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ATTACHMENT "Gr
<br />..
<br />Request for Taxpayer
<br />Give form to the
<br />Forth
<br />(Rev. March 2024)
<br />Identification Number and Certification
<br />requester. Do not
<br />Department of the Treasury
<br />Go to wwwJmgov/FormW9 for instructions and the latest information.
<br />send to the IRS.
<br />Internal Revenue Service
<br />Before you begin. For guidance related to the purposo of Forth W-9, see Purpose of Form, below.
<br />Enter
<br />back
<br />resid
<br />1 Name of entitylndividual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the busineswaisregaraeo
<br />entity's name on line 2.)
<br />2 Business name/disrogarded entity name, if different from above.
<br />3a Check the appropriate box for federal lax classification of the entitylindividual whose name is entered on line 1. Check
<br />4 Exemptions (codes apply only to
<br />only one of the following seven boxes.
<br />certain entities, not individuals:
<br />❑ IndividuaUsolo proorietor ❑ C corporation ❑ S corporation ❑ Partnership ❑ TrusUostato
<br />see instructions on page 3):
<br />❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) . . . .
<br />Exempt payee code [if any)
<br />Note: Check the "LLC" box above and, In the entry space, enler Eha appropriate code (C. S. or P) for the tax
<br />classification of the LLC, unless it is;; dwega+dod entity, A disregarded entity should instead check the Abpropriate
<br />Exemption from Foreign Account Tax
<br />box for the tax classification of its owner.
<br />Compliance Act (FATCA) reporting
<br />❑ Other (see instructions)
<br />code (d any)
<br />(Applies to accounts maintained
<br />31a If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered 'P" as ,ts tax classification,
<br />and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check ❑
<br />outside the United States.)
<br />this box it you have any foreign partners, owners, or benefirdarft. See instructions . . . . . . .
<br />5 Address (number, street, and apt or suite no.). See Instructions.
<br />Requester's name
<br />and address (optionao
<br />6 City. state, and ZIP code
<br />7 L;sI account number(s) here (optional)
<br />Taxpayer identification Number (TIN)
<br />your TIN in the appropriate bode The TIN provided must match the name given on line 1 to avoid Sxlut securty number
<br />up withholding. For individuals, this is generally your social security number (SSN ). Howevar, for a _
<br />` m
<br />ent alien, sole proprietor. or disregarded enlity, see The instructions for Part 1. Wef. For other
<br />entities. It is your emptoyer identification number (EIN). If you do not have a nurrbef, see How to gat a or
<br />TIN, later. Employer identffcatfon number
<br />Note: If the account is in more than one name, see the instructions for line 1. See also What Name and �j _ j�j�r
<br />Number To Give the Requester for guidelines on whose number to enter. II li
<br />Certification
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this form is my correct taxpayer identification number (or I am waiting 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 will-t•olding, or (b) 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)1he IRS has notified me that I am
<br />no longer subject to backup withholding; and
<br />3. 1 am a U.S. citizen or other U.S. person (defined below); and
<br />4. The FATCA code(s) entered on this form (f 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 ORA), 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
<br />Here i U.S. person Date
<br />General Instructions
<br />New line 3b has been added to this form. A flow -through entity is
<br />indirect
<br />required to complete this line to indicate that i1 has direct ar
<br />Section references are to the Intemal Revenue Code unless otherwise
<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 />noted.
<br />Future developments. For the latest infomtation about developments
<br />change is intended to provide a {tow -through edify with Information
<br />regard!ng the sIalus of its indirect foreign partners, awners. or
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, go to www.irs.gov/FormW9,
<br />beneficiares, so that it can satisfy any applicable reporting
<br />requirements. For example. a partnership that has any indirect foreign
<br />What's New
<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 />Line 3a has been modified to ciarfy how a disregarded entity completes
<br />this line. An LLC that is a disregarded entity should check the
<br />Purpose of Form
<br />appropriate box for the tax classification of its owner. Otherwise, it
<br />should check the "LLC" box and enter its appropr.ate tax classification.
<br />information return with the IRS is giving you this form because they
<br />Cal. No. 10231X
<br />Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 18 of 23
<br />Form W-9 (Rev 3-2024)
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