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Form W-9 {Rev. 3-2024}Frue5
<br />Part ll. Certification
<br />To establish to the withholding agent that you are a U.S. perscn, or
<br />resident alien, sign Form W-9. You may be requested to sign by the
<br />withholding agent even if item 1, 4, or 5 below indicates othen+ise.
<br />For a ioint account, only the person whose TIN is shown in Part I
<br />should sign (when required). ln the case of a disregarded entily, the
<br />person identified on line 1 must sagn. Exempt payees. see Exemptpayee
<br />code, earlier.
<br />Signature requirenrents. Complete the c*rtilicalion ss lndicated in
<br />itemslthroughSbelow.
<br />l. lnterest, dividend, and barter exchange accounts opened
<br />before '1984 and broker accounls considered aclive during 1983.
<br />You must give your correct TlN, but you do nol have lo sign the
<br />certification.
<br />2. lnler€st, dividend, broker, and barter exchange sccounts
<br />opened after 1986 and broker accounls considsred inactive during
<br />'l98il. You must sign the certification or backup withholding rvill apply. If
<br />you are subiect to backup withholding and you are merely providing
<br />your conect TIN lo lhe requester, you must cross out item 2 in lhe
<br />ceftification before signing the form.
<br />3. Real estale transactions. You must sign the c€rtification. You may
<br />cross out item 2 of the certification.
<br />4. Other payments. You must give yourconecl TlN, but you do fiot
<br />have to sign the certification unless you have been nolified lhal you
<br />have previously given an inconect TlN. "Other payrnenis" include
<br />payments made in the course of lhe fequester's trade or business {sr
<br />rents, royalties, goods (other than bills for merchandise), medical and
<br />health care services (including payments to corporalions|, paymenls ts
<br />a nonemployee {or seruices, payments made in setdement of payment
<br />card and third-parg network transactions, payrnents to certain fishing
<br />boat crew memb€rs and fishermen, and gross proceeds paid to
<br />atlomeys (including payments lo corporations).
<br />5. Mofigage interest paid by you, acquisilion or abandonment of
<br />secured property, cancellation of debt, qualilied tuition pragram
<br />payments (under section 52S1, ABLE accounts (under seciion 529A),
<br />lRA, Goverdell ESA, Archer MSA or HSA contributions or
<br />distributions, and pension dirtributions. You must give your ccfiect
<br />TlN. but you do not have to sign lhe certification.
<br />What Name and Number To Give the Requester
<br />For this of account:Give nanre and SSN of:
<br />For this of accounl:
<br />8- Disregarded entity not owned by m
<br />individual
<br />9. A valid tfust, e$tate, Dr pensim kust
<br />'lO- Corporation or LLC elrcting corporate
<br />stalus on Fm 8832 ar Flrm ?553
<br />11. Assmiatim, club, reli1giws, chritable,
<br />educational. or other tax-exxnpl
<br />organiation
<br />12. Pnrtneehip or multi-member LLC
<br />13. A broker or regislered nomin*
<br />14- Armmt wilfr the Departmmt o{
<br />Agriculture in the name ol a public
<br />eniity {such * a siate or lml
<br />govemmmt schd di*trict, or priscn)
<br />ihat receivas agricultuml progrm
<br />paymsts
<br />15. Gmtor trust filing Fwm 1041 or
<br />mder the Optional Filing Method 2,
<br />requirinq Fom 10€9 (s* Regulatiom
<br />smtion 1.671-4{b}{2[i]@)"
<br />Give name and EIN ol:
<br />The owner
<br />Legal entitya
<br />The crpcration
<br />The crganizalicn
<br />The partrership
<br />The broks or nominee
<br />The public atity
<br />1. Individual
<br />2. Two or more individuals {oint account)
<br />other than an account mainkined by
<br />an FFI
<br />3. Two cr nore U.S. persons
<br />fioinl account maintained by an FFI)
<br />4. Custodial account oJ a ninq
<br />{Unifom Gift to Minors Acl}
<br />5. a. The uslal Evocable svings trust
<br />(granlor is also trustee)
<br />b. So-alled trust accdnt thai is not
<br />a legal or valid trust under state lavi
<br />6- Sole proprielorship or disregarded
<br />miity owned by an individual
<br />7. Grantor trust filing under Optional
<br />Filing Method 1 (see Regulations
<br />setion 1.671 -4(bXaXiXAD"
<br />The individual
<br />The actual oqner of the rccrunl or.
<br />il mmbined funds, the imi i*dividual
<br />on the aEcsuntl
<br />Each holder of the mcmnt
<br />The minor:
<br />The grmtor-trusiffil
<br />The acfur! ownerl
<br />The ovrner3
<br />The grmtor'
<br />Th€ trust
<br />'List first and circle the name of the peftion whose numb€r you fumish.
<br />lf only one person on a joint account has an SSN, that person's number
<br />must be fumished.
<br />2Circle the rninor's name and fumish the minor's SSN"
<br />3You must show your individual nafire on line 1, and enter your business
<br />or DBA name, if ahy, on line 2. You may use either your SSN or EIN [f
<br />you have one), but the IRS encourages you to use your SSN.
<br />I List first and cirrle the name of the trust, estate, or pension trust. (Do
<br />not fumish the TIN of the p€rsonal representative or trustee unless the
<br />legal entity itself is not designated in the account title.)
<br />'Note: The grantor mu$t also provide a Form W-9 to *re trustee of lhe
<br />trust.
<br />" For more information an optional filing methods tor grantor trusls, see
<br />the lnstructions for Form 1D4i .
<br />Note: ll no name i9 circled when more lhan one name is listed, the
<br />number lvill be considered to be that of the Jirst name listed.
<br />Secure Your Tax Records From ldentity Theft
<br />Identity theft occurs when someone uses your personal information,
<br />such a5 your name, SSN, or other identifiTing information, wilhout your
<br />permission to commit fraud or other crimes. An identity thiet may use
<br />your SSN to get a job or may file a tax retum using your SSN io .eceive
<br />a refund-
<br />To reduce your risk:
<br />r Protect your SSN,
<br />. Ensure your employer is prolecting your SSN, and
<br />r Be careful when choosrng a tax return preparer.
<br />ll your tax records are affected by identity theft and you receive a
<br />notice from the lRS, respond right awoy 1o the name and phone number
<br />pnnted cn lhe IRS nobce or letter.
<br />lf your tax records are nol cunenlly affected by identity theft br|t you
<br />think you are al risk due to a lost or stolen purse or wallet, questionable
<br />credit card activity, or a questionable credit report, contact the IBS
<br />ldentity Thefl Hoilire at 800-90&4490 or submit Forlll 14039.
<br />For more information, s€e Pub. 5027, ldentity Theft lnfcrmalion fo!'
<br />Taxpayers.
<br />Kittitas County Agreement for Services (rev. 5/La/25)
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