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Form W-9 {Rw.3-202.1)Page 3
<br />Certain payeee and payments are exempt from backup withholding.
<br />Se Exempt pyee code, later, and the separate lnstructions lor the
<br />Hequester of Form W-9 for more information.
<br />See also Fsfablishing U.S. status for purposes of ehapter 3 and
<br />chapter 4 withhdding, eailier.
<br />What ls FATCA Reporting?
<br />The Foreign Arcount Tax Compliance Act (FATCA) requires a
<br />parlicipating foreign financial institution to repod all U.S. account
<br />holders that are specified U.S. persons. Certain payees are exempt from
<br />FATCA reporting. See Exemptlon from FATCA repofting code,later, and
<br />lhe lnstruclions for the Requester of Farm W-9 {or more information.
<br />Updating Your lnformation
<br />You must provide updated information to any pemon to whom you
<br />claimed to be an exempt payee if you are no longer an exempt payee
<br />and anticipate receiving reportable Payments in the future {rom lhis
<br />person. For example, you may need to provide updated information il
<br />you are a C corporation that elects to be an S corporation, or if you are
<br />no longer lax exempt. ln addition, ycu must fumish a nevr Form W-9 if
<br />the name or TIN changes for the account, for example, if lhe grantor of a
<br />grantor trust dies.
<br />Penalties
<br />Failure to furnish TlN. lf you fail to funrish your conect TIN to a
<br />requester, you are subject to a penalty of 950 for each such failure
<br />unless your {ailure is due to reasonable cause and not to willlul neglect.
<br />Civil penalty for false infornration witlr respect to withholdittg. lf you
<br />make a false staternent rvith no reasonable basis that results in no
<br />backup withholding, you are subject to a 9500 penalty.
<br />Grinrinal penalty for falsifying inlormation. Willfttlly falsifying
<br />certifications or affirmations may subject yor-r to criminal penalties
<br />including fi nes and/or irnprisonment.
<br />Misuse ol TlNs. lf the requester discloses or uses TlNs in violation of
<br />federal lavr, lhe requester may be subject to civil and criminal penalties.
<br />Specific lnstructions
<br />Line I
<br />You must enter one of the following on this line; do not leave this line
<br />blank- fhe name should match the nams on your tax relum,
<br />lf this Fotm W-9 rs for a joint account (other than an account
<br />maintained by a foreign financial inslitution {FFl)}, list first, and then
<br />circle, the name of ihe person or entity whcse number you entered in
<br />Part I ol 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.5. person must
<br />provide a Form W-9.
<br />. Indiviclual. Generally, enter the name shown on your tax return- lf you
<br />have changed your last name without informing the Social Security
<br />Administratiorr (SSA) of the name change, enter your firsl name, the last
<br />name as shown on your social securily card, and your new lasl name.
<br />Note for lTlN applicant Inter your individual name as it was entered
<br />on your Form W-7 application, line 1a. This should also be the same as
<br />lhe name you entered on the Form 1040 you {iled with your applicalion.
<br />. Sole proprietor. Enter your individual name as shown on your Form
<br />1040 on line 1. Enter your business, trade, or "doing business as" (DBA)
<br />name on line 2.
<br />. Parlnership, C corporation, S corporation, or LLC, olher than a
<br />disregarded entity, Enter the entity's name as shown on the entity's tax
<br />return cn line 1 and any business, lrade, or DBA name on line 2.
<br />. Olher entities. Enter your name as shown on required U-S. federal tax
<br />documenls on line 1. This name should match ihe name shown on the
<br />charter or other legal documeni creating the entity. Enter any business,
<br />lrade, or DBA name on line 2,
<br />. Disregardetl errtity. ln general, a business entity that has a single
<br />owner, including an LLC, and is not a corporation, is disregarded as an
<br />entity separate from ils owner (a disregarded entity). See Begulations
<br />sectibn 301.7701-e(c){z). A disregarded entity should check the
<br />appropriale box for the iax classification of its owner. Enter the ownefs
<br />name on line i ^ The name of lhe owner entered on line 1 should never
<br />be a disregarded entity. The name on line 1 should be the name shown
<br />on tfie income tax r€tum on which the income should be reported. For
<br />Kittitas County Agreement for Services (rev. 5/L4/25)
<br />Page L9 of 22
<br />exarnple, if a foraign LLC that is trealed as a divegarded entity for U.S.
