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Forn W-9 tF+v. $202{) <br />2-The United Sltat€s il any of hs sg€ncies or irBrumerrtsfitiee. <br />3 -A stat6, tha District of Colrntir. a U.S. commonwedth or tefiilo.y' <br />o{ any of th€ir politicd 3r$divid6s o{ insa{flentrliti*. <br />4-A {orcign goveriment or any of iE political ruMiviehrB. rgettcllq <br />or frlsfrrmerfidilies. <br />5-A coryoratirn. <br />6-A d€alor in sacuitits or c€{ilmdtiel tocFdrad to regbter in the <br />Uniled St te h€ Dbtict of Cduntria or a U.S. commonv+eallh or <br />teaitory. <br />7-AiunrE6 cornnission m*chart regbtared sith the Comolodly <br />Furures Trading Commbdon. <br />8-A real aGtats inv€drlent trusl. <br />g-An entity .€Obtar€d at a[ tnes dning the Er yoar utderfie <br />lnussurlefit CoflFany Act cil 1010. <br />10-A common lust ftrnd aperat€d br a bank mder sectix 58{a}. <br />1 I -A fnancial instiMion es defined uftder seclkil 581 . <br />12-A middl€m8n kno*n ir lhe iftestr€fit cofirmunity a9 a mmileo or <br />cuctodiin, <br />13-A tust exenpt from tax und€r !€cliori 654 or dosctib€d io s€ctioo <br />4947. <br />Th€ blbwing chartstrows typ$ of pNymenBtist msy be €x€fiitr <br />from backrp wit*roldkrg. the charf eCies to the ex€fipt pE!€Es fiEtod <br />sborr6. 1 13. <br />lF the paym+m is for.THEil ttte payme* ig cranpt <br />for... <br />. trnst srddviderd paymentt €xefipt p8y€as exeegt <br />tcr 7. <br />p.ye€ r <br />F-A deder in secrrities. comrnoditiec, or derivstiuc fFtercid <br />lffrum€$B tndudng nodond ptinclpd co{ttr*tg. finlt€' bftvardE' <br />arid optimellhat is tegbte{ed s3 8ucfi trds lhe bvs of the Urited <br />Slat6 oiany siate. <br />G-A lEal stete iilr€afii€nt tutt <br />H-A r€gdated itwedn€nt comPstly a def;ned in s€ction 851 or trl <br />entty rs{*tt€red 8td tiftle3 dJritE he tsx yert ltrld6ru|e lnve3tn€nl <br />Cmrprny Act of 1910. <br />l-A c!flilnon tn,gt frmd $ ctefined in sec{ion f*14{el' <br />J-A bstk s dcfinod in lec{bn 581. <br />K-A brokir. <br />L-A urst exeflpt irom tar( md€r s€c{bn 664 or deccribed in 3ectifi <br />4E47(eX1i. <br />M-A tax+xerpt tust ud€f a seclion m{b) plsn or 8€ction 457($ <br />plan. <br />l{ots: You may wigr to corlsdt with tl6frEncid l]stiftnion r€SrasliE <br />lhb fo.m to detannine whetfier the FATCA cnde ador 6rem$ psyee <br />codo should be codpl€tsd. <br />Llne 5 <br />Enler riour ad&ese {rutnb€r. stsot ad spattnont or siile fltnberl' <br />thb ijwhsretrc rcqt.licrotthb Form W-9 wil mcil yqr infotmttion <br />ret,lfts. lt$[B addGss dficrsfiom the one Ute l€S.Eltsrahea4ha on <br />file, €fiter "NEw' at ttre top. lf a rrw addeas 'rs prwidad. hee b stil a <br />ctrarrce the old addrcse wi{ be uaad und the pays chttt€s3 yol.r <br />ad&ess h fdr tecot*. <br />Llne 6 <br />Entar yonr ctty, state, {rd ZF cod€. <br />Part l. Taxpayer ldentilication Number (TlN) <br />EnrGryotr TtN h lho smloorht€ bor. ll lur are a €skJem dien erd <br />you Odnot hav+ and a;irot *tiOte to g6t. an SSN, yourllN b yun <br />lm mH. E*er it;nthe enty sp*eforhe Socid seoxity nunbar. l{ yar <br />do not hsve m lTlN. e€e F ow b gEt t 7n, b€ta{r. <br />f yo{r are a sole Fop.ie€or ad pu hane an E}N. you may enter dth€r <br />yoor SSN or ElN. <br />lf plj are a s&rgle-member tIC thei is diqt€g€td€d a8 an ent/ty <br />seo;rate from t3 own€r. enter the owner's SSN (or Ehl, ii the ottner h€s <br />or#t. tt th€ UC t dassifed as a corporali:n or fzlrle'*rip. anter tfie <br />edity's EtN. <br />llotr: See Whst fferne and l&,mber To Giy|- dtc Rag.r*ter, lat*' f6 <br />ndl€rchrifidim dmme atd TIN combhationE. <br />ll,ow to gct r TlN. f you do not bve a T!l'1. apply ior me iffitodiaely. <br />To apCy-lbr an SSN, gpt Fo{trt SS-5, Applicstkn for a Scid See.uity <br />Canl'from yorr bcd SSA office org€tfieform onllrc at <br />wrryw.SSAgov-You may *og€{tl* fofmby