity in which it has an ownership interest. This
<br />change is intended to provide a llow-through entity wilh intormallon
<br />regarding ths status of its indirect foreign partnersr own€rs, or
<br />beneflciaries, so that il can satisfy any applicabie teporting
<br />requir€ments. For example, a partn€rship that has any indirect foreign
<br />pertners may bs tequired to complete Schedules K-2 and K-3. See the
<br />Partnership lnstructions for Schedules K-2 and K-3 (Form 1065).
<br />Purpose of Form
<br />An individual or entity {Form W-9
<br />intormation reurn wllh the IRS is
<br />requester) who is required to file an
<br />givlng you thls foffn because they
<br />3a Ch€ck ths appropriate box lor fedoral tax classilicallon of tho sntily/indlvidual whose nams is cnterod on lir€ .1. Chsck
<br />only one of tho followlng aovon boxee
<br />n tndividuat/soia propri€tor fl C corporarion m S corporatlon I eartnentrip f] Trusvostate
<br />fJ f-f-C. Enl€rthotax cla3silicatlon {C = C corpotation, S = S corporatio!'I, P = Partnsrship)
<br />Note; Check thB "LLC" box abov€ and, in the ontry space. enler the app.oprial€ cods (C, S, or P) lor lne lsx
<br />ctagsrtieallon of tho LLC. unl€sg it is a disrogardod snlity. A disrsgardod ontity should inst€ad ch6ck ths appropriate
<br />box for th€ tax classificat'lon ol lts owner.
<br />! Otherlsee;nslructions)
<br />3b It on lhe 3a you ch6ck6d "Partn6rshlp" or "Trusl/osrale," or checked "Ll.C" and en'lered "P" ag its tax classillcation,
<br />and you are providing this form to a parlne.ship, trust, or estale in which you have an ownershlp inlorsst, ch€ck
<br />lhi6 box if you havo any toroign parlnors, ownorc, or bonoticlsrlos. Soe Instluctions I
<br />5 Address (number, strs€t, and apt, or sutt€ no.). s€e inskuotlons.
<br />l5o1 CaDitol Wav. Suite 203
<br />0 City, slato, andZlP codo
<br />Olvmoia. WA 98501
<br />numbor
<br />Part I
<br />I a I I ,t T I I
<br />Pad ll
<br />Sionat{rreol ,/ , -,:"C.';;;; /{,ad'" ('/a'6u
<br />Cat. No. 10231X rorm l/V-9 1nev. 3-zoz,t)
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