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3Fom ttl-e lFev. 3-it24l
<br />Certain payeeo and peyrn€ntB se ar(ernpt ftom badorP wid{tol&tg.
<br />S€e &a,nptF-6y6e codr, htrf,, and tltc lepar& lffitucliorrg fs lhc
<br />H€guescr of FornW-g b(tnote hfomatbn.
<br />S€e abo Est8bnClits U.S. s0rais forpurpo*s ol clts4/ts.r 3 Efrd
<br />cfiqptsr { Hfrrro&dhg, e{*€f.
<br />What ls FATCA Repoiling?
<br />exan6le. if a forchn LLC thril b tseaed as s dbregarded aility for U.S-
<br />gae.l tln purposb heg s sangb owrw tha b E U.S. peaon' the U-S.
<br />owneis ngine'b recdied to ue prov*Jd on line l. lfthe diectolner of
<br />fie ontlty b abo sti*ag€td€d €nlity, lntcr$€fret o$,ncr Fat F r.lot
<br />dbr€oarA€d lorfod€rd lax ptnpos6. Emerttre dcregsdad ontryt
<br />nardon line 2. lf tre orrrarei ol'tte dsogatd+d tnrityb a brcign pelson,
<br />fio cn rnermuqt cofipl5E an app(oghn Fom W{ hstead of a Form
<br />W-9. This b tre casi erren il tha {ct?ign pereon hes a U.S' TlN.
<br />Llne 2Ttre Forelp Accoutl Tex Corqplhnce Act fATCA) reqdre a
<br />parti:ipatifu foreiep fin&cid irE{iiltbn o raporr aI U.S. accourn
<br />holthrs tni ae rpccffi€d U.S. pcrsons. Cenein payecs are e,(€tnpt fiorn
<br />FATCA reportingL'See &grigirn ttqn FATCA np*ting cod€, b0et. ttd
<br />thc kratruc'tions fu thc Rcs,aaEr d Fonn W-9 dor more hfomatiort.
<br />lf you
<br />edtit)'
<br />t}3lre a h.Fine6s cam€, trade name, DBA name, ordb'egded
<br />rsnre, errler it on line 2,
<br />UpdaUng Your lnformation
<br />You musl provi&
<br />'.Fdatod
<br />infum€lion to any p€rron to wtnm you
<br />chin€d to be 4l o(€(rpt pape il yor rre no looger an exempt pey6€
<br />snd anficinde racidno remrtrHo oamanta in he frnrro fiom d$
<br />penm. For cx*nplc, Fu mry rreri ui povidc r4drtcd infonrutirx if
<br />yotr ara a C corporairx th{ elEc€ lo be an S coporrtion. o( if you re
<br />iro longe arexarpl h addlim, lou mrstfrnish anew Form lV4 if
<br />the nane or TIN cfrangeo for tre acca*rl ftr o6npte, il lhe grante of a
<br />grantor tust de..
<br />Penatties
<br />Fdhre to ft'rnbh TlN. ll you trf to fun[stl yc{.r cotrocl TF,l b a
<br />r6$r€ere(. you ete e*i€ct b aper,dtyof l$5o for eadt suc*t htue
<br />urdcso yorr failuc is drr€ to r€smbt€ csrso dd not to wifft{ n€gilect
<br />Cird parel{y lor fal* infonnation with ra.pcct to witlthddiltg. lf yorl
<br />make afCrcstdgnenl wilh no reemneble bsdethd, tsult3 in no
<br />bac*rp wi[*toldtg. ]ou ar6s*i{.ct b a S50O pendty.
<br />Crinrhd peoalty ior fahityirg hformatiort WtftNy faktitying
<br />certificalions or affi nnainr rny a*{ect yoo !o aimind pe{rhia*
<br />indsdftU fnes a<Yor hpdsorm€nt.
<br />lfisrpc of Tll{r. ffttre ruqueerar disclooesor r.EesT}tls in vbldbn cf
<br />ftderd lecr. fie iESFlsrmryb6 subiea b civil and c'in*C pendtiee.
