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Form W-9 (R6v.3-2024)
<br />ebove. 1 13,
<br />lF the payment is lor. .
<br />. lnterest
<br />. Barts
<br />parnents
<br />tran8actbns
<br />card or thirdgarty
<br />mnsactio{rs
<br />THEIiI t'le payment is exernpt
<br />for
<br />Al oxompt paye€r exceFt
<br />fot 7.
<br />psye€s 4 6
<br />1l andallCcorporaliom
<br />S corporations must not enter an
<br />eronpl payee cde beceuse lhey
<br />are erempt orilyfor sales of
<br />noncovered sesrrities acqjired
<br />b201?.
<br />4.
<br />exempt payees
<br />I lