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Form W-9 {Rev,3-2024)Paqe 3
<br />Certain payees and payments are exempt from backup withholding.
<br />See Exempt payee code, laler, and the separate lnslructions for the
<br />Requester of Form W-9 for msre information.
<br />See also Fsfab/lshing U"S, status for purposes af chaptet 3 and
<br />chapter 4 withhalding. eulix.
<br />Whal ls FATGA Reporting?
<br />The Foreign Account Tax Complianee Act {FATCA} requires a
<br />parlicipating foreign financial ;nstitution lo repart all U.S. account
<br />holders thal are specified U.5. persons. Cerlain payees are exempt from
<br />FATCA reporting . See Exemption from FATCA reptfting code, later, and
<br />lhe lnstructions for the Requesier af Fonn !V-9 for rnore information.
<br />Updating Your lnformalian
<br />You must provide updated information to any pers.on to whom you
<br />claimed to be an exempt payee il you are nc ionger an exempt payee
<br />and anlicipate receiving reportable payments in fte future front this
<br />person. For example, you may need 1o provide updated information lf
<br />you are a C corporation thal elects to be an S corporation, or if you are
<br />no longer tax exempt. ln addilion, you must fumish a new 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 />Fsilure to {urnish TlN. lf you fail to fumish yolr conect TIN to a
<br />requester. you are subject to a penalty of $50 for each such failure
<br />r-rnless your failure is due to reagonable cause and not lc willful neglect.
<br />Civil penalty for {alse information urith respect to withholcling. lf you
<br />make a false slatement wilh no reasonable basis that resuhs in no
<br />backup withholding, you are subject to a $500 penalty.
<br />Criminal penalty tor falsifylng information. Willfully {alsifying
<br />certifications or affnnations may subject you lo criminal penalties
<br />including f nes ancVor imprisonment.
<br />Misuse of TlNs. lf the requester discloses or uses TIIJs in violation of
<br />federal law, the 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 linei do nat leave this line
<br />blank, The name shr:uld match the name Dn your tax relum,
<br />lf this Form W-9 is for a joint accouni (o1her than an account
<br />nraintained Lry a foreign finarrcial inslitution {FFl)}, lisl first, 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 to an FFI to docum€nt
<br />a ioirlt account, each holder of the account that is a U-S. person must
<br />provide a Fonn W-9.
<br />. lndividtral. Generally. enter the name shown on your tax return. lf you
<br />have changed your last name wittrout informing lhe gocial Security
<br />Administration (SSA) of the nanre change, enler yDUr firsl name, the last
<br />name as shown on your social security card, and your new last nanre.
<br />Note fe'r lTlN applicant: Enter your individual name as it v/as entered
<br />on your Fornr W-7 application, line la. This should also be the same as
<br />the name you entered on the Form 104o you liled with your application.
<br />r Sole proprietor. Enter your individual name as shcrvn on your Form
<br />1 040 on line 1 ^ Enter your business, lrade, or "doing business as" (DBAi
<br />name on line 2.
<br />r Padnership, C corporation, S corPoraliorr, or LLC, olher than a
<br />disregarded entity. Enter the entity's rrame as sholen on lhe enlity'e tax
<br />retum on line 1 and any business. trade. or DBA name on line 2.
<br />. Other entities, Enter your name as gholnrn on required U,S. federal tax
<br />documents on line 1. This name should match the name shown on the
<br />charter or other legal document creating the entity. Enter any business,
<br />trade, or DBA rrame on line 2.
<br />. Disregardecl entity. ln general, a business entily lhat has a single
<br />owner, including an LLC. and is not a corporaticn, is disregarded as an
<br />entity separate fron its owner {a disregarded entityi. See Regulatic,ns
<br />section 301.7701 -2{c){?). A disregarded entity should check the
<br />appropriate box for the lax classificafion of its owner. Enter lhe owner's
<br />name on line 1. The nanle of lhe owner entered on line 1 should never
<br />be a disregarded entity. The naire on line 1 should be the name shown
<br />on the income tax retum on which lhe income should be reported. For
<br />Kittitas County Agreement for Services (rev.5/L /25]r
<br />Page LG of 22
<br />example, if a foreign LLC that is treated as a dis.egarded entity for U.3.
