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Form W-g {Fl8v. 3-20?4}Page 4
<br />z-Tfre United States or any of ils agencies or inetrumentalities.
<br />3-A state, the Distr:ct ol Columbia, a U.S. commonwealth or terrilory,
<br />or any of lftdr politiaal suMivisions or instrumentalities.
<br />4-A loreign government or any of ils political subdivisions. agencies.
<br />or instrumentalities.
<br />5-A corporation.
<br />5-A dealer in securities or commodities required to register in the
<br />Uniled $lales, the Dislrict of Golumbia, or a U.S. commonweallh or
<br />t6nilory.
<br />7-A fulures commission merchanl registered with the Commodity
<br />Fulures Trading Commission,
<br />8-A rEal e€tate inu€strnent busl.
<br />$-An entig registered at all times during the tax year under the
<br />Investment Company Act ol 1940.
<br />10-Acomn'lon trust fund operated by a bank under section 584{a).
<br />11 -A linancial inslitution as defined under section 581 .
<br />12-A middleman known in the invesiment communhy as a nominee or
<br />cuslodian.
<br />13-A lrust exempt from tax under seclion 664 or describ€d in section
<br />4947.
<br />The following chart shows types of payments that may be exempt
<br />lrom backup withholding. The chart applies to the exemFt payees listed
<br />above, l through 13.
<br />lF the payrnent is for TH€N the paynrent is exempt
<br />tor ,,.
<br />. inlerest and dividend payments All exempt payees excepl
<br />lar 7.
<br />. Brokertransactions Exempt payees t through 4 and 6
<br />through 1 1 and all C corporations.
<br />S corporations must not enter an
<br />exempt payee code because they
<br />are exempt only for sales of
<br />noncovered securities acquired
<br />la 2012.
<br />. Earter trsnsactions Exempt payees 1 through 4.
<br />and idends
<br />. Paym€nts over $60O required to
<br />be reported and direct sales over
<br />ss,000r
<br />' Payments made in settlenrent of Exempt payees 1 through 4.
<br />paym€nt card or third-party
<br />networ* tramactions
<br />I See Fcrm 1099-MlSC, Miscellaneous lnformation, and its in$tructions.
<br />2 However, the following payments made to a corporatiotr and
<br />r€psrtable on Form 1099-MISC are not exempl from backup
<br />rvillrholding: medical and heallh care payments, attomeys' {ees, gross
<br />proceeds paid to an attorney r€portable under seclion 6045(f), and
<br />paymenls for services paid by a federal executive agency.
<br />Exemption frorn FATCA reportirrg cocle. The following codes idenlify
<br />payees that are exempt from reporting under FATCA. These codes
<br />apply to persons submitting this form for accounts maintained outside
<br />of the United States by certain foreign financial institutions. Therefore, if
<br />you are only submltting this form {or an account you hold in the United
<br />States, you may leave this field blank. Consult with the p€rson
<br />requesling this form if you are uncedain if the financial institution is
<br />subiect to these requiremenls. A requester may indicale that a code is
<br />not required by providing you wilh a Form W-9 with "Not Applicable" (or
<br />any similar indication) entered on lhe line for a FATCA exemption code.
<br />A-An organization exempt from tax under section 501(a) or any
<br />individual retirernent plan as detined in section 77o'l(a\(37)'
<br />B-The United Slales or any of its agencies or instrumentalities.
<br />C-A stale. the Dislrict of Columbia, a U.S. commonwealth or
<br />lenitory, or any af their political subdivisions or instrumentalities.
<br />D-A corporation the stock of which is regularly traded on one or
<br />rnore established securilies markets, ag described in Regulations
<br />section 1.1 472-1 {c}(1 }(i).
<br />E-A corporalion that is a member of the same expanded affiliated
<br />group as a corporation described in Regulations section I .1 472- l (c)(1 ){i).
<br />Kittitas County Agreement for Services (rev.5/La/251
<br />PagetT of22
<br />F-A dealer in securities. cammodities, or derivative financial
<br />instrurncnts lincluding notional principal conlracts, futures, forwards,
<br />and options) that is registered as such unde. th€ laws of the United
<br />Stales or any slate.
