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<br />ATTACHMENT,,E"
<br />Request for Taxpayer
<br />ldentifi cation Number and Certification
<br />Go to ww|v.r?s.govlFormwglot instructiors and lhe lateet inlormation.
<br />Give form to the
<br />requester. Do not
<br />send to the lRS.
<br />(Uev. March 2024)
<br />Depanmont oi ths Trussury
<br />lutorna, Rsvorue Saflico
<br />B6{ore you For rslatgd to tho ol Form W-9, see ofFonn, bololv
<br />I Nmeg{entity/individual,Anentrylsrequired,{Forssoleproprietorordisregardedstily,enlcrlheowner'scameonlinel,andenterihebusine3vdlsregarded
<br />wtity'g name on lin€ 2-)
<br />2 Busin8s namo/disrcgardod ontity aarno. ;l dftoront frorn abovo.
<br />4 Exomptions {codos apply onfy lo
<br />certain entilis, not individuals:
<br />see inslruclisns on page 3):
<br />Exempt paym codo {lf any)
<br />Eiefiption lrorn Foreigt Account Tax
<br />Compliancs Aet {FATCA} ropodixg
<br />codo {il any)
<br />(Applies to rccMnts maittained
<br />Ntsida ths United Stal*.)
<br />Fle4(esler'g nams and addt6ss {optlonat)
<br />7 i,sl accounl ilmlr€rts) her€ {opliooaf
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<br />Enter your TIN in the appropriate box. The TIN provided must rnatch the name given on lin€ 1 to avoid
<br />backup wilhholding, For individuals. this is generally your social security numb€r {SSN), Howevor, for a
<br />ro$ident alion, $olo propristor, or dlg.egarded entity, soo tho instructions for Part l, laler. For olher
<br />entities, it is your employer identitication number (ElN)- lf you do not have a nurnber, see Horv lo gel a
<br />IlN, later.
<br />Note: lf the account ,s in more than one name, see the instnrclians for lino 1. See also What Name and
<br />Numbar To Give ttt6 Roqoesldr for guidelinca on whoso number to enler.
<br />Signaturo ot
<br />U.8. psrson Dat€
<br />or
<br />Certilication
<br />Under penallies of perjury, I cerlify that:
<br />1, The number shown on thic torm is my coilecl iaxpayer identification nurrber {or I am lvaiting for a number to be issued to me); and
<br />2. I am not subject to backup withholding because (aJ I am ex€mpt from backup lvithholding, or (b) I have not boen notifiod by ihe lnternal Revsnrre
<br />Se|ice {lRS} lhat I am subiect to backup withholding as a result ot a failure to repod a1l interest or dividertds, or (c) ihe IRS has notilied me that I sm
<br />no longer subiect to backup withholding; and
<br />3, I am a U-S. citizen or other U.S. person {defined beiow): and
<br />4, Th6 FATCA oode(s) entared on tilis form (if any) indicaling that I arn cxempt frorn FATCA reportlng is oorrect.
<br />Cenmcdbn inslruclion5. Yori rnust 6ross out item 2 abovd lf you have been notifiecl by lhe IRS thst you arc cilrrenlly subjetl to backup withholding
<br />b€cause you have lailed to rsport all interest and dividends on your tax return. Fo. real estate hansactio[s. item 2 do€s not apply. For mortgage interest paid,
<br />olh6r than intorost and ara not to lhs co.tification, but must conscl TlN. Se€ the instructiofls for Parl ll, lator.
<br />$ign
<br />Here
<br />General lnstructions
<br />Section references are to lhe lntemal Revenue Code unless othenvise
<br />noted.
<br />Futura d6v6lopmonta. For th€
<br />'ate$t
<br />lnformalion about devslopmenl$
<br />related to Form W-9 and its instruclions, such a$ legislation enacted
<br />atter they were published, go to www.its.govJFormW9,
<br />What's New
<br />Lins 3a has been modilied to clarify horv a disregatded entity completes
<br />this line. An LLC that is a disregarded sntity should check the
<br />approp,iate box for the tax classification of ils owner. Othoryr'ise, lt
<br />$hould check the "LLC" box and enterlts approprjat6 tax classjtication.
<br />Nev.' lln6 3b ha$ bsen addod to lhi$ form. A floulthrough €ntily is
<br />required to complele this line to indicate that it has direct or indirect
<br />foreign partners, orvrrers, or beneficiaries when it provides the Fonr W-9
<br />to anothar flow-through entity in which it has an ownership interest. This
<br />change is intendod lo provldo a llow-through ontily w!th informalion
<br />rogardlng tho stattr$ of its indlrocl forsign partrlorg, ownors, or
<br />ben€liciari€s, so ihat it can satisty any applicable r6porting
<br />requirements. For example, a partnsrship that has any itrdirect ioreign
<br />partners may be required to complete Schedulss K-2 and K-3, See tho
<br />Partnership lnslructlons for Scheduls$ K-? A d K-3 (Form 1065).
<br />Purpose ol Form
<br />An indlvidual or ontlty (Form W-9 requestsr) who is required to file an
<br />intorfiation retrnr with the IRS is giving you this lonn bocause they
<br />3a Chtrk lhe appropriale box tor fe{i€ral lax classificaiton of lhe mlily^ndrvidual whos€ nanro is mltr€d on lne 1. Check
<br />onty ono ot ths following soven box€s.
<br />fl lndividuayslopropriotor ! Ccorporatlon I Scorporation n PadmEhip ! Trust/ostato
<br />n LLC. Fnt6r the lax clas$ifleslion {e - e eerpoffitloh, S = $ mrporallon, P = Pottnorship}
<br />Note: Check thd "LLC" ltox abova and, in lhs 6nlry space, 6nter the approprlat€ code iC, S, or P) ior lho tnx
<br />classificatlon ot lh6 LLC, !nlscs lt is a ditr€gardod onllty. A disr€9ard6d ontlty should insload chek tlre approPriato
<br />box tor ihg ts clsification ot its orvnor-
<br />n Olhtr {soe hrslructiors}
<br />3b t, on lino 3a you checkBd "Padrership" or "Tft€U€slat€," or chock€d "LLC" and entetsd "P" a3 its lax classitication,
<br />snd you tra praviding llis form lo a pflrtn€€hip, trust, qr eslale in whi€h you hRve nn ownersiip intetsst, ch*k
<br />thls box lf yor have any lorelgn parlrsrs, ow{eB, or bemliclarles. Ses instrucllonc ,
<br />5 Addrs6s (ncmber, itr€el, flnrJ apl, or stit6 no.). Sed lnitruclions.
<br />A Ciiy, stat€. and ZIP code
<br />ldenlification Number
<br />numbsr
<br />Part I
<br />Psrt ll
<br />Cat. No. 10231X
<br />Kittitas County Agreement for Services (rev.5/I /251
<br />Page L4 of 22
<br />Form W-9 (ncv. 3-2024i
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