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Form W-9 {Ftev.3-20?4)Pa6e 4
<br />2-The United Stales or any of its agencies or instrumenlaiilies.
<br />3-A state, the District of Colunrbia, a U.S. commonwealth or territory,
<br />or aay of their political subdivisions or instrumentalities.
<br />4-A foreign govemment or any of its pclitical subdivisions, agencies.
<br />or instrumentalities.
<br />5-A c.orporation.
<br />6-A dealer in securities or commodities required to register in the
<br />United Slates, the District of Columbia, or a U.S" commonwealth or
<br />lenilcry.
<br />7-A futures commission merchanl register*d wilh the Conrmodity
<br />Fulures Trading Commission.
<br />8-A real estale investment trust.
<br />9-An entity registered at all times during the tax year under the
<br />lnveslment Company Act ol 1940"
<br />.10-A common trust fund operated by a bank under section 584{a}.
<br />1 1 -A financial institution as defined under seclion 581 .
<br />12-A middleman known in the investrnent communhy as a nominee or
<br />cuslodian.
<br />13-A trust exempl trom tax under section 664 or described in section
<br />4947.
<br />The following chaft shows types of paymenls that may be exempt
<br />from backup wilhholding. The chart applies to the exempt payees listed
<br />above. 1 13.
<br />lF the paynrent is for THEN the paynrent is exempt
<br />lor,..
<br />r lnteresl and dividend payments All exempt payees except
<br />for 7.
<br />o Broker transactions Exempt payees .l through 4 and 6
<br />through 11 and all C corporalions.
<br />S coporations must not enter al
<br />exerlpt payee code because they
<br />are exempt only for sales of
<br />noncovered secnrilies acquired
<br />10 2012.
<br />r Bader exchange transact:ons Exempt payees 1 through 4.
<br />and dividends
<br />F-A dealer in s€curities, commodities, or derivative {inancial
<br />instruments $ncluding notional principal contracts, futures, forwards.
<br />end options] that is registered as such under the larvs of the United
<br />States or any slate.
<br />G-A reatr estate investment frust.
<br />H -A regulated investrnent company as defined :n section 851 or an
<br />entity r€gibt€red at all times during the tax year under the lnvestrnent
<br />Company Act of 1940.
<br />l-A cornmon trust fund as defined in s€ction 584{a).
<br />J-A bank ss defned in section 581.
<br />K-A broker.
<br />L-A trust exempt from tax under section 664 or described in seclion
<br />4e47{al{1J.
<br />M-A lax-exempl trust under a seclion .lo3{b) plan or section 457{9)
<br />p[an"
<br />l{ota: You may wish to consult with the financial insliiution requesting
<br />this torm to delermine whether the FATCA code and/or exempt payee
<br />code should be completed.
<br />Line 5
<br />Enter your address {number, skeet, and apartment or suite nunrber}^
<br />This !s where lhe requester o{ this Form W-9 will mail your infotmation
<br />relums. lf this address differs from lhe one the requester already has on
<br />file. enler "NEW" at the top. lf a new address is provided, there is still a
<br />charrce the sld address will be used until the payor changes your
<br />addrcss in their records.
<br />Line 6
<br />Enter your cily, state, and ZIP code.
<br />Part l. Taxpayer ldentification Number tTlN)
<br />Fnter your TIN in the appropriate box. lf you are a resident alien and
<br />ycu do nct have, and are not eligibh to get, an SSN, your TIN is your
<br />IBS tTlN.l. Enter it in the entry space for the Social security number. [f you
<br />do not haue ar lTlN, see How to get a IJN below.
<br />ll you are a sole proprietor and you have an ElN, yoit may enter either
<br />your SSN or ElN.
<br />lf you are a single-member LLC that is disregarded as flt enthy
<br />separate fom its owner, enter the owner's SSN {or ElN, il lhe owner has
<br />one|. H the LLC is classilied as a corporalion or partnership. enter the
<br />entity's ElN.
<br />Note: See l$hat Name and t'lumber To Give the Reguester,later. for
<br />further ciarifrcation ol name and TIN combinations.
