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Fom T&9 iH*. +2oe4l 2
<br />mlsl obt h your conEct tsrpsye. i{ientin{afion rrurnb* fflt'$. witich
<br />may be yor'social sec{dty ir"ftb€r F$'ll, indvkltrsl laxPtyer
<br />k Enfficatim mrnb€r (mttl. aCoption lo(payor iJ€ntificdttn number
<br />lAn$, o. efirployor id€ntific$ion mjrtter (ElNf, lo rcpotl on an
<br />infonrnion returit th. atnou1l Faid toyou. e odrcr arnount repo*table
<br />dr gl inbrmslion relt{n. Exafipl€8 of hfotrftttion r€t4r8 inctrde, but
<br />eo nd lhu'ted tc, $cfolts{ing-
<br />. Fc(In 1099-lM fnterest eamed ot pa;d).
<br />. Fsm I GXlOltt (dividends, inclsdqg fnos. ftotn slocks ar rutral
<br />nrtds).
<br />o Fmn tO9ll-lrllSG {varianE tfpes of incomq pizes, awade, or groas
<br />Froceeds).
<br />r Form IIXX)-NEC (non€rndoyee cornpenEstbn).
<br />. Fclm 1099€ {stock s rnund frmd 3d€3 trid cacsin otfi€r
<br />trrrsadbrr bvbok€tsi.
<br />. Fonn t 099.S (ploce€& ton red €tEte tBnsactifi3).
<br />. Fmn 1009-l( (merchant c€d andSfrdfady netuo* tansaclbns).
<br />. Fsm 1098 (home mortslsg€ hteres$- 1098{ (strdent ban inteGs$.
<br />and 10e&T&ilirn).
<br />. Fom t00S-C tc&cd6d d€bti.
<br />. Fonn 10O9iA (ac$deitidr or abandonmBnt of sectJd F.oP€rtyl.
<br />l}$i Fonr W-9 o.ily if pu rre a U.S. Pe$on ffidtding e t€slt nt
<br />dico[ to provide your corruct TlN.
<br />Crrlion: lf you chrt'r rrb.5n Foon W-e lo fle recfJest€r with a TlN, pu
<br />might bc u.&ricci r beckLp wittlulding Scc tvtEt b btcrarp
<br />wr'lrtoldng, Hsr.
<br />By !*yrirs ilre filed-ottt {onrr' you:
<br />1. Cerd$rhat $€ TIN )tou are givlE b cor.ct (orybu sewdtlE fo( I
<br />rurn$er to be iasued[
<br />2. CefiTyfr.t tou a€ rEt $*i€ct to b€ckjp *if$okftg; or
<br />3. Clsim exemFbo ftqn brclqp wi$*tolding if you are a U'S. erernpt
<br />pE/Ec;8t1d
<br />4. Ceriryto t€ilt non-fu{1n statw forpurposes of wi*rholding utder
<br />chade( 3 ar 4 otfie Code 0f apdicable): antl
<br />5. Cadiry $d FATCAcode€ientered on thb iom ftf onyi inrticat'tng
<br />$atyq.ii exorptftonr the FATA\ reporlhg b corrrct, See l4ftatls
<br />FATCA BWtilA, htar, ftr frrfig infometbn.
<br />l{otc: lf you *e a U.S. person ard a leqr€lcr gi€t },ou a brm oltrcr
<br />tlgr Fofifl w-g to mqrosr !'our nN, ]ou mr.d' r.ee rhe rcquestr's tam if
<br />it b srbtdrtialy slnihr to tSa FomW-9.
<br />Defufrixt of e U.S pe€on. Fot l€dord tex ptxpos€4 you ata
<br />conskJ€(€d a U.S. psron if tru are:
<br />. An lrdivkhd vrrho is a U.S. cithen or U.S. resih alien;
<br />. Ap6rtlerrti', corPoralion. conpany, or essociditn crded or
<br />orgarized in rhe Urfted Stater s undertre lars dthe lnftcd $eg;
<br />r An estate {orhertian eb€ign estatel or
<br />. AOrn€slic tnsl (as &tn€d in RegulatiorB 3ectbn 3Ol-7701-7).
