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Fornr W-9 iFlev. 3-282-$Page2
<br />must Dbtain your correct taxpayei identification number [IlN], which
<br />may be your social securig number d.SSI{}, individual taxpayer
<br />identification number {[TlN], adoption taxpayer identification number
<br />{ATIN), or ernpbyer idenlification rumber {ElN}, lo report on an
<br />informalion rehrn th6 arnount paid to you, or other amount:eportable
<br />on an informatian return. Examp8es o{ info!'mation retums include, but
<br />are not limitd to, the following.
<br />r Form 109gJNT {interest earned Dr paidl.
<br />. Form 1099-DlV {dividends. including tfrose from slocks or rnutual
<br />funds).
<br />. Form 1099-MISC {various types of irr,cme, prizes, awards, or gros$
<br />praceeds).
<br />r Form 1099-NEC {nonemployee cofip€nsation).
<br />. Form 1099-8 {stoclt or n'rutual fund sal€s and cerlain other
<br />lransactions by brokersJ.
<br />. Form 1o99-S {proceeds fiorn reai eslaie transactions}.
<br />r Form lo99-K {merchanl card and third-party network transactions).
<br />. Forfi lo98 {home mortgag€ intere€ll. 109s-E {student loan inlerest),
<br />and 1098-T {tuition).
<br />' Fonn logg-C {canc,eled debtf.
<br />o Form 1o99-A {acquisition or abandonment of secured property).
<br />Use Form W-9 onty if you are a U"S. petsrn tlncluding a resident
<br />alienJ, to provide your conect TlN.
<br />Cautiorr: lf you don't retum Form W-9 lo the requester with a TlN, you
<br />might be sublect to backup withholding. See Wiaf is backup
<br />withholding,laler.
<br />By signing the {illed-otrt form. yDu:
<br />'I . Certify rhd lhe TIN you are giving is correct ior you are waiting for a
<br />number io be is*:ed);
<br />2. Certily that you are not subject to backup withholding; or
<br />3. Clainr exemplion ftorn bacltup wiBrtrolding if you are a U.5. exenrpt
<br />payee; and
<br />a. Certify to your ron-loreign slatus for purposes of lvithholding under
<br />chapter 3 or 4 of the Code [if appiicable]: and
<br />5. CefiiE rhat FATCA code(s) entered on this form [f any) indicating
<br />that you are exempt from the FATCA reporting is conect. See What ls
<br />FATCA Reponing, laler, for further infonnation.
<br />Note: lf yr:u are a U.S- persor and a requester gives you a form other
<br />lhan Fornl V[-g 10 request your Tll'1, you must use the requester's folm if
<br />it is substantially similar to this Form W-9.
<br />Oefinition ol a U.5, person. For federal tax purposes, you are
<br />considered a l-!"S. person il yau are:
<br />. An individual ltho is a U.S. cilizen or U.S. resident alien;
<br />. A partne€hip. corpcration. company, or association created or
<br />arganized in th+ United Statcs o{ under the laws of the United States;
<br />. An estate {olher than a {oreign estalel: o{
<br />o A domestic lruel {as defined in Regulations section 30 1.7701 -7).
<br />Eslablishing U.S. status {or purposer of chapter 3 and chapter 4
<br />withholdirrg. Payments rnade lo foreign persons, including certain
<br />distributions, allocalions of incorne. on lranslers ol sales proceeds, may
<br />be subiect lo wrlhholding under chapter 3 or chapter 4 of the Code
<br />(sections 1441-147 41. Under those rules. if a Form W-9 or olher
<br />certification of non-foreign slatrs has nst been received. a wilhholding
<br />agent, transleree, or partrrership {payorl generally applies presumption
<br />ruies that may require the payor lo,.vrttrhold applicable tax Jrom the
<br />recipient, owner, transferor. or partner fpayeel. $ee Pub. 51 5,
<br />Withholding of Tax on Nonresident Aliens and Foreign Entities.
<br />The follor,.iing persons must ryD'ride Form W-910 the payor tor
<br />purposes of establishing its Eofl-fqre'Un slatus.
<br />. ln the case of a disregarded entily tsith a U.S. owner, lhe U.S. owner
<br />of the disregarded entity and not the disregarded entity.
<br />' ln the case of a gtantor trust with a U-S. grantor or other U.S. owner,
<br />generally, the U.3. grantor or other U.S. twner ot the grantor tnrst and
<br />not the grantor trust.
<br />. ln the case of a U.5. trust {other than a grantor lrust). the U.S. trust
<br />and not the beneiicraJies of the trust.
<br />See Pub" 515 for rnore infonnation on groviding a Form W-9 or a
<br />certification of non-forergn slatus to arioid rtithholding.
