|
Form W-9 {Rev. 3-2024)Foge 3
<br />Cedain payees and payments are exempt ftBrn backup withhofldinE.
<br />See Exempt payee code, later, and the separate lnstructians {or lhe
<br />Requester of Form W-9 for more infonnation.
<br />See also Fstab/ishftrg U.S. sfatus forpurposes of cftEptergsfld
<br />chaqtet 4 witfiholding, earlier.
<br />What ls FATGA Reporting?
<br />The Foreign Accornt Tax Compliance Act {FATCA} requines a
<br />participating foreign financial institdion tc repryt all U-S. accounrt
<br />holders lhat are specified U.S. perso{rs. Certain payees are *xempt from
<br />FATCA reporting. See F.vemption fram FATCA repfting code, later, and
<br />the lnsbuctions for the Requesler of Form W-9 {or rnore infonnalion.
<br />Updating Your lnformation
<br />You must provide updated information to any person to whom you
<br />claimed to be an exempt payee if you are no longer an ex€{npt payee
<br />and anticipate receiving reportable paymenls in the future fionfl thie
<br />person. For example, you may need to provide updated lnrformatisn if
<br />you are a C corporation that elects to be an S corpomtbn, or if you are
<br />no longer tax exempt. ln addition, you must furnish a nerrl Form W-9 if
<br />the name or TIN changes for the aecount, lor example, if lhe grantor of a
<br />grantor trust dies.
<br />Penalties
<br />Failure to fumish TlN. lf you fuil to fumisit ycur correct Tlt,l to a
<br />requesler, you are Bub.iecl to a penalty of ll50 for each such fuilure
<br />unless your failure is due lo reasonable cause and not to willful neglect-
<br />Civil penalty lor false infomration with respect to wilhholding. tf you
<br />make a false statement with no reasonable basrs tfiat resulie in no
<br />backup wilhholding, ycu are subject to a $Stl0 penalty.
<br />Criminal penalty for lalsifying inlormation. Willfully falsifiling
<br />certifications or affirmations may subject you lo criminal penalties
<br />including fi nes and/or imprisonrnenl
<br />Misuse ol TlNs. lf the requester discloses or uses T[!'ls in violatlon of
<br />federal law, the requester may be subject to ci'.ril and criminal penalties.
<br />Specific lnstructions
<br />Line 1
<br />You must enter one of the following on this lins; do not leave lhis line
<br />blank, The name should match the name on your tax retum.
<br />lf this Form W-9 is for a joint account (other than aE eccount
<br />maintained by a foreign financial institution {FFl)}, llst firct, and then
<br />circle, the name of lhe person or entity vuhose number youl entered in
<br />Part I of Form W-9" lf you are providing Form W-9 to an FFlto document
<br />a.ioint account, each holder ol the accounl lhat is a U.S- person must
<br />provide a Form W-9.
<br />. lndiviclual. Generally, enter the name shown on your tax return- [f you
<br />have changed your last name without informing tfrre Social Securily
<br />Administralion {SSA) of the name change, enter your frst name, lhe last
<br />name ag shown on your social security card, and your new last name.
<br />Note lor lTlN applicant: Fnter your indMdual name as it lvas enlered
<br />on your Form W-7 application, line 1a. This should also be the sarn€ as
<br />the name you entered 6n the Form 1040 you liled wilh your application.
<br />. Sole proprietor. Enter your individual narne as shol'.'n cn your Fonn
<br />1040 on line 1. Enler your business, lrade, or "doing businees as' {DBA}
<br />name on line 2.
<br />. Partnership, C corporation, S corporation, or LLC, other than a
<br />disregarded entity. Enter the enlhy's name as shswn on lhe entity's tex
<br />retum on line 1 and any business, trade, or DBA name on line 2"
<br />. Other entities. Elter your name as shown 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 name on line 2.
<br />' Disregarded entity. ln general, a businees entity that has a single
<br />owner, including an LLC, and is not a ccrpora$on, is disregarded as an
<br />entity separate ftom its owner {a disregarded entry}. See Regulations
<br />sectibn 3o1.7701 -e(c)(2). A disregarded entity should check the
<br />appropriate box for the tax classification o{ its owner- Enter the qwner's
<br />name on line 1. The name of the owner entered on line 1 should never
<br />be a disregarded entity. The name on line -l should be the narne shown
<br />on the income tax retum on which lhe incorne should be reported. For
<br />Kittitas County Agreement for Services (rev.5lL4/25l,
<br />Page t6 of 22
<br />example, if a foreign LLC lhat is treated as a dnsregatded entity {or U.S,
<br />{ederat lax purposes has a singfe ownerttrat is a [.!.S. person, Sne [.r.S.