<br />Ertab$Cting U.S. rtatus for purpotct ot c*t+tcr 3 rd chaPtct 4
<br />sitl*rokting. Psyrnerts m.d€ to br€ign p€cons" indudng c€rfein
<br />rfistrihtiocr a$ocalims 6f hcorlE, or tE rsf;aB oi sal€ proc€eds. may
<br />be s.tFct to wihhd&E underctrapter 3or ctrader a of lhe Code
<br />{scclion! 1441-14741. UftLrthc. rde*, if 8 Fom W€ oro'fr.r
<br />cerlificati$ of non-frldgn status has not b€€n rccdv€d. a wihhdding
<br />agfftt bilsfuree,or padqqgldp (p8ytrl genetaly app{€e Feqmptim
<br />nlce thatrnay regtdiE lh. pc!/o?lo lritt$old epy'iceble lex fiom ll'e
<br />rocitenil, orvner, bam#eror. { panner {payae}. See R.6. 51 5,
<br />lifrhhoLlhg of Tax on Notmsitent Afi€lE ancl FqEiga Enlfti€s.
<br />the fubwing Forlons mrrst provfrJe Fom W-9 to lhe payor for
<br />purpo*s ol eclabsohirg its non-brebn Etatrs.
<br />. ln the cs€ of a dk Egarded antity vrith a U.S. qmer, fte U.S. otvo6.
<br />of he divegrarded mtfu and nd the dbcgarded €ntity.
<br />. ln the ca6e of a granior trusl wilh a U.S. Erantor or othet U,S. osn!€r,
<br />g€neraly, the U.Slgwrnor or other U.S. orJner ol fre grurtor tust and
<br />noltt€ gantorurBt
<br />. h th€ cge of 6 U.S. tud {oerer than * grrantor tus$, ihe U.S. hrst
<br />and nol th€ ben€ficiarb6 ofthetust
<br />Se€ Pub. 515 for .ncrE irfonnation on prwirJing e Form W4 cr e
<br />certifioation of rpn-froreign ctehs to av<*J withhoHirq.
<br />Kittitas County Agreement for Services (rev. 5lL4l25l
<br />Page 23 of 28
<br />Fof6i4l Dar$oG lf wu ata N brsiqn p€tson or the U.S. bdnch of s
<br />foreifr bink trat hiF deced b ba ttt\rtd a* a U.S. PcFon (undor
<br />Fbotlatirrns s€clton 1.r{41 -loxz}fr} or cilrer appficable seclion br
<br />ch6ter 3 or 4 ootresgt. tlo mt rnc Form W-9. lnsttSd, use $e
<br />ao*,oortate F<im W{ * Fcnn SA3g F€e ft&' 515). lf you sro a
<br />oirl*nie lorelsr osrgion fnd wder Resditisg section 1.€K}70Fl{d}' or
<br />i oartnonfiio-tttit is whow o{nlgd bv qu€fifsd forei$ p€il{on rtllds'
<br />ttrlt u metia ar a non-{cieign pcrson i* purpoces of seclo1 14€
<br />withhoHingi do rrot use foml Ui-e. hsreao, rrs€ Fo.m W 8E)tr (or other
<br />ccrtificaticn ot n*{ora$t statx).
<br />i*onrecided alicn who bocorne a nriricnt aten' GeneralV, ott a
<br />nonrcJUa{ atcn indyirud rrtay t€a thc tc{rnt of r trl bsdty to redJce
<br />or eliildnet€ U.S. iar on ccrEh tyPe8 ol itrcom€. l-lowr$€r. mo8tta(
<br />tseeti€B contain a provbbn krorh as a saving cbose. Extqtitttls
<br />eoeciEed in ttre savim chlso may gdmit ar, axemFion ftom hr to
<br />continuefor ccrtah tybcc of lesni cvcn dtcr he payre ho otten$se
<br />become a U.S. rPd{tefit aEcn fo'r trx pwpdlos.
<br />ocoegirn
<br />an sxefisixr
<br />1. lha trsaty county. G€n€rdly, fS! m.rst be hs sane t€av under
<br />ufi*r yotr Unimed exinption fiom tax aca nsnesfuleftt elierr
<br />2. The treaty adde addr€e*g the income.