<br />Kittitas County Agreement for Services (rev.5lL4l2S)
<br />Page 18 of 22
<br />Foreign person. ll you are a foreign person or *te U.S. branch ol a
<br />foreign bank that has elected to be trealed a€ a l-J.S. person (under
<br />Regulations section 1.14411(bl{2}ii','} or other appiicable section for
<br />chapter 3 or 4 purpoeesf, do not use Form W-9, Instead, use the
<br />appropdate Form W-8 or Fonn 8233 {see Pub. 515}. lf you are a
<br />qualified foreign pension {und Llnder Begulalions section 1.897{0-f(4, or
<br />a partnership that is rvholly owned by qualified foreign persion funds,
<br />thal is treated aB a non-{oreign perscn for purpcses of section 1 445
<br />withholding, do not uee Fonr 1, '9. lnstead" rjse Form W-8EXP (or other
<br />cerlification of non-foreign status|.
<br />Itlonresident alien who becomer a residenl alien, Generally, only a
<br />nonresident alien indiuidual may use tfie tenns al alax treaty io reduce
<br />or elirninate U.S. tax on cerlain types of income" However, most tax
<br />trealies contain a provision knol'rn as a salring clalse. Exceptions
<br />specified in the saving clause rnay psynit are exemplion from iax to
<br />conlinue for certain tlpes ol inccme even afier the payee has otherwise
<br />become a U.S. resident alien for tex purpas€s"
<br />ll you are a U.S. residenl alien who is relying on an exceplion
<br />csntained in the saving claus€ of a tax treaty to clairn an exemption
<br />from U.S, tax on certain types of intome, you must attach a statement
<br />to Form W-9 that specilies lhe follorring fiue ilems.
<br />'1. The treaty country. Generally. this must be the same t eaty under
<br />which you claimed exemptiofi Jrotn tax as a nonnesident allen.
<br />2" The treaty arlicle addreesing the inccme.
<br />3. The article number {or location) in lhe tax treaty that contains the
<br />saving clause and its exceptions.
<br />4. The type and amount of income that quali{ieg for the exemption
<br />from lax.
<br />5" Sufficient facts to justify the exemption from tax under the terms of
<br />the treaty atticle.
<br />Example. Article 20 of the U.S.-China income tax treaty allows an
<br />exemplion from tax for scholarship income received by a Chinese
<br />student lemporarily presenl in the United Statee. Unds U.S. law, this
<br />student will becorne a resident alien for tax purFoses if lheir stay in the
<br />United States exceeds 5 calendar years. l-{oweuer, paragraph 2 of the
<br />first Protocol to the U.$.-China treaty fdated April 30, 1984] allows the
<br />provisions of Anicle 20 10 continu€ to appiy e,ren after the Chinese
<br />student becomes a resident alien of tl"re United States. A Chinese
<br />student who qualifies for this exception {under paragraph 2 of the first
<br />Protocoll and is relying on this exception to cfaim an exemption trom tax
<br />on their scholarship cr lellowship incorne would attach to Form W-9 a
<br />statement that includes the in{or.mation described above to support that
<br />exemption.
<br />ll you are a nonresident alien or a foreign enlity. give lhe requester the
<br />appropriate completed Form W-8 or Form 6233"
<br />Backup Withholding
<br />What is backup withholding? Persons n:akrng c€dain payments to you
<br />muet und€r oertain condilions'..,,ithhofd and pay to tlre tRS 24% of such
<br />payments. This is called "backup lrithholding.' Payments that may be
<br />eub,ect to backup withholding include. but ate rot lirnited to, interest,
<br />lax-exempt interest, dividends. hroker and barter exchange
<br />transactiors, rents, royalties, nonernpfoyee pay, payments made in
<br />settlement of payment caird and thir4party n€ttrttk itansattions, afld
<br />cerlain payments from {ishing boat opetators. Fleat estate transactions
<br />are not subject to backup withholding.
<br />You will not be subject to backup rvhhholding on payments you receive
<br />il you give the requester your corect Til'i, n'r.ake the proper certifications,
<br />and report all your iaxable interest and di'ridends 4n your tax return.
<br />Paynrents you receive will be subject to backup withholeling if:
<br />1. You do not fumish your TIN to the rsqueslel;
<br />2. You do not certify yourTll'l r.rhen requirec! {see lhe instructions for
<br />Part ll for details);
<br />3. The IRS tells tfie requester that you iurnished an inconect TIN;
<br />4. The IRS tells you tfrat you are subjecl to backup wilhholding
<br />because you did nct report all your interest arnd diridends on your tax
<br />retum (for reportable interest and dividends only]; or
<br />5. You dD not certr{y to the requesler that you ate not subject to
<br />backup lvithholding. as described m ilefii,1 under "Ey signing the filted'
<br />out form" above {for reFortable interest and di'uidsd accounts opened
<br />after 1983 only).
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