<br />federal tax purposes has a single owner ihat is a U.S. person. the U.S.
<br />owne/s name is required to be provided on line 1" ll he direct owner of
<br />the enlily is also a disregarded entity, enter the firsl cwnet that is not
<br />disregarded for federal tax pu.pqses. Enler the disregarded entih/s
<br />nai'ne on line 2. lf the owner of the disregarded entity is a foreign person,
<br />the clvner muet complete an appropriate Form W-8 instead of a Form
<br />W-9. This is the caee e-ven if lhe foreign perxon has a U.S. TiN.
<br />Line 2
<br />lf you hava a businegs narrle. trade narne. DBA name, 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. federal tax
<br />classification of the person whose name is entered on line 1. Check only
<br />one box on line 3a-
<br />Line 3b
<br />Check this boxrt you are a partnership (including an LLC classified as a
<br />partnership for U.3. federal tax purpcses), lrust, or estate that has any
<br />foreign partnBrs, owners, or beneficiarieg, and you are providing this
<br />form lo a partnership, trust, or estate, in ',vhich ycu have an ownership
<br />interesl. You must check the trox on line 3b if you receive a Form W'8
<br />(or documentary evidence) from any partner, owler. or beneficiary
<br />establishing foreign status or if you receive a Form W-9 {rom any
<br />partner, owner, or beneficiary that has checked the box on line 3b.
<br />Note: A partnership that provides a Form W-9 and checks box 3b rrtay
<br />be required to complete Schedules K-2 and K-3 {Forrn 1 065), For niore
<br />information. see the Parkrcrship lnstructions for Schedules K-2 and K-3
<br />(Form 1065).
<br />lf you are required 1o complele line 3b but fail to do so, you may not
<br />receive the information necessary to file a correct informatiot.r return with
<br />the IRS or furnish a correcl payee ctaternent to your partflers or
<br />beneficiaries. See, for example. sertisns 6698. fi722. and 6724 tor
<br />penalties that may apply.
<br />Line 4 Exemptions
<br />lf you are exempt from backup withholding and/or FATCA repoding.
<br />enter in the appropriate space an line 4 any code(s) that nay apply to
<br />you.
<br />Exenrpt payee eode.
<br />. Gerrerally, individuals {including scle proprietors} ars nol exernpt {rom
<br />backup withholding.
<br />. Excepi as provided below, ccrporations are exempt {rom backup
<br />withholding for certain paymente, including interegt and dividends-
<br />' Corporationg are not exempt trom backup withhcldinq for payments
<br />made in settlement of payment card or third-party network transactions.
<br />. Corporations are not exempt fronr backup wilhholding with respect to
<br />attomeys' fees or gross proceeds paid to attomeys, and corporations
<br />that provide medical or health care services are not ex*mpt with respect
<br />to payrnente reponable on Fl]rm 1099-MlSC"
<br />The follorving codes identify paye€s lhat are exempt from backup
<br />withholding. Enter the appropnale code in the space on line 4.
<br />1 -An c,rganization exenrpl lrom tax under section 50 1 {a}, any lFA, or
<br />a custodial account under seclion 403(bX7) if the account satisfies the
<br />requirements of section .tol (t{2}.
<br />lF the entity/individual on line 1
<br />isa{n) ...
<br />THEI'I check dre bcr for
<br />. Corporation Corporation.
<br />r lndividual or
<br />r Sole proprietorship
<br />lndividual/sole praprietor.
<br />r LLC clagsffied as a partnership
<br />for U.S. federal tax purposes or
<br />r LLC that has filed Form 8832 or
<br />2553 elec(ng t6 be taxed as a
<br />corporation
<br />Limited liability cornpany and
<br />enter the appropriate tax
<br />classification:
<br />P = Padnership,
<br />C=Ccorporation.or
<br />S = S corporation.
<br />Partnemhip Partnership.
<br />. Trust/estate Trusf,/estale.
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