<br />s. Thc rilide flrs.t {or locdbni in the t8,( lrcsily thot cofiails tle
<br />ssi/ing d{Jse dld iB srcQtirts.
<br />4.lho t]'pe and grcuil of income that qualfiea forthe o<emption
<br />fiom tex-
<br />5. Sufficist facb to i.rrli'fulhe exenption frctn tEx uder fie tatYns of
<br />thebeaty arlid6.
<br />Etrzrab. &lid. 20 o{ thc U.S.ttSm income to( tsr€iy dhl,c atl
<br />exendiin tom tEx fur tcftohrship income recei'red by a Chirure
<br />strCeirt tcarooraritv Fsn€rt in fie l$it€d $Et€, Utdrr U.S. lnv, thig
<br />*dent ufl beconir'a reslCent dien fort8,( purpoess if lhir siey in lhe
<br />Ur*ed SletEg etccedE 5 cd€.derFalB. Hosever' psragr+h 2 of the
<br />fird fuocd to the U.S.-China leaty (dated Ap.il 30' 19e{ atoss 0te
<br />*o*iong Uaniae 20 to contiil,e tet Epdy even dtr tltc Chires€
<br />Itd€nr b€comes e r€id€nt dien ol lha thiled Sutes' A G-}hese
<br />stdentrvho qualifies forthb 9lc€Sitn (uder para€fi'eph 2 of lhd first
<br />ProtcoD end is rtlvkrq oo tis cxcepton to chin sn cxatnption lreflt tar
<br />m their ictrohr{ip or-telorvst* ;ipme wotrld attach b Fotm W4 a
<br />*Nbment that inc*.Kb the ir$ormation descr!€d $o/8 lo sr+p€rt that
<br />erenplion.
<br />lf you ars amrueeiitentd€n otaforeiln 6nlity, give the reqleeerthe
<br />aporoprfute compleU Form W4 or Fqm 823t1.
<br />Backup Withholding
<br />l{tral b backrp wil*rolergr? PeGons rnaking csdeinPlF enu.byou
<br />mmtrrdercertrin cofidlifis wihhoH a.d Pryto th.lffi24% of such
<br />o.nflr€ots. tHs b celLd tcht p witlthol&tg.' Paymentu thel m8y b€
<br />iuiiect to lec*rp witrhol&rg i.dLde, hn lte not lir*bd ro' inlerst.
<br />to(i"ernEl itd€{st dfuiderds. brokst gtd barterorctr*4o
<br />transscddE, ren6. roydti6. no€dtPttye. pay, FyaIGil$ madc in
<br />seilcnrent ol pslment cad ard tlat+pany nctwo.k Eaffi8cdoog' atrd
<br />cErAen prymdmi funr fisttktg bdt op€catirs" Real stat€ttatBetims
<br />are not s*rieab bocl{.F witiftoklng.
<br />You wil rEr b€$.6FcttobecJa.pwitlhoklltgon paylt}Ents yqr leceive
<br />if lou giv. he r€qucst* pur canec{ ltN, na&e the Foper certiftdirne.
<br />aid rEport a[ yorr laxt$t ifit.r€€r 8nd divilcndg on lout tax reltm.
<br />Paymanle you rccaivc wil bc ertricct to bect4 witHtolding ift
<br />1. You do mt frllnish lour T]N fo the r€qu$tat;
<br />2. You do not c.di8 yow nN whcn rtqdl'd (sce the hshrclittie for
<br />Psrt tl {Drd€tsils};
<br />3. Th6 IRS ttls {te tequ€stat $at yeu ftfirished vt inconcct T['l:
<br />1. Th6 IRS Els )ou trat you Ue srtbioct to b€d$4 withholdrE
<br />becarse yorr dd not repod eil your iftbr€st etid di\rideft& dl yburtax
<br />r3tvn (for repo.tabb ;nte{€ct 8rd dttit€n<b only} ot
<br />5. You do mt ccdifu to t€ requests. that you er€ nd $t*ect to
<br />b€cl1rp wif*oHng, &dc€ctibea in item atfu"BysigningilEfratd'
<br />orrl,birn'abo/e {for r€portsble intersst atd dvid€fid accornt3 open€d
<br />after lgel orly).
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