celing€[s772-1213. U3€ <br />Form W-7. Aodi,:stion lbr FS krdvklud ToOatrcr ldcntificalix <br />Nl.rnb€r, lo dpty fot sr ft[.], or Fonn SS-{, &Ffrcalion ftr Emplo}er <br />klentifrairn l&rinler, to apply b'r m ElN. You cm mly for an EIN <br />onlire by acceermrg fia ffi website a$'r,w.hs.gov/ErJ. Go !o <br />www,irs"wtlFotms to vi€rv. donnlo84 or print Form W-7 andor Form <br />S94. OrI you can gp to pww.rlrs.gpe/O..kifttrns lo drcc an orde{ 8rd <br />have Foryn W-? etdor Fofin S94 maibd to you witir 15 h.tsitl€gs <br />dayt. <br />li lDu arE 6ked to csr$lete Form W-9 htt do not hEve a llN' Wly <br />tor dTtN and eflter .ApF#6d For" in *te sP€ca tor tfte TlN. eign and dete <br />th€ fo.m, ard girrc rt trir ihe reqres{cr. For interet and dvl:deod <br />paflglts. and certEinpaym€nts made wlth respect to.sad*y ta&ble <br />irxrumsru+ fuu wil gonera$y ha,rc 60 days to g4 a TIN ffd gi'r€ it b <br />ttre rc(il.leter bedore y{u are drbie{* to baclop witt*toldng-ut <br />psFn nE th. Eodsyntadoec not rppry toothertlpa3 of Paymenti <br />Yoir will bs Butiectto bachp wilhholdhg on afl such Fayr$o$ts umil <br />you provide yori TIN b fh€ r€q.csts. <br />llots: Enterirg "Applied Fcf mea'ls fisr lou have deady appted for a <br />TIN or urat vqr intbhd to sDolv for ona socn. Se€ &o EstEbfslmo U.S. <br />stdris fiorlirposac of cnliei s u,a c*qrtet 4 wialtuidrg. 4.8, tq <br />whon you mey krstr.db€ it$jtc{ to witt*toldng underchaPlsS or 4 ot <br />tls Coda- <br />Caulion: A disragard€d U.S. $riy $8t has a focign owne mtH use <br />lh€ appropriate Fonn W-8, <br />Paec 4 <br />Urougfi 11 8nd dl C coeor8thrts. <br />S corporatixr rud rpt enl€r s0 <br />ercrryt pyrr code bec** tfry <br />aruex.fiSontyforslesot <br />noncovarEd seqriths ac4ked <br />'6m12.trans&tions Exefiplpdye€3l tvor€h4, <br />roquind to <br />and dt€ctsd€g over <br />rnade p89€e6 1 4. <br />. Paynrertg <br />b€ epofted <br />s5,000' <br />G€nerdly. exempt psye€E <br />1 ftough 5"3 <br />PAFnenrtrlwdk <br />card or thfudfarty <br />hanseotiqp <br />t See Form 1089dllSO. Miscolhnoous krfumalktfl, and its h$ttJclit€. <br />zHonrerer, Ore folloring psynte(6 nlade to e corporstiod ild <br />repori$le m Fmn 1099-MISC are notoreoelfiom bado+ <br />utC*rolCng m€dcd srd hedfi care pEymEnt* atom€ys fees, grms <br />procs€G pdd b sr atofnoyr€potuble unds 6action 6045{S, and <br />payvrents lor sewi:ae paiC by a federal erdcutive egieney. <br />Exerpticr ftont FATCA repoetiq code. The lo{orkg codes llenlify <br />pqpec that ara or€ntpt ftom rspordrq l.cld€r FATCA. th€e cod€3 <br />applyto pe.sone s$miting thb lcm ioraccq.rrls mai{*afuiod outsid. <br />of tre tjnited Stales by c€dah toft*l.t frrarrid lnstiu,nions. Ih€rsfoG, it <br />you se only *bmittr6 t&iorm tof'ar accorrm y4r tldd h lfi€ L'*t€d <br />Stales, you mat hst6 $ie feld Ua*. Gorpdt wih the p€Gon <br />re+eting $ie fom if yur are uncerain ilfiefn$cial inCitrtion b <br />w$ectto tlteee reqdcnentE, Ar€glestsr may indcate that a code is <br />not r€qrir€d by plovirtng rou wit'l s Fofln W4 with "Not Applicabb" {or <br />eny sidfiar indicetbnl erit*sd ofl the line for a FATCA ensip{ion coda. <br />A-tu orgsniaation exefipt ftom tsx under s€cfion 50-l{al or any <br />irdvltud retisnent *n s <refued h seclirn 701(aX34. <br />E-Th€ hited Stet€ or any of h3 a€pncles or insfifilent8ltiss. <br />C-AsEte, lhe Dbtid cd Colun6h, e U.S. commonwedthor <br />tenitory, or any of tnir pdhkal wMvbiun or hstwEntdities. <br />D-A corporstim ths cd( of wtlidr b regdady traded on otltt or <br />mo.e establbtt€d led.ditlE mskss, as d$cribed i.n Regtiltbng <br />8€ctirn 1.1 172-l tcxl m. <br />E-A corporaionth* b a msr$cr of lhc san* cxpstdcd cffliatcd <br />gro{rp .lE I coDoration describod h R€odaliofis 3€ction 1 .1472-1{cxllft. <br />Kittitas County Agreement for Services (rev.5lLal25l <br />Page 25 of 28