|
Form t{-9 (Frr. $2{ts4!
<br />Fordri3 o{ eccount
<br />Paec 5
<br />Part ll. Certification
<br />To esldish to tre wihholding ag€ilt thqtyouare a U.S. person, or
<br />ranklenl alhn, *f Form W-9. You may bc reqeated to sQn by the
<br />yuittfiol&g ag€nt eeEri f item 1, 4. or 5 bdow indc*es ottlervrise.
<br />For a jc*rt accour( orrly Ule penon whoee TIN is shoiln in Patl I
<br />stprid dgn (wh€n r€+ir€d), ln the care of a disregeded eqtrty, the
<br />perscn identifnd on lino 1 mrst 3ign. Exanpl peleee . se+ Erf,'4pl
<br />'€qlioccda, eadier.
<br />Sigodurr rrquirufitc.rls. Complete tfte eeriifrcsti)n es hdioal€d in
<br />itensl hrough5bslo$r.
<br />t. htdG*. drribtrd, and bsttorerdEngc accotltts op$qd
<br />b.fore lS4 .rd brot.r accounts corrid.t d aciivc dring 18.
<br />Yau musl give your conect TlN, but you do not have to sign the
<br />cartification.
<br />e htqeet dvi{and. broker, and bartcr erchonge sceort$s
<br />oocncd alter 1081qrd hoka accorrts conridcrcd irac-tin dwhg
<br />1!83. Ycxr mtet ri]n th€ cediicaliofl or badup wibholding will apply. ]t
<br />you are eu$ect io beck4 wir$rok*ng and you ae marraly Providns
<br />yo{r comcl TIN to t* r,cquestr. you m$tcroos out itorn 2 in tho
<br />certficdtorn bftr? dgnhg he lorm.
<br />3. FcC csbto tdrs{clbn , You m.st s(p the cat'ficcirn. Yor tmy
<br />cross ols at€rn 2 of ftc c€rlifiealion.
<br />iL odrr peyrrnta, You must give your cofiect TlN, hit you do not
<br />lnve to sign tfu certificatirn r.nless yor tnve been not:fed lhet you
<br />hsve prsriol,sU given an incor€cr IN. 'Ofi€rp8ym€lrt!' incftide
<br />prynhrts rradein tha cotrge of the reqresieC's thde or brsiness for
<br />r€ntB, roydtba. groodg lollrerfian bilb fot morchan&ef, rrt€dcd.nd
<br />herilh csres€wi:€E frrCrding psyfilsnts to coryoralio{B}. paymsnts to
<br />a nonsmpbyee foreerybas, paymants madB insctt€met{ of pa$net*
<br />card ard'hi*perty ne{rerort<'fthsacliol€. paFl€r$s lo c€tlefu fi'hing
<br />b€t crery members std fidrerrpn, ard g!*s p{oceedt peid to
<br />atbm€ys (h€fudirq Faynerts to conoralbm).
<br />5. llortgngo htcred psid byyou,€c+AiEon or abandonmant of
<br />ceculd pron rty, cacdlatirn of debQ qrdified tritirn gogran
<br />pr.ymant! (titdC raclioo 5201, AELE *conlt frnder rcctuh 529A),
<br />tRA Cowrdafl ESA Arehcr lilSA o. HSI contibstinnr or
<br />dHr$dionq and pcnshn d*fDrrtions. You murtgiveyotrcdt€cl
<br />TlN. but yu, do rbt hev6 to sbn lh€ ca{ttffcttion.
<br />What Name and Humber To Give the
<br />thcuwt
<br />rlistfirsterd circletlm mne of lhe p{lr'on who6.rxnberyttufumi$.
<br />lf only one person on ajrint acca:nt has an SSN, that person's nur6er
<br />mustbeflrttrish€4
<br />:Cird6 lh€ minodg nrme rnd fumish tlp ninodg SSN.
<br />lYou nxjst dlos, \rorr individrd nanre on line 1. atd eflter yo(r budnees
<br />or DBAnanra. it atry, on tne 2. You m8y use eitlw yer SSN or EIN ff
<br />yos have one)" but*re lFFi encorirag€lsuto trs€ yor SSN.
<br />'Liot firln drd ckcle the namc of tre h€t €4te!6, or pe.l8ifi btrti. (Do
<br />nol firniirftp TIN olthc persorul rcpreaentdive d tushe unlols the
<br />legd €rltly itselt ismt ddBigflet€d h tlc accotnt litle.)
<br />'tlotel lhe granur mustabo ptovhc a Fom W€ to ttretrtelce of the
<br />tu8t.
<br />*For morc infonnaticn on optiond lli,ng m€dmd3 for grantoth$B, s€e
<br />tle ltx'Euqtio'ls for Form 1041.
