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Form W-9 {ReY.3-e024j Page 3
<br />Cerlain payees and payrnents are exempt from backup withholding.
<br />See Exemptpayee code, later, and the separate Instructions for lhe
<br />Requester of Form W-9 for morc information,
<br />See also Eslablishring U",3. sfafus for purposes of ehapter 3 and
<br />chapter 4 lvrtfiho/ding, earlier.
<br />What ls FATCA Reporting?
<br />The Foreign Account Tax Cornpliance Act {FATCA) requires a
<br />parlicipating foreign tinancial imtilution to report all U.S. account
<br />holders that are specified U.S. perso{rs. Certain payees ate exempt from
<br />FATGA reporting. See F.vempfion from FATCA repofting code. latel and
<br />the lnsFuctions for lhe Requesler of Form W-9 lor more information.
<br />Updating Your lnformation
<br />You must provide updated information to any person to whom you
<br />claimed to be an exempt payee if you are no longer an exempt payee
<br />and anlicipate receiving reportable payments in the future {rom this
<br />person. For example, you may need to provide updated information if
<br />you are a C corporation tfiat elects 1o be an S corporation, or if you are
<br />no longertax exempt. ln addition, you must lumish a new Form W-9 if
<br />the name or TIN changes for the account, for example, if the grantor af a
<br />grantortrust dies.
<br />Penalties
<br />Failure to Iurnish TlN. lf you fail to fumish your conect TIN to a
<br />requesler. you are subjecl to a penalty of $50 for each such failure
<br />unless your lailure is due 1o reasonable cause and not lo willful neglect.
<br />Civil penalty lor false information with respect to withholcling. lf you
<br />nrake a false slatement,rvith no reasonable basis that resufts in no
<br />backup wilhholding, you are subfect to a $500 penalty.
<br />Criminal penalty for {alsifying inlormation. Willfully falsifying
<br />certifioations or affirmations may subject you to criminal penalties
<br />includilrg f nes and/or imp.isonment.
<br />Misuse ol TlNs. lf the requester discloses or uses TlNs in violation of
<br />{ederal lal'r, the requester may be subjecl lo civil and criminal penalties.
<br />Specific lnstructions
<br />Line t
<br />You must enler one of the following on this line; do not leave this line
<br />blank. The name should match the name on your tax relurn.
<br />lf this Form W-9 is fur a joint account (other than an account
<br />maintaioed by a foreign financial institution {FFl)), list firsl, and then
<br />circle, the name of the person or entity whose number you entered in
<br />Part I of Form W-9. lf you are providing Form W-9 lo an FFI to document
<br />a joint account, each holder of the account that is a U.S. person must
<br />provide a Form W-8.
<br />. lndividual. Generally, enter lhe name shown on your tax return. lf you
<br />have changed your last name without informing the Social Security
<br />Administration pSA) of the name change, enter your first name, the last
<br />name as shorvn on your social security card, and your new last name.
<br />Note for lTlN applicant Enter your individual name as it was entered
<br />on your Form W-7 appNication, line 1a. This should also be lhe same as
<br />lhe name you entered on the Form 1040 you liled with your application.
<br />' Sole proprietor. Enter your individual name as shown on your Form
<br />1040 on line 1. Enter your business, lrade, or "doing business as" {DBA)
<br />name on line 2.
<br />. Partnership, C corporation, S corporalion, or LLC, olher than a
<br />clisregarded enlity. Enter the entity's name as shown on the entity's tax
<br />retum on line 1 and any business, trade, oi DBA name on line 2.
<br />. Otlrer entities. Enter your name as shown on required U.S. federal lax
<br />documenls on line 1. This name should match tfie name shown on the
<br />charter or other leEal documenl creating the entity. Enter any business,
<br />trade, or DEA name on line 2.
<br />. Disregarded entity. ln Eeneral. a business enlily that has a single
<br />owner, insluding an LLC. and is not a corporation, is disregarded as an
<br />entty separate from its owner {a disregarded entity}- See Regulations
<br />section 301 .7701 -2{cX2}. A disregarded entily should check the
<br />appropriale box for the tax classifcation of its owner. Enter the ownefs
<br />name on line 1. The name of the owner entered on line 1 should never
<br />be a disregarded entity. The narle on line 1 should be ihe name shown
<br />o:r the income tax retum on lvhich lhe income should be reported. For
<br />Kittitas County Agreement for Services (rev.5lM/25)
<br />Page t9 of 22
<br />example, if a foreign LLC ihat is treated as a disregarded entity for U.S.