<br />federal lax purposes has a single owner that is a U.S. person, the U.S.
<br />orvnels rarne is requlred ts be provided on line 1. lf tfie direct owner ol
<br />the entity is also a disregarded entiiy. ent*r the lirsl owner that is not
<br />dieregarded for {ederal tax purpos€s- Enter the disragarded enti$'s
<br />narre on llne 2. lf tfie owner of the disregarded entity is a foreign person.
<br />lhe oruner rnust trom,plete an appropriate Form W€ instead of a Form
<br />W-9. This is the case even [f the foreign person has a U.S. TlN.
<br />Line 2
<br />lf you have a business name. trade name. DBA name, or disregarded
<br />entity name. ent€r it cn line 2"
<br />LinE 3a
<br />Cherk the aFFropriate box on line 3a for the U-S. federal tax
<br />cfassificalion of lhe person whose lame is entered on line 1. Check only
<br />one box on line 3a
<br />Line 3b
<br />Check this box i{ you are a partneship (including an LLC classified as a
<br />partnership for U.S. federaf tax purposes), lrust, or estate that has any
<br />{oreigfl partners, owners, or beneficiaries, and you are providing this
<br />form to a parlnersirip, !rust, ot estate, in which you have an ownerehip
<br />interesl. You rnust cFreck tlne box on line 3b if you receive a Form W-8
<br />(or documentary evidencef from any partner, Dwner, or beneficiary
<br />establishing foreign status or if you receive a Form W-9 lrom any
<br />partner, owner, ar beneficiary that has checked the bax on line 3b.
<br />Note: A partnership lhat provides a Form W-9 and checks box 3b may
<br />be required 1o cornpl€te Schedules K-2 and K-3 (Form 1065). Fr:r more
<br />infqrmation, see the Parlnership lnstructions for Schedules K-2 and K-3
<br />{Form 1065i.
<br />l{ you are required lc complete line 3b but fail to do so. you
<br />r.eceive the information necessary to file a correci infomtation
<br />may nol
<br />retum with
<br />the IRS or fumistl a coreci payee statem€nt to
<br />heneficiaries. See, for example" sections 6698,
<br />penalties ihat may appty.
<br />Line 4 Exemptions
<br />lf you are exempt fonl baokup withholding andrbr FATCA reporling.
<br />enter in !t!e appropriate spac€ on line 4 any code(s] lhat may apply to
<br />yDu"
<br />Exenrpt payee code.
<br />. Generally, individuals {including sole proprietors'i are nol exempt {rom
<br />backup withholding.
<br />. Except as provid*d belolv, corporations are exempl from backup
<br />wilhholdinE for certain payrnents. including interest and dividends.
<br />. Corporations are not exernpt from backup withholding for payrnents
<br />made in setrllement o{ pal.rnent card or third-party networt transactions.
<br />. Corporations are not exernpt from backup wilhholding wilh respecl to
<br />atlomeys' fees or gross proceeds paid to attomeys, and corporatir:ns
<br />lhat prrvide rnedical or heallh care services are nol exempt with lespect
<br />to payments reporlable on Form 1099-M|SC.
<br />The f,rllorving codes idenirfy paye€s lhat are exempt from backup
<br />wilhholding. Enter lhe apprr:priate code in the space on line 4.
<br />1 -An organization exernpl from tax under section 501 (a), any lRA, or
<br />a cuslodial accoilnt ilnd€t section 403PX7) if the account satisiies the
<br />requireniefl ts of secti'rn 4s1 fj{21.
<br />your partners or
<br />6722. and 6724 lot
<br />lF the entity/individual on line 'l
<br />isa{n)...
<br />THEN check the box for
<br />r Corporation Corporation-
<br />r lndividual or
<br />r Sole prop{ieto.s}iip
<br />lndividual/sole proprietor
<br />. LLC classi{ied as a pattnership
<br />for U.S. lederal tax purpcees or
<br />r LLC that has filed F rm aB32 or
<br />2553 electing to be taxed as a
<br />corporation
<br />Limiied liability company and
<br />enter the appropriate tax
<br />classification:
<br />P = Parhership,
<br />C=Gcorporation.or
<br />S = S corporation.
<br />I ParErership Partnership.
<br />. Trulsty'estate TrusUestate.
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