<br />llotr: lf no nama b circled wtren more thar one nane b hfed, t€
<br />nrnberwi[ becondderedto betH dlhcHngn€ I$ed.
<br />Secure Your Tax Records From ldentityTheft
<br />Hentitvlheft cqns when sorneooe uses yorr persond infodnatiorl
<br />ructr ril yorr narne, SSN, or otlur ller{i$ing itibttnsti.tn, wifiou you
<br />pcrmirrlln to conunit lrard or ollrer crineo. An idenlity lfde{ may se
<br />your SSN o get a F)b or may fih i lax teurm usitE )our SSN to teceive
<br />a reftnd-
<br />To rudrceyurdsk
<br />. Praecr)rorgsSN,
<br />r Entr.re yorr grndo),€r b prdecling pu SSN, md
<br />r Be carsftd wlren cfrooding a ta)( retjfii F8peter.
<br />lf yowtax racorde ar€ afscted by idefllity troft and yql recdve a
<br />noticefom the lFS, t€€pond 4$l aray to thensrn€ etd Phons nunb€r
<br />prit*donthe l$nolice or leter.
<br />lf r/ourt8,( r€cotds ere rEt curenty sfftcted by ijenliry thefl but you
<br />thin* pu are at ddr dJe to I last or atotsn pl.rse or waud, qudionSh
<br />cncft-cad activity. or a S.€stionebl€ cr€dt t€Po.t co{ltsct tE IRS
<br />Ideitity Thcft llodin€ st 410-9@4490 or $.6mh Fofln 14009.
<br />Fcr more irfonmtion, gee PrS. 5027, ldentity Th€ft lrformalim for
<br />Taxpayers.
<br />of
<br />9. Dbr6gndcd cflt'g rut o{,nrd by.tt
<br />indivilud
<br />9- A vdit rud, *tetet 0( pc.ltoo rl€t
<br />t0. Csporakx ilLLC cgalu coa.orte
<br />rlst8 on Form 3832 or Fcm 2553
<br />11. Arsocr'di.x. ehrb. rrligcrrt. drsilb|g,
<br />cdrctliodol. or o,*cr tox{einpt
<br />ortil*?ttbn
<br />12, Port'lar$b or mdtifi./ib.r ILC
<br />13" A brckror rcgkercd nadrc
<br />1*. Accotnt wih lha Ocptrrri$r ot
<br />Agriq4lJr. h rh. t$tt of c a$lic
<br />cmily {rccfi 6e a stdcorlocd
<br />co"crrn€dt. ldlcolditH. tr Pdroil
<br />lhtt Ectivts 3gi"'tdttrat PrDlr'lt
<br />t'ryYtc.ttt
<br />15. Gralrtor h.ct lililg Fo.il 1041 d
<br />rsrdcr hc Opticnd F&tg M.fFd 2.
<br />r.quiing Foritl 1H {tcc Ragt-etln!
<br />e6c,rbn 1.871 {bl{4fiFri-
<br />Th* cvnei
<br />Lcaal*dY
<br />Thc caporgion
<br />thes'ls1i:$in
<br />lhr pl.tedstip
<br />tha brok€ tr no.r,t$€
<br />TL-puUh crniV
<br />t.
<br />2. T*o s m hd'ryiftn& &*tt dDRFtl
<br />ollstio on mut mchtrincd by
<br />mFE
<br />3. T*o or rnoru U-S- Fcr:qrs
<br />Fintlccfi{ltnritaiFd bV rn FFll
<br />4. &r3todi* a€o.$t cda mhsr
<br />('Jnibrm Gilt ro Mimrc Act|
<br />5. c. "lirc r.sJd lltrocaHe ravlxF tucl
<br />&rfibrb&otrlt c)
<br />b. Secolod rsctccclnlf|ar i! noi
<br />d lc{d crtlsld turt \cda itrtt bw
<br />6. Soi. popri.t nrlip or disngod{d
<br />atity ocncd by on irdvifuol
<br />?- Gradorfu:t fihg drC.. Optimal
<br />Fil?19l&dtod I +!.c Ra$idiod
<br />r.Edoc :,671 -4lW.2f'XAi!"
<br />n&tP
<br />Ihc irdividud
<br />Th6 aaad ffi of thc accdrl d,
<br />it conbi$d fui6, tu fmt idivid:al
<br />mlt€*fft]
<br />Eaci l.oldcr cffe accoud
<br />Th.mhdr
<br />Thc qronl€a-turee'
<br />Tho q€tJal ownort
<br />Ihcdm.d
<br />Ths grgsto.'
<br />Kittitas County Agreement for Services (rev.5lL4l25l
<br />Page26ol 28
<br />Givr b6ln€
|