<br />federal tax p{rposes has a single owner that is a U.S. person, the U.S.
<br />ownefs name is required to be provided on line 1. lf the direct owner of
<br />the entity is also a disregarded entity, enter the lirst owner that is not
<br />disregarded for federal tax purpo€es. Enter the disregarded entity's
<br />name on line 2. ll the owner of the disregarded entity is a foreign person,
<br />th€ owner must complete an apFropriate Form W-8 irrstead ol a Form
<br />W-9. This is the case even if the foreign person has a U.S. TlN.
<br />Line 2
<br />lf you have a business narne, lrade name. DBA nanre, or disregarded
<br />entity name" enter it on line 2.
<br />Line 3a
<br />Check the appropriate box on line 3a for the U.S. lederal tax
<br />classificaiion af the person whose ilame is entered on line 1 . Check only
<br />one box on line 3a-
<br />Line 3b
<br />Check this box il you are a partnership {including an LLC classified as a
<br />partnership for U.S. federal tax putposes), trust. or estate lhat has any
<br />foreign parlners. owners, or beneficiarles, and you are providing this
<br />torm to a parlnersftip, trusl or eslate, in which you have an ownership
<br />interesl. You rnusl check the box on line 3b il you receive a Form W-8
<br />(or documentary evidence| lrom any partner, owner, or beneficiary
<br />eslablishing toreign slatus or if you receive a Form W-9 from any
<br />partner, owner" or beneficiary tiat has checked the box on line 3b.
<br />Note: A partnership that prouides a F.Jrm W-9 and checks box 3b may
<br />be required to csmplete Schedulee K-2 and K-3 (Forrn 1065). For more
<br />information, see th€ Partnership lnstructions for Schedules K-2 and K-3
<br />(Form 10651.
<br />lf you are required to complete line 3b but fail ta do so, you may not
<br />receive the information necessary.to file a correct information retum with
<br />lhe IRS or fumish a conect payee stalernent to your partners or
<br />beneficiaries. See. for example. sections 6698, 67?2, and 6724 lor
<br />penalties that may apply.
<br />Line 4 Exemptions
<br />lf you are exempt from backup wilhhoidlng and/or FATCA reporting,
<br />enter in lhe appropriate space on line 4 any code(s) that may apply to
<br />yoil.
<br />Exempt payee cocle,
<br />. Generally, individuals {including soie proprietorc} are not exempt trom
<br />backup withholding.
<br />e Except as provided belo'.v. corporations are exenrpt from backup
<br />withholdrng for certain payments, including interest and dividends.
<br />. Corporations are not exempt {rom backup wilhholding for payntents
<br />made in settlement o{ payment card or third-party network transaclions.
<br />r Corporulions are not exempt lrom backup withholding with respect to
<br />altomeys' fees or gross proceeds paid to atlomeys, and corporations
<br />that prouide rnedical or heallh care services are not exempl with respect
<br />10 payments reporlable on Form lGg9-MlSC.
<br />The follorving codes ident:fy Fayees that are exempt frcm backup
<br />withholding. Enter the apptopriat€ code in the space on line 4.
<br />1 -An organization exempl {rorn tax under seclion 501(a), any lRA, or
<br />a custodial accounl under section 403{bX7} if the account satisfes the
<br />requiremenls of section 401 (tl{21.
<br />lF ihe entity/individual on line 1
<br />isa{n).,.
<br />THEN check the box for
<br />. Corporation Corporation.
<br />o lndividual or
<br />r Sole proprietorship
<br />lndividual/sole proprietor
<br />r LLC classi{ied as a partnership
<br />for U.S. federal tax purposes or
<br />r LLC that has filed Form 8832 or
<br />2553 electing 10 be laxed as a
<br />corporation
<br />Limiled liability company and
<br />enter lhe appropriate tax
<br />classificetion:
<br />P = Partnership,
<br />C=Ccorporation.or
<br />S = S corporation.
<br />r Partnership Partnemhip.
<br />. Trusty'estate TrusUestate.
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