|
Form W-9 {Flev- 3-2024)Pase 4
<br />z-Tire United States or any of its agencies or instrumenlalities.
<br />3-A state, the District ol Columbia, a U.S. commonwealth or territory,
<br />or a.ry ol lheir political suMivisions or instrumentalities.
<br />4-A foreign govemment or any of its pclitical sub'divisions, agencies,
<br />or inskumenlalities.
<br />5-A corporation.
<br />6-4. dealer in securities or commodities required to register in the
<br />United States. the Dislrict of Columbia. cr a U.S. commonweallh or
<br />lenitory.
<br />7-A fulures commission merchanl regislered wilh the Commodity
<br />Futures Trading Comrnission.
<br />8-A rea! estate investment trust.
<br />9-An entity registered ai all times during the tax year under ihs
<br />;nve$trnent Company Act of 1940.
<br />10-A crmmon trusl fund operated by a bank under section 584(a).
<br />'1 1 -A linancial institution as defined under section 581.
<br />12-A middleman known in the investment communhy as a nominee or
<br />cuslodian.
<br />1 3-A lrust exempt lrom tax under section 664 or described rn section
<br />4947.
<br />The following chart shows types of paynrenls lhat may be exempt
<br />lrom backup wilhholding. The chart applies to the exempt payees listed
<br />aL:ove, I through 13.
<br />lF the payment is for THEN the paynrent is exernpl
<br />lcr.,.
<br />e Interest and dividend payments All exempt payees excepl
<br />for 7.
<br />payees 1 4and6
<br />thrcugh 11 and all C corpolalions.
<br />S corporafions must not enter an
<br />exenrpt payee code because lhey
<br />are exempt only for sales of
<br />noncovered securities acquired
<br />Io 241?,
<br />r llarter transactions Exempt payees l lhrcugh 4
<br />and
<br />. Payments over $600 required to
<br />be reported and direct sales over
<br />$s,0001
<br />. Payments nrade in settlement of
<br />payment card or third-party
<br />netvrork lransactions
<br />l See Form 1099-MlSC, Miscellaneous lnformation. and its instructions-
<br />: However, the following payments nrade lo a corpcretion and
<br />reporlabfe on Form 1099-MISG are not exemFl from backup
<br />rsiihholding: medical and health care paymenls, atlomeys' fees, gross
<br />proceeds pard to an aftorney reportable under section 6045(f), and
<br />paymenls for services paid by a federal executive agency.
<br />Exenr;>tion frorn FATCA reporting cocle. The following coeies identify
<br />payee$ ihat are exempt from repoding under FATCA. These codes
<br />apply lo persons submitting this {om lor accounts maintained outside
<br />of the Uniled States by certain foreign financial institulions. Therefore. if
<br />you are only submitting this form for an account you hold in the United
<br />States, you may leave this {ield blank. Consult with the person
<br />requesling lhis form if you are uncertain if lhe financial instikrtion is
<br />subject to these requirements. A requester may indicate that a code is
<br />not required by providing you with a Form W-9 lvith "Not Applicable" {or
<br />any similar indication) entered on the line lor a FATCA exemption code.
<br />A-An organization exempt from tax under seclion 50.1(a) or any
<br />individual retirenrent plan as defined in section 7701{aX37).
<br />B-The United States or any o{ its agencies or instrunrentalities.
<br />C-{ stale, the District of Columbia, a U.S- commonwealth or
<br />lenitory, or any of lheir political subdivisions or instrumentalities.
<br />D-A c.orporation the stock of which is regularly traded on one or
<br />more established securities markets, as described in Regulatiorrs
<br />section 1 .1 a72-1 (c){1}(i).
<br />E-A corporation that is a menrber of the same expanded affiliated
<br />gmup as a corporation described in Flegulations section l.la72-l{c}{l}{ii.
<br />Kittitas County Agreement for Services (rev.5l14l25)
<br />PageLT of22
<br />F-A dealer in securities, commodiiies, or derivative financial
<br />instrurnents {including notional principal contracts. fuiures, forwards,
<br />and options) that is registered as such under the larvs of the United
<br />States or any slate.
<br />G-A reaf estate investment trusl.