<br />Specific lnstructions
<br />Llne'l
<br />You fifiBt ent€r orE ol the lolourirg ontris line; do ttot leaYe lhis lin
<br />blerd( The nanE shordd tildtch tfa naiE o.r yd.B ter tetrn.
<br />f tis Fofln W{ is br a Flrl aDodrnt (ottt€t tl€n an account
<br />maintined by a fq*n fttarcid irxt'hJtion (FFID, btfirst atld ltien
<br />circh, lhc nars of lhe peiton or enlity rrnhare rumber you efit6red in
<br />Part I of Form W{. lf rou ale ortnrir$m Fom W€ toan FFlo tbcrrneot
<br />a iint .ccortrt €sch fiolder oi lh€ sc.-ouil fl61 b 8 U.5. porson mtlst
<br />pruvite a Fom W-9.
<br />o lndini&at Gamrdty, €fiter dre mtn€ stBwn on tour ta( r€ttIfl lf you
<br />harre ctnngd your lst nare withor.t kfonninO fie Socht Seodty
<br />Adninbfetioil (SSA, cf ifn nanre charqe, ottt€? tollrfu rHn€. tle leet
<br />narns er rhouln on yoor Eocirl sccuity catd, 8nd yqlt neYt lad ndne.
<br />ilore nor ITlil appftceot: Ente* yoor indvidual name as it wae enter€d
<br />on yor.r Form W-7 apdio.liorr, lino 1a. Thb shordd .bo be lhe sarne as
<br />$s nane yE{, efitered on the Folm 1 o4o you fled vift you €p,plbalion.
<br />. Sola prop,rietor' Entv your irdivftkral narne rs slrown on your Form
<br />1040 on fne1. Sreryou hrines, Usde, or "doi.E hlsin€ss €' {DgAl
<br />name on fnr 2.
<br />. PartnerrHp, C corpralion, S cooora&xr. or LLC, olher{lrsn a
<br />d'rrcgodcd'.ntity. €nter fie erlily'si nane d 3hogyn m ttle eilitys tax
<br />retm on kte 1 and any buiness, trade, or DBA mme ofl line 2.
<br />. Othrr cntitlec. Efiter yo{r n{ns as drown il Gquir€d U.S. fedsral ta\
<br />docltrtr€fttsonf$or. Thisnanc EfiooH mddrtc namestsftrr ontl16
<br />ctr*,tcr or ollrer bgnl docun€nt creetirE thc entity. Emer arry busirncs,
<br />trado.cD&{ngrtcofllit 2.
<br />. Dbrsgadrd edity. ln gened, a hrsineto entity that has e eingle
<br />ovrner, indudirqg an LLC, and b not a corporation, ie disrugraded as an
<br />entity eep€rste fr,ofii ib 011116r (a (brcgarded €fiityl. S€e neg{Aliong
<br />s€ctlm 3o1.7701-2(cx2l. A diErsgdded efitity shordd ctrec*tre
<br />epproprbe box forrth. t x d83sif,cdi{xr of itr oryrpt Bttor tfu orfie/s
<br />nima on brc 1. Tlu narnc of lhs orynar antcrud on krc 1 shordd rpter
<br />be a dsrEoerded efittv. The name on lln6 1 shodd be he nstne gfiown
<br />on the inc6me tax r*in on which ttre incqne $or.dd ba t€ptrt€d. For
<br />Llne 3a
<br />Ch*k the app'ropiate box on lins 3e br tlE U.S" ftderal tar
<br />aeifcation'ottire person vtro€e name b €ntsred on line 1- Ch€ck or*y
<br />ore box oo line3a-
<br />Llne 3b
<br />Check tris box * you {e a psfn€tstit fnddttg an LLC cJassified s s
<br />gdhetship br U.S. fsd€d tar pirpq€€6). lrud. ot eo{sto lhd h8 eny
<br />lolElglt pai$eB. ol'Yn€t3, of, b€n€fidaaies, &xt you 8re F.ffidng Olb
<br />frorm-to a oarbrrehb. ULEI ot 6tete, h whicfi yoU hane fi osnsstlip
<br />hteregt Vou rnrct dreck tle bor on lire 3b if you receive a Fom W-8
<br />{or doorn€ot8ty evidetEe} fiorn any peurer, ownet. ct beneficaary
<br />iratgH$no tvirlm gtlnE s it voq Eceive I Fofir W4 fiom any
<br />parocr, owirer, oiUencnUary ti* has chec*6d h. box ct lin€ 3b.