<br />G-A real estate investment trust.
<br />H -A regulated invesunent cornpany as defined in section 851 or an
<br />entiql registered at all tirnes during the tax year under the lnvestment
<br />Company Act of 1940.
<br />l-A ccmmon trust lund as defined in section 584{a}.
<br />J-A bank ss defin€d in section 581.
<br />K-A broker.
<br />L-A trust exernpt {rom tax under section 664 or described in seclion
<br />4e47{al{1}.
<br />M-A lax-exernpt lrust under a section 4S3{b) plan or section 4s7(g)
<br />phn"
<br />Note: Ysu may wish to ccnsult with lhe financial institution requesting
<br />this form to detennine whether lhe FATCA code and/or exemPt payee
<br />code should be completed.
<br />Line 5
<br />Enter your address (number, sbeet, and apartment or suite numberi.
<br />This is where the requester of tfris Form W-9 will mail your information
<br />retums. lf this address dilfers from the one the requester already has on
<br />file, enter "NEW'' at the top. lf a new address is provided, there is still a
<br />chance the old address vrill be used until the payor changes your
<br />addregs in their records.
<br />Line 6
<br />Enteryour city, state. and ZlP code.
<br />Part l. Taxpayer ldentification Number (TlNl
<br />Enter your TIN in dre appropriate box, lf you are a resident alien and
<br />you do not have, and are no1 eligible to get. an SSN, your TIN is your
<br />IFS ITIN. Enter it in the entry space for lhe Social security number. lf you
<br />do not have an lTlN, see How to get a I/tV below.
<br />lf you are a sole proprietor and you have an ElN, you may enter either
<br />your SSN or ElN.
<br />lf you are a singte-member LLC that is disregarded as an enthy
<br />separale frorn its owner, enler th6 ovJner's SSN (or ElN, if the owner has
<br />oneJ. tf the LLC is classi{ied as a cctporation or partnership, enter the
<br />entity's ElN.
<br />Note: See lVhaf Name and Number To Give the Requester, later, for
<br />further clarification ol name and TIN combinations.
<br />How to get a TlN. lf you do not have a TlN, apply for one immediately.
<br />To apply for an SSN, get Form SS-5, Application for a Social Security
<br />Card, from your local SSA offtce or get lhis form online at
<br />www.SSA.gov. You may aiso get this form by calling 800-772-1213. Use
<br />Form W-7, Application for IRS lndividual Taxpayer ldentiiication
<br />Number, to applyfor an lTlN, or Form SS-4, Applicalion for Employer
<br />ldentification Number, to apply for an Elf.l. You can apply for an EIN
<br />online by accessing the IRS website at www.irs.govlElN. Go to
<br />www.irs"govlForms to view, download, or print Form W-7 and/or Form
<br />SS-4, Or. you can go to rvuwv.irs.gnvlOrderForms io place an order and
<br />have Form W-7 ancl/or Form $S-4 mailed to you within 15 business
<br />days.
<br />lf you are asked to complete Fom W-9 but do not have a TlN, apply
<br />for a TIN and enter ''Applied For" in the space for the TlN, sign and date
<br />the form, and give it to the requester. For interest and dividend
<br />payments, and certain payments made with respect to readily tradable
<br />instruments. you will generally have 60 days to gel a TIN and give il to
<br />the requester before you are subject to backup withholding on
<br />payments" The 60-day rule does not apply io olher types of Payments-
<br />You will be subject to backup withholding r:n all such payments until
<br />you provide your TIN to lhe request€r-
<br />Note: Entering "Applied Fof' means tfiat you have already applied for a
<br />TIN or that you int€nd to apply for one soon. See also Establishing U.S.
<br />sfatus forpnrpo.ses ol chapler 3 a nd chapter 4 withholding, earlier, for
<br />when you may instead be subjecl to withholding under chapter 3 or 4 of
<br />the Code.
<br />Catrtion: A disregarded U.5. entity that has a foreign owner must use
<br />the appropriate Fonn W-8.
<br />Generally. exempt payees
<br />1 ttrrough 5.3
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