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Form W-9 (trer'.3-20241 Psge 4
<br />2-The United States or any of ils agencies or instrumentaiities.
<br />3-A state, the Dislrict of Columtria, a U.$. cornnrcnr,vealth ar territory,
<br />or any of their polilical subdivisions or instrurnsntalities.
<br />4-A foreign govemmsnt or any of its political subdivisions. agencies,
<br />or instrumentalities.
<br />5-A corporation.
<br />6-4 dealer irr eecurities or commodities r*4sired to register in the
<br />ljnited States. th€ District of Cotunrhria, or a U.9. comrnonwealth or
<br />territory.
<br />7-A futures commission merchanl registered with the Ccnrrnodity
<br />Fulures Trading Comnris$ion,
<br />8-A real estate investment trusl.
<br />S-An entity registered at ail times during the tax year under the
<br />lnvestment Company Act ol 1 $40.
<br />10-A conrmDn trust fund operated by a bank under section 584{.4}.
<br />11 -A financial institution as defined under s€ction 581.
<br />'12-A middlernan knov,,r'l in the investment cornrnunity as a nornine€ or
<br />custdian.
<br />13-A trust exempt from tax under section 664 or d€scrih€d in section
<br />49,t7.
<br />The following chart sho,.,.,s lypas cf paynrents tlut ma!.[],e sxempt
<br />from backr.rp withholding. The chart applies to tie ex€mpt payees listed
<br />above, 1 tirrough 13.
<br />lF the payment is for TIIEN the payment is exernpt
<br />for...
<br />. lnterest and di'.,idend payments All exenrpt palees excspt
<br />far7"
<br />. Broker transactions Exenrpt Faye€s 1 through 4 a
<br />through 11 and all C corpc,rations.
<br />S ccrporations rnust nst ent€r an
<br />exerrgt pa.f# code L'ecause they
<br />are exempt only for sales cf
<br />n rr n cov e red se cunlies acqwi r etJ
<br />ta 2$12.
<br />, Barter lAtlgaclions Exempt payees 1 throuEh 4.
<br />and cls
<br />. Paymenls over $600 required to
<br />bareporled and direct salesover
<br />$s,ooo'
<br />. Payments made in gettlement of
<br />payment card or thkd-party
<br />netrvork transactions
<br />15ee Fornr 1099-FJlSC. Miscellaneous lnformation. and its instructions.
<br />2However. the fallo',ving payments made to a ccrpcratron and
<br />reportable on Form 1089-MISC are not exempt from backup
<br />withholding: medical and heallh care payments" attomer,qs,'fees, gross
<br />proceeels paid to an attorney repDrtab{e under section 6045(f1, and
<br />paymenls for tewice.s paid b]' a federal exectti'ae agency-
<br />Exernption from FAtrCA repcrling cocle, The following codes identi!'
<br />payees that are exempt from reparling un(ler FATCA. These ccdes
<br />apply to persons submitting ttris form for accounts rnaintained olltside
<br />of the United States by certain foreign financial institutrons. Therefors, tf
<br />you are only eubmitting this fonn for en accounl yolr hold in the United
<br />States, you may leave this field blank. Consuh',r,'ith the person
<br />requesting this form i{ you are tjncerlain il the financial institutian is
<br />subject to these requirements" A requester may indicate that a code is
<br />nol required by providing ynu wilJ, a Fcrm \rT-6'-,iith "t'lnt Appiicable".{or
<br />any similar inriication) enlered on the line for a FATC,o, exerrpfion code-
<br />A-An organizaiion exempt frrrtn tax under section 5ct1{a} or any
<br />individual retirement plan ae defined in sectir:n 7701{a){37).
<br />B-The United States ar any of its agencies or irrstrumentalities,
<br />C-A state. the District of Columbia, a U.5. cornmanrrealth or
<br />teffitory. or ani/ of their Folitical subdivisiong or inskumentalities.
<br />D-A corporation the etock of which is regularly traded on one an
<br />more established securities marketg. as described in Fegulations
<br />section 1.1 a72-1 (cJ{1)(i}.
<br />E-A corporation that is a member of the same expanded affiliated
<br />graup as a corparatron described in Regulations section 1.1 472-1 (cl{1 lf,i
<br />Kittitas County Agreement for Services (rev.5/L4/251
<br />Page 20 of 22
<br />F-A dealer in securities, comrndities, or derivative finaflcial
<br />instruments (includin g notional principal contracts, futures, forwards,
<br />and aFtionsJ ihat is registered as such under the lalvs of the United
<br />States or any state.
<br />G-A real estate investment trusl.
