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Farm �'9 I Request for Taxpayer I (live form to the
<br />(Rev. Morcb 2D24) Identification Number and Certification requester. Do not
<br />Dapadment of the Treasury Go to www,(rs. ov1FormW9 for instructions and the latest Information. Send to the IRS.
<br />Internal Revenue Service 9
<br />Beforeyou begin. For guidance related to the Dumose of Farm W-9, see Pumose of Fomr, below.
<br />1 Name of entllyAndivldual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name online 1, and enter the buslnessrdaregarded
<br />entity's name on line 2)
<br />ROSAUERS SUPERMARKETS, INC.
<br />2 Business ❑amerdlsregarded entity name, if dlgerent from above.
<br />ROSAUERS FOOD & DRUG CTR, SUPER 1 FOODS, HUCKLEBERRY'S NATURAL MARKET HANK'S HARVEST FOODS
<br />®
<br />3a Check the appropriate box for federal tax classification of the eAlitydndivlduel whose name is entered an line 1. Check
<br />4 Exemptions (codes apply only to
<br />m
<br />M
<br />only one of the fallowing seven boxes.
<br />certain entitles, not Individuals;
<br />c
<br />❑ IndNldue/sole proprietor i 1 C corporation ❑ S corporation ❑ Partnership ❑ Tmstleslate
<br />see Instructions on page 3)0
<br />yp.
<br />❑ LLC. Enter the tax classification (C = C corporation, S = 8 corporation, P = Partnership) . . . .
<br />Exempt payee code of any)
<br />Note,. Check the "LI.C" box above and, in the airy space, ant" the appropriate code (0, S, or P) for the tax
<br />C
<br />r6
<br />classlikalIon of the LLC, unless it b a disregarded entity. A disregarded entity should Instead check the appropriate
<br />Exemption from Foreign Account-r"
<br />box for the tax classification of its owner.
<br />Compliance Act TATCA) reporting
<br />G r
<br />❑ Other (see Instrucnane)
<br />code (if MY)
<br />Q•
<br />3b If on line 3a you chocked "Partnership" or "TrusVestate;" or checked °LLC" and entered'P' as its tax classification,
<br />(pppfies to amounts moinWnad
<br />and you are this form a hip, or In which you have an ownership Interest. check
<br />this box if have foreign
<br />oufsfde the United States.)
<br />iestate
<br />uprovidinghean
<br />you any ar rs, om r be
<br />partners, owners, or beneficiaries. See Instructions ❑
<br />.
<br />y5
<br />Address (number, street. and apt. or suite no.). Sae Instructions.
<br />Requesters name and address (opllonal)
<br />1515 IN GARLAND AVE. PO BOX 9000
<br />6 city, stale, and ZIP code
<br />SPOKANE WA 99205 SPOKANE WA 99209
<br />T Ust amount numbegs) here (opticnal)
<br />JUM
<br />Taxpayer Identification Number (TIN)
<br />Enter your TIN In the appropriate box. The TIN provided must match the name given on line 1 to avoid
<br />Social security number
<br />fora
<br />backup withholding. ode For individuals, this Is generally your social security number (SSNr. For
<br />resident alien, sole proprietor, or disregarded entity, she the instmctions for Part I, later, For other
<br />- m -
<br />IImII
<br />Ih�I
<br />t1I
<br />entitles, It Is your employer identification number (EIM. If you do not have a number, see How to get a
<br />or
<br />TIN, later.
<br />Note: It the account Is in more than one name, we the Instructions for line 1. See also What Name and
<br />Number To Give the Requester for guidelines on whose number to enter. 9 1 - 0 s s 2 0 T s
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this farm is my correct taxpayer identification number (or I am wailing for a number to be Issued to me); and
<br />2.1 am not subject to backup withholding because (a) I am exempt from backup withholding, or 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 />3.1 am a U.S. oilizon or other U.S. person (defined 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
<br />because you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an. individual retirement arrangement (IRA), and, generally, payments
<br />other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Part 11, later.
<br />Sign Signature of // 03
<br />Here u.s.person (�trC.1.(.r1�-- Date ('.�.�. •�,�
<br />General Instructions
<br />Section references are to the Internal Revalue Code unless otherwise
<br />noted.
<br />Future developments. For the latest information about developments
<br />related to Form W-9and its instructions, such as legislation enacted
<br />after they were published, go to wwueJm,gov1FarmW9.
<br />LINTM l C
<br />Line 3a has been modified to clarify how a disregarded entity completes
<br />this line. An LLC that is a disregarded entity ghoul( check the
<br />appropriate box for the tax classification of its owner. Otherwise, it
<br />should check the "LLC" box and enter Its appropriate tax classification.
<br />New line 3b has been added to this form. A flow -through entity is
<br />required to complete this line to indicate that it has direct or Indirect
<br />foreign partners, owners, or beneficiaries when it provides the Form W-9
<br />to another flow -through entity in which It has an ownership Interest. This
<br />change is intended to provide a flow -through entity with information
<br />regarding the status of Its Indirect foreign partners, owners, or
<br />beneficiaries, so that it can satisfy any applicable reporting
<br />requirements. For example, a partnership that has any indirect foreign
<br />partners may be required to complete Schedules K-2 and K-3. See the
<br />Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
<br />Purpose of For('
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />Information return with the IRS is giving you this form because they
<br />Cal. No.1 r231X Farm W-9 (Rev. 3.2024)
<br />
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