<br />owner's nan€ is required to be provided on line 1- lf tfie direct owner of
<br />lhe entity is also a disregarded enlily, enter tlrc first owner fiat is not
<br />dbregarded for ledetel tax purpo€es. Enier ltre d{sregarded entity's
<br />narne on fine 2. ll the owner of the disregarded enlity is a furetgrn person,
<br />lhe owner rnust camplete an appropriate Form W-E inctead of a Form
<br />W-9. This is the case even if the loreign person has a U.S. T!N.
<br />Line 2
<br />ff you have a business name, lrade narne, DBA narne. or disregarded
<br />entity name, enter it on line 2.
<br />Lins 3a
<br />Checlt the appropriate box on line 3.4 for the U-S. lederat tax
<br />classification of the person whoge name is en{ered orl line '1" Checte cnly
<br />one box on line 3a
<br />lF the entity/individual on line 1
<br />is a{n) ...
<br />THEN check the bor. for
<br />. Corporation Corporation-
<br />r lndividual or
<br />. Sole proprietorship
<br />lndividual/sole p(oprietor.
<br />. LLC classilied as a partnership
<br />for U.S. federal lax purposes or
<br />. LLC that has filed Fo:m 8832 or
<br />2553 electing to be taxed as a
<br />corporalion
<br />Lirniled liabilfrty ccrnpany and
<br />enier ihe apprspriale lax
<br />clsssification:
<br />P = Parhership,
<br />C=Ccorporation,or
<br />S = S corporatiot'1.
<br />. Parherehip Partnership.
<br />r Trust/estate Trust/estate.
<br />Line 3b
<br />Check thb box if you are a partnership $ncluding an Ll-C classilEed as a
<br />partrrership for U.S. federal tax purposes). trust, or estate that has eny
<br />loreign partners. owners, or beneficiaries, and you ar* prouiding this
<br />form to a partnership, trust, or eslate, in which you haue an owr:ership
<br />interest- You rnust check tF,re box on line 3b !f you receiue a Fonrn t{rI-a
<br />{or doa$rnentary evidenceJ from sny partner, owner, or berae{iciary
<br />establishing loreign status or if you receiue a Forrn, W-S lrom any
<br />partner, owner. or beneficiary tfrat has checked the hax on line 3b.
<br />Note: A partnership that pnovides a Form W-9 and chechs bcx 3b rney
<br />be required to comphle Schedules K-2 and K-3 {Fom 1065}" F r rnore
<br />information, see the Fartnership lnstnrctions for Schedules K-2 and K-3
<br />(Form 1065).
<br />ll you are required 1o ccrnplete line 3b but fai{ tq do so, you may ftot
<br />receive lhe information necessaty to file a correcl inforrnatioct rcfurn with
<br />the IRS or fumish a correct payee stalem€nt to your partners or
<br />beneficiaries. See, for exarnple" sections 6698, 6722" and 6T2,1 fior
<br />penalties that may apply.
<br />Line 4 Exemptions
<br />lf you are exempt frorn backup withholding and/or FATCA rcpaninE.
<br />enter in the appropriate spac€ on line 4 any code{s} ihat rnay apply to
<br />yau.
<br />Exempt payee code.
<br />. Generally, individuals {including sole proprietorgi are not €xeffpt irom
<br />backup rvithholding.
<br />. Except as provided below, corporalions are exernpt lrom backup
<br />wilhholding for certain payments, including interesi tad dhtidends-
<br />r Corporations are nct exempt lrom backup wilhholding for payments
<br />made in settlement ol payment card or third-partf netwotk transaclions.
<br />. Corporalions are not exempl lrom backup wilhholding whh respect to
<br />attomeys'fees or gross proceeds paid to attoffiey9. and corporation:s
<br />that provide medical or health care services are nol exempt with r€€pect
<br />to payments reportable on Form-1099-M:SC.
<br />The follorving codes identify payees that are exernpl fiom backup
<br />wilhholding. Enter the appropriate code in tfte spa.ce on line 4.
<br />1-An organization exernpt from tax under section 501{aJ. any lFA, or
<br />a custodial account under seclion 403pif] lf ttle acccunl satisfies llhe
<br />requiremenls of section 4O1(0(21.
|