<br />H-A regulated inves8nent comparry as defined in section 851 or an
<br />entity registered at alt times during the tax year under tfie lnvestrnent
<br />CrmFanyActof 1940.
<br />l-A common trust fund as defined in section 5s4{al.
<br />J-A bank as defined in section 581.
<br />K-A broker.
<br />L-A tn:st exempt trsm tax und€r secfion 664 or described in sectian
<br />aeaT{a}{1 }.
<br />M -A tax-exempt lrust under a section 4031b| plan or section 457(9)
<br />plan.
<br />Note: Yos ma'f wish to E{nEUlt with the financial institution requesting
<br />this famr to determine vrhether the FATCA code ancl/or exernpt palree
<br />code should be completerl.
<br />Line 5
<br />Enter y"our address {rrurnber, sheet. and apartnnent qr suite number}'
<br />This is, r,.rhere lhe requester of this Fonm fi-9 vrill mail your infc'nnation
<br />returns. lf this address differu ftorn lhe ooe the requester already has on
<br />fih. enter 'NEW' at the top. lf a new address is provided. there is still a
<br />chance the old addrp.ss','dll be used urntil the payor changes your
<br />address in th€ir records.
<br />Line 6
<br />Enterl.ou! cit/. state, and ZIP code.
<br />Part l. Taxpayer ldentification Number (TlN)
<br />Enter your TIN in the appropriate box" lf you are a resident alien ancj
<br />you do nolhave, and are ncl eligible to get. an SSIJ, your TllJ is your
<br />1Fg fflN. Enter it in the €ntry spacetor the Social security number. lf you
<br />do not have an lTlltl, see H6't to get a l/r1i belsw.
<br />ll yau are a lole proprielor anrJ yrsuhave an ElN, yc,u may enter either
<br />your SSF! c'r EIFJ.
<br />ll you are a single-member LLC lhatie disregarded as an entity
<br />separate from its ourrer. enter th€ orvner's 9SN (cr ElN, if the orvner hae
<br />one). lf the LLC is classilied ae acorparatiot"r or partnership. enter the
<br />entity's Ell\.
<br />Note: See What llame aed f'lumberTa Give the Requester,later, for
<br />fr.rrther clarification of name and TIN combinationg,
<br />Haw 7o gel a TlN. lf you do not have a TlN, apply for one immediately.
<br />To apply fr:r an SSN, get Forrn $S-5, Application lor aSq,cial Security
<br />Card,fromyrsurlor;al 5SA office c'r get this form online al
<br />w.,av.SSA.gov. You rnay aleo get this form by calling 800-172-1213. Use
<br />Fonn 14/-7, Application for lFlS lndividual Taxpayer ldentification
<br />lJumber. to apply for an fflN. or Form 3$-4. Application for Ernployer
<br />ldentificalir:n f,lumber, to apply for an Ellrl. You can apply for an EIN
<br />cnline by accessing the lFS r,vebsite at nn'rrv.irs.gov/FlN. Go to
<br />vnr,+,.irs"govlFotms to view, download, or print Fonn W-I and;'or Form
<br />S$4. flr, 'r'au can Ea tc w'wwJrs-gavfA'derforms lo place an order ard
<br />have Forn W-7 and./or Forrn S$'4 rnailed to you wilhin 15 business
<br />days.
<br />lf yr:u are asked to comFlete Forrnr,rd-9 but do not have a TlN, appiy
<br />for a Tlltl and enter "Applied For" in the space for tfie TlN, sign and date
<br />the fonn, and give it to the requester. For interest and diuidend
<br />payments. and certain payrnents made nith resp€ct to readily Fadable
<br />instnrments, you will generally have 6O days to gel a TtrN and give it to
<br />the requeeter before you are subject to backt.lp t','ithholding on
<br />payments. The 60-day nrle doee nct apply to olher types o{ payments.
<br />You will be subjecl to backup ri/ithholding on all such payments until
<br />you plovide your TIN ts the requesler.
<br />Note: Entering "fuplied For" meane that you have already applied for a
<br />TIN or that y6u intend to apply for ene sa',n. $e€ also Esfab/ishlng q.S.
<br />slatus for pilrposes of chapter 3 and chapter 4 withholding, earlier, for
<br />when you may instead be Bubjett to withholding ufldrr chaplet 3 or 4 ol
<br />the Code.
<br />Caution: A disregrarded U.S. entity that has a loreign o*'ner must use
<br />the appropriate Form W-8.
<br />G e n er ally, e xempl p ay ee s
<br />-l through 5.r
<br />Exempt payees 1 through 4.
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