<br />H -A regulated inuesFnent comparry as defined in section 851 o[ sn
<br />enrtity registered at a.il llmes during the tax year under the lnvp-stnenl
<br />Conrpany Act ol 1940.
<br />!-A common trust lund as delined in seclion 584ia).
<br />J-A bank as definad in section 581.
<br />K-A broher.
<br />L*A trust exernpt from tax under sectian 664 or descnbed in seclion
<br />4s47{al{1 ).
<br />M-A tax-exempt lrust under a seclion 403(b) plan or section 457{9)
<br />plan.
<br />Note: You may wish to Donsult wilh the financial institrltion requesting
<br />this tonr to determine whether the FATCA code and/or exempt payee
<br />code should be completed.
<br />Line 5
<br />Enter your address {number, street, and apartment or suite nunrLrer}.
<br />This is where the requester ol this Form W-9 will nrail your information
<br />retums. ll this address differs from lhe 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 lhe rld address vdll be used until the payor clranges your
<br />address in their records-
<br />Line 6
<br />Enter y0ur clty. state, end ZIP code.
<br />Part l. Taxpayer ldentification Number (TlN)
<br />Enter your TIN in fie appropriate box. lf you are a resident alien and
<br />you do not haue, and are not eligible to get, an SSN, your TIN is your
<br />tFS lTlN. Enler it in lhe entry space for the Social security number. lf you
<br />do not have an lTlN, see Haw to get a IJN below.
<br />lf you are a s.ole proprietor arrd you have an ElN. you rnay enler either
<br />your SSN or Ellil.
<br />lf you ar* a single-mernber"LLC that is disregarded as an entity
<br />separate fron'! its ou/ner, enter the olvner's $SN {or ElN. if the r-,wner has
<br />one|. if tlre LLC is classi{ied as a corporation or partnership, enter ihe
<br />entitg's Elt{.
<br />Note: See b?hat lVame and Nuraber To Give the Requesler, later. for
<br />furllrer clariftcation ol nanre and TIN combinalions.
<br />llow to get a TIN, !f you do rrot have a TlN. apply for one immediately.
<br />To appiy for an SSN, get Form SS-5, Application for a Social Security
<br />Card, fronr your local SSA of{ice or get this fomr online at
<br />Lvw!,r.S51.g6v" You rnay also gei this form by calling 800-772-1213. Use
<br />Fornr W-7" Application for IRS lndividual Taxpayer ldentiiicalion
<br />Number, to apply for an lTlN" or Form SS-4. Application for Enrployer
<br />ldentilicatiDil Number, to apply for an ElN. You can apply for an EIN
<br />online by accessing the lB$ website at wu'r,r.lrs.govlElN. Go to
<br />r,vlrv.lrs"godForrns to view, downlaad, or print Form W-7 and/or Form
<br />SS-4. Or, you ran go to wtwv.irs.govlArderForms lo place an order and
<br />have Form W-7 afld1or Forn'! SS-4 mailed to you within 15 business
<br />days.
<br />l{ you are askecl to complete Form W-B but do not have a TlN, apply
<br />for a TtN and enter "Applied For" in the space for the TlN, sign and date
<br />the form, and give it lo the requester. For interest and dividend
<br />payments, and certain payments made with respect to readily ltadable
<br />instnrments, you v:iil generally have 60 days to gel a TIN and give h to
<br />the requester before you are subiect to trackup withholding on
<br />payments, Tl'!e 60-day rule dr:es not apply to other types cf payments.
<br />You will be subject to backup withholding on all surh payments until
<br />you provide your TIN to the requester,
<br />Note: Entering "Applied Fod' means that you have already applied for a
<br />TIN or that yr:u intend to apply for one socn. See also Estab/ishtng U.S"
<br />stalus Icrpurycses of chapter J d n<l chapter 4 withholding, earlier, for
<br />when yol nray instead be subject to wrlhholding under chapter 3 or 4 of
<br />the C,:de.
<br />Cat{ion: A disregarded U.5. entity that has a loreign o,,yner must Lrse
<br />th€ appropnale Fonn W-8.
<br />Generally. exempt payees
<br />i through 5.:
<br />Exempt payees 1 through 4
|