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Fo,,n Ulfrg
<br />ATTACHMENT "E"
<br />Request for Taxpayer
<br />ldentification Number and Certification
<br />Go to wlvw,ris.govlFormlllglot instructions and the lateEt inlormetion.
<br />(ff€v. March 2024)
<br />Depanrnant ot the Tr€&ury
<br />lntornal Fl.vonue Soruico
<br />Give lorm to the
<br />requester. Do not
<br />Bend to the lRS.
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<br />Ent€r your TIN in ihs appropriate box, The TIN provided must match the name given on line 1 to avoid
<br />backup withholding. For individuals, ihis ia generally your social security numbor (SSN). However, for a
<br />resident alien, solo propriotor, or disregarded eniity, $ee lhe instruetlonc for Parl l, later. For other
<br />entities, it is your ernployer identificatiod number (ElNl. lf you do rrot have a number, see How to gel a
<br />nN, lAter.
<br />Noter lf the account is in more than one name, see ihe instfl.rctions for lino 1. See also What Nama and
<br />Numbot To Giva the Feguest&r tar guidelinas on whose number to enter.
<br />Signalurc ot
<br />U.S. p6rron Da16
<br />For rolal6ci io lh6 ot Form W-9, soo of Form, balow.
<br />I Name ol ontity/irdlvidual. An enlry is required. tFo( a $ole proprietor or disregarded sirly, enter the owntr's n8me on lim 1, and enter lhe busincss/disregarded
<br />entity'$ name on line 2.)
<br />2 Bwino$ nmoldismgardod ontity namo, il difforsnt trom above.
<br />4 Fxomptions (codas apply sly to
<br />certsin entitl€, not individualsi
<br />i€e Imtruclions on page 3):
<br />exompt paytr codo tif aoy) _
<br />Eremptlon {rom Foreign Account Tax
<br />Compliance Act {FATCA} roportilrg
<br />cods (if my)
<br />fAppir'os lo accounts tnaintainad
<br />@,sido lhe Uaitod staf6s.l
<br />H6qu6$ter's haril€ And addrees (optional}
<br />7 I ,sl &corni .rumtler{si here {opliora0
<br />or
<br />Under penalti€s ot parjury, I certify ihai:
<br />1 . The number shown on thi6 torm is my correct iaxpay€r identification number (or I am waiting for a number to be issued to mol: and
<br />?. I am not $ubjsct to backup I'/ithholding bs€ause (a) I am oxempt from backup rvithholdlng, or {b} I have no1 boon notificd by the lntarnal Rovonuc
<br />Service (lRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or {c} tha IRS has notilied tne that I arrl
<br />no lor]ger subiect to backup wilhholding; and
<br />3. I am a U.S. citizen or other U.S. person {defined belolv}; and
<br />4. Th6 FATCA cod6(sl entored on thas lorft (if any) indicating that I am oxempt frorn FATCA reporting i$ eorrect.
<br />Cortincation instruclions, You must eross orrt ilern ? above if you have been notified by the IBS that you are currently $ubJoct to backup withhillding
<br />b€causc yori have failsd to reporl all intsrost and dividends on your lax rsturn. For r€al $tate transactions, item 2 doas nol apply. For mortgage inlerest paid,
<br />acquisition or abandonment of secured properly, canc€llation ol debt, contributions lo an individual retirement anangernenl {lRA), and, generally, paymenis
<br />othar than intsrsst and dividsnds,aro nol to tho certi{ication, but must corrsc{ TlN. See lhs instruclions for Part ll, lator
<br />Sign
<br />Here
<br />General lnstructions
<br />Section references are to lhe lntemal Revenue Code unl€ss otherwise
<br />noted,
<br />Fuluro devglopman$. For the latost infoflralion about dsvolopmnnts
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, go lo www.irs.govll:onnW9,
<br />What's New
<br />Line 3a has been rnodilied to clarify hov/ a disregarded en{ity completes
<br />this line. An LLC that is a disregarded entity should check the
<br />approp.iale box for the tilx classificatlon of ilc own8r. OthenviBo, if
<br />should check lhe "LLC" box and enler it$ appropriale tax classiiicatian.
<br />Nevr llne 3b has b€€n addod to this form. A llow-through sntity ig
<br />required to complste this line to indieate that it has direct or indirect
<br />foreign partrrers, orvrrers, or beneficiaries when il provides lhe Fonn W-9
<br />to another flow-through entity in which it has an ownership intetest. This
<br />chango is intended to provide a llow-through enlity u/ith information
<br />r6garding the $lalu$ of als indirecl foroign parlnors, ownerli, or
<br />ben€ticiaries, so that it can saiisfy any applicable reporting
<br />requirements. For example, a partnership that has any indirect loreign
<br />partners may be required to complete Schedulos K-2 and K-3. Se€ tho
<br />Parlnorship lnstruction$ for Schodulo$ K-2 and K'3 (Forrn 1065).
<br />Purpose of Form
<br />An individual or ontily (Forln W-9 reque3ter) who is required lo flle Bn
<br />{rformation returr) wilh th6 IRS is giving you this lortn because they
<br />6a Ch*k the appropriala box for fedaral lar elassiflcalion of the entityindildual vhos nam6 is €nlered on line 1 . Check
<br />only ono ot th6 following !:6v6n boxo$.
<br />n lndividuaysolo propriotor f] C corporation n S co.pqaiion E Partnorchlp I Trusiloststo
<br />E LLC. Enterthe taxclas$iflcalion {C =C eorpodtion, S- $trrporatisn, P = Pafloorship}
<br />Nole: Chtrk the "LLc" box above asd, in lhe snlry spac€, enler lhd apprcprlats code (c, s, ry P) lor lha tu-
<br />classlllcatlon ol lhe LLC, urloss lt is a disfgardtrl entlty, A disr€gsrdod eniity shouid iosl€ad clt*k tho approprlalo
<br />bcx lor th€ til clffiification of its oivllot-
<br />n olhtr{s€o hslructions}
<br />3b It on line 3a you checkGd "Parlo6rship'' or "Tru5vsslate." or ehockod "LLC" and srtetod "P" as its tu classification,
<br />flnd you #e providing lhig lorm to 6 parln€.ehrp, trust, or sglats jn which you hflvB an ownership interest, chtrk
<br />lhls box il you have any lorelgn pa.tn€re, ov/nem, or beosficiaries, Sec instruclioRg
<br />5 Address (numbe., street, and apt, oa strite no.l. $e€ Instrucllons.
<br />6 Cit, stato. and ZIF cod8
<br />ldentilication
<br />number
<br />Part I
<br />Part ll
<br />Oal. No. l02s1X
<br />Kittitas County Agreement for Services (rev.5l!4/25]|
<br />Page t4 of 22
<br />Forln W-9 {tnev. 3-2024}
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