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Fo,,n lllfrg
<br />ATTACHMENT'G"
<br />Request for Taxpayer
<br />ldentification Number and Gertification
<br />Co to u/ww.rilr,govlFormW9lor inEtructlonE and the latG$t information.
<br />{Hev, March 2024)
<br />Dsparirndnl of lhs Truasury
<br />lntsrnal Rovouuo Soruicc
<br />Give form to the
<br />requester, Do not
<br />send to the lRS.
<br />oor{ogo-o{rEao\Sd(J
<br />oEz6
<br />a-st
<br />0oath
<br />o
<br />Q1
<br />Before
<br />Enter your TIN in the appropriate box. The TIN provided must match the name qiven on lin6 1 to avoid
<br />backup lvithholding. For individuals, this is generally your social securily number {SSN}. However, for a
<br />resjdenl allen, sole proprietor, or dlsregarded entity, s6e tho inlrtri]ollons for Part l, laler. For othe.
<br />entlties, it is your ernployer identitlcation number (ElNl. lf you do not have a nurnber, see How to get a
<br />I/N, later-
<br />Note: lf the account is i,l mors than one name. see the instructrons for line 1. See also What Name and
<br />Number To Give the Roguester for grridolines on whose nurnbor lo en16r.
<br />Slgnaluro ol
<br />U.S, porson Dat6
<br />General lnstructions
<br />Section references are io the lnternal Ilevenue Code unless otherwise
<br />noted.
<br />Future d6v6lopments. For the latest informdtion about developmenlg
<br />related to Foiln W-9 and its instrudions, $uch as legislation enacted
<br />after they were published, go to r,yww.lrc.govlt:omwg,
<br />What's New
<br />Line 3a has besn rnodified to clanty how a disregarded sntity completes
<br />this line. An LLC that is a rjisrsoarded enlity should chock rro
<br />appropridte box for iho talx classification of its orvnar. Other\vise, it
<br />shodld check the "LLC" krox ar'ld enter !ts approptiat€ lax classiiication.
<br />For rolated to thc purposo of Form W-9, s6e of Form,bolovt.
<br />I Name ol entitylindlvidtal. An entry ls tequired. {Fot R sole proprjetor or disregarded entity, enler the awner's pame on line 1, ild enter lhe business/dbregarded
<br />enlity'3 name on lina 2J
<br />? Busin.se nsnoldisrogardsd ontily nam6, if dattoront irom above.
<br />4 Exomptions (codos apply sly to
<br />certain enlities, nol individuals:
<br />s* inslnlclion5 on page 3):
<br />Exempt paytr coda (il flnyl
<br />Excrnpllon frsn For€ign Acfount Tax
<br />Compliance Act {FATCA) ropo.ting
<br />codo {it ey}
<br />(Applios lo accwnts fraintainad
<br />outsids the Unit8d Slaf6.l
<br />ReqlestBr's name ind flddress (apllon6i)
<br />7 I st accounl ilunrhsr{$) Dere (ofrtronaD
<br />ldentification Number
<br />or
<br />Under perlalties of perjury, I certity that:
<br />1 , Ths number shown on thrs fofm is my corect taxpayer iclenti{ication number {or I am waiting for a nurnber to be issued to rne); and
<br />2. I am not subject to backup wilhholding becnuso (a) I am exornpt tro.n backup withholding, or {b) I havo nol been notified hy the lntomal Rc'renue
<br />Service (lRS) thai I am subject 10 backup withholding as a result of a failure to report all irtterest or dividerrds, or (c) the IRS has notilietl rne thal I arrr
<br />no longer sub,ect to backup yJilhholding; and
<br />3. I am a U.S. cilizen or other U.S. peson (defined belolvlt and
<br />4. The FATCA code{s} onteled on tlri:t form (if any) indicaling thal I am axernpt frorn FATCA roporting is corroct.
<br />Ce,'tmcailon in$tructlons. You nust cross oul ;lem ? above if you hav6 been nolified by lhe IRS thal you ate durrently subjecl lo backup wilhholding
<br />because you have fai,ed to report all interest and divid€nds on your tax retu.n. For real estate lransaclions, ilem 2 does tlot appiy. For tnortgage ilterest paid,
<br />other than inlerast and ar6 not raquired lo sign the cort$ication, but mu61 correcl TlN. Soe tho instructions for Part ll,
<br />'atorSign
<br />Here
<br />NoYr line 3b has been addod to lhis form, A flolr-through entity is
<br />required to cornplete this line to ir)dicate lhat it has di,ect or indirect
<br />foreign partners, orvners, or beneficiaries lJhen ii provides the Form W-9
<br />to another {low-through entity in which it has an ownership intercsl. This
<br />change is intended to providn a flow-through enlily with information
<br />r6garding th€ siatus of it$ indirscl torsign partners, owner$, or
<br />ben6liciaries, so ihat it can sat'sFy any applicable reporting
<br />requirements. For example. a parlnership that has any indireci foreign
<br />partr]ers rnay be required lo complote Schodulns K-2 and K-3. See tho
<br />Parlnership lnslructions for Schedules K-2 and K-3 (Fonn 1C65).
<br />Purpose of Form
<br />An individual dr enlity (Fonn W-9 requester) who is requirod to lile ail
<br />information return with the IRS is giving you tlris form b€cause they
<br />3a Chtrk lhe apProBriale box fol ffrlerai tar dla$Srficdlioil of lhe enliiyrndrvi(tual vhoge n€rn6 ls enlersj dn line 1 - Check
<br />only on6 ot tbo lollow;ng s€von boxss.
<br />E lndividuaUsolcpropriotor I Ccorpora:ion I Scorpontion n Partnorship n TrusgoEtato
<br />E LLC. Eilt€rlhetax classiflralion {C = C aorporation, S = Scorpo..tion, P = Padnership}
<br />Noiq: Chtrk th€ "LLC" bcx abovg d*d, kl the entry space, enler the €pproprlate code (C, 5, or P) for the ti*-
<br />da6slticalion ot tho LLC, uill69s lt ls a disegardod ontlty. A disrsqarrlod srrlily should insload cb*k th6 dnpropridto
<br />box tor i'le ld clssilication ol its awner-
<br />fl Other {sce l.struclio.s)
<br />3b It on line 3a you checkad "Patlnership" or ''lrusv€state." or chock€d "LLC" and eqlored "P'' as its iax classification,
<br />sld you ile p.oviding !hi3 fqrn to a pednership, trusl, or estate rn which ygu have an ovJnersiip interesi, chtrk
<br />lhls box il you have any toreigfl partf,eB, own€ri, or be4eficlaries, Sea instr$cllone , n
<br />5 Address (nr,rnber, utreet, and jrpr, ar srrte no ). Scc rnstttctlons.
<br />6 City. slai€, and ZIP cod6
<br />Social socurity numbet
<br />Part I
<br />Employer
<br />Part ll
<br />(]at. flo. 102ll1X
<br />Kittitas County Agreement for Services (rev. 5/Ial25)
<br />Page L7 of 22
<br />Form W-9 lnev :-202.11
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