<br />ilote: A oarEHnhip Itld pro'rrides 3 Fofltl W-9 dd drcd(s box 3b lmy
<br />b€ resrind to conipbta Stma*a n+ and K€ (Form 10€5f Fa more
<br />iniodatba s€€ fG klg dlip hshictirno fror Scfieddee K{ ad K-3
<br />lFom1065l.
<br />lf vou are required to co.npleto lino 3b hJt fuil to do eo. lou mey not
<br />ncoivstrc ;nlormltbn n silarytofile aconsct hhtrralign ratum with
<br />lh6 lflS orftrnhh a cofioct FeyEe stdg{fient to tqlrpath6{3 tr-
<br />bentriarbs. Sce, forexample, sedions 6698, 67n- di6724bf
<br />pendti€s f,tai may +PlY.
<br />Llne 4 Exemptone
<br />lf wu are oxerpt t om b*kup withholdng etdlor FATCA rsfotlilg'
<br />*iter in the appropriae spec€ on liE 4 any oode(s) trat tnay apply to
<br />you,
<br />Ercnpt pryec codc.
<br />r Generaly, kdtvkfuaa firrctuahg sde prcPd€totsl tte r$l e)(€lrpt trorl
<br />bac*w withhol&tg.
<br />. Except as prwid€d below. ccrporttiotls t€ exomFfi tom bech.p
<br />wltrtrotkng *" ee.tah pafrnenta indtdr1g intenet vd dviden&.
<br />. Coroontlcns are not ot€$ot ftBm bac*D wit$o'kfno ftr Fsym€{tts
<br />made ir satd€ment of peyrneirt card or thki-psry netvrod( trareetionr.
<br />. OorPoratbns se oot oxempt hom bsc*tF wi$hdceE with resF€ct to
<br />attomeF' f€€s or go€s p.oce€ds paid to dbmqF, rxt corporaiiors
<br />EEtpr&ida m€dcal or treallh care gearic$ are nct exempt with re€P€cr
<br />to paymarts reporuble on Form 109$MISC.
<br />The fofiowlrg codes idarlifu peyees trat are o<ern$ ftom backup
<br />witholdrg. Enterthe agp'ogiate code in thc apact on litle 4.
<br />1 -An orqgizdion exemft frofit tNx u{}dsr s€ctito sollal, eny nA €r
<br />a cuslodid rccoqrt wrderscction 4CK{bXD if ft}c scJount estbfiec tE
<br />rs$drefit€fi8 of secdon 4016i2).
<br />Kittitas County Agreement for Services {rev. 5lL4/251
<br />Page 24 of 28
<br />. Trusua€tNta
<br />Parkr€Bhts
<br />. LLCd*sified*eFdtLchb
<br />la U.S. fed€rd ta,( F p*€8 or
<br />r LLC thathas flad Fom 8832 or
<br />2553 eloctirg lo betaxad s e
<br />corproration
<br />. lndvidtJd or
<br />. Sotepopri*onhip
<br />Coooratim
<br />lF thc mtly/hrditifid cn linc t
<br />ir{nl ,..
<br />Trusl/€etab-
<br />Partprstip.
<br />tinitcd Sablity corpany atd
<br />snt6rtha+propliet€ tex
<br />chsdfeaim:
<br />P = Fartnerddp,
<br />G=Cco4oraiot.or
<br />S = S corporalirn.
<br />tndvidudlsole poprietor
<br />Coroofetiofl.
<br />IHEX drcck {hs bor fot , , .
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