<br />Hore to get a TlN. lf you do not have a TlN, apply for one immediately.
<br />To apply for an SSN, get Form SS-5, Application for a Social Security
<br />Card. from your local SSA office or get this form online at
<br />r*wn.S,SA"gov- You may also gei this form by calling 800-772-1213. Use
<br />Fonn W-7, Application for IRS lndividual Taxpayer ldentification
<br />Number, to apply for an lTlN, or Fonn SS-4, Applicalion for Employer
<br />ldentilic.ation Number, to apply for an Ellr,l. You can apply for an EIN
<br />online by accessing the IRS website at lvulw.irs.govlFlN. Go to
<br />www.i*"govlForms to view, download, or print Form W-7 and/or Furm
<br />SS-4. Or, ycu can go to wr,vw. irs.govlArde6orms lo place an order and
<br />ha're Form W-7 andlor Form 5S-4 mai|ed to you within 15 business
<br />days.
<br />lf you are asked to complete FDrm W-9 but do not have a TlN, apply
<br />for a TIN and enter "Applied For" in the space for the TlN, sign and date
<br />lhe form, and give it lo the r€quester. For interesl ancl dividend
<br />payments. and certain payments made with respect to readily lradable
<br />instnrments, you will generally have m days to get a TIN and give it to
<br />the requester before you are subject to backup withholding on
<br />payments" The 60-day rule does not apply to other types of payments.
<br />You wiltr be subjeel to backup withholding on all such payments until
<br />yr:u provide your TIN to the requester.
<br />l{ote: Entering "Applied Fo/' meens that you have already applied for a
<br />TIN or lhat you intend to apply for one soon. See also Estabi,shing U.S.
<br />slalus forpu4ooses of chapter 3 and chapter 4 withholding, earlier, for
<br />when you may instead tre subjeci to withholding under chapter 3 or 4 o{
<br />the Gode.
<br />Carrtion: A disregarded U.S. entily that has a foreign owner must use
<br />the appropnale Fonn W-8"
<br />. Payrn€nts over $600 required to
<br />be reported and direct sales over
<br />Generally. exempt payees
<br />1 through 5.r
<br />. Payments made in settlenrent of
<br />payment card or third-party
<br />netrsork transactions
<br />Exempt payees 1 through 4.
<br />lSee Form 10s9-MlSC, Miscellaneous lnlomration, and its instructions.
<br />? However, the following payments made to a corporation and
<br />repcrlable on Form 1099-MISC are not exempl from backup
<br />wilhholding: medical and health care paymenls, attomeys' fees. gross
<br />proceeds paid to an attorney repodable under section 6045(f), and
<br />paymenls for services paid by a federal executive agency.
<br />Exemption fronr FATCA reporting code. The following codes idenlify
<br />payees thal are exempt from repoding under FATCA. These codes
<br />apply to persons submitting this form for accounts maintained outside
<br />of the Uniled States by cerlain foreign financial institr"rtions. Therefore. if
<br />you are only submitting this form lor an accounl you hold in the United
<br />States, you may leave this field blank. Consuh with the person
<br />requesling this form i{ you are uncertain if the financial institution is
<br />subiect to these requirements. A requester may indicale that a code is
<br />nol required by providing you with a Form W-9 with "Not Applicable" lor
<br />any sirnilar indication) entered on the line {or a FATCA exemption code.
<br />A-An organization exempt from tax under section 50.1{a} or any
<br />individual retirement plan as defined in section 7701{aX37).
<br />B-The United States or any ol its agenciee or instrun:entalities.
<br />C-A state, the District of Columbia, a U.S. commonwealth or
<br />terdtory, or any of their political subdivisions or inslrumentalities.
<br />D-A carporation the stock of which is regularly traded on one or
<br />rnore established securities marketa, as described in Regulations
<br />section 1.1472-l(c)(lXi).
<br />E-A corporation thal is a menrber of the same expanded affiliated
<br />group as a corporatiorl described in Regulations section 1.1a72-1(c)(1|{i).
<br />Kittitas County Agreement for Services (rev.5/7a125)
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