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Pitney bowel (I AUTHORIZED PARTNER Dear Valued Customer: Federal law under The USA PATRIOT Act requires us to obtain the (9) nine digit federal Taxpayer Identification Numbers (TIN) from customers that participate in a Pitney Bowes Bank product, notably Reserve Account and/or Purchase Power. Additionally, the Internal Revenue Service (IRS) requires the Pitney Bowes Bank to obtain Taxpayer Identification Numbers (TINS) from customers in order to report the fi•ee postage earned on the Reserve Account. For Partnerships, Corporations, Banks, Government Agencies, or Non-profit Organizations, the Taxpayer Identification Number is the Federal Employee Identification Number. For Sole Proprietors, the Taxpayer Identification Number is the owner's Social Security Number. Please complete the form below and return it with your signed contract to your dealer representative. Thank you. INFORMATION REPLY FORM Please indicate if your company is one of the following _Partnership State / Gov't Agency X _Sole Proprietor Non- Profit _Corporation Foreign Bank Other Organization Name: Kittitas County Auditor Street Address: 205 W 5th AVE Suite 105 City, State, Zip: EllensbuE& WA 98926 Date 9 Digit Taxpayer Identification Number (TIN): Certification: Under penalties ofperjury, I certify that: (1)The number shown above is my correct taxpayer identification number(or I am waiting for a number to be issued to me); (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 Internal Revenue 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 no longer subject to backup withholding; and (3) I am a US person (including a U.S. resident alien). Ifyou have been notified by the IRS that you are subject to backup withholding, cross out item 2 above. Signature Title Below Mr Pitnev Bowes Use Only: Pitney Bowes Customer BPN (10 Digits) Postage by Phone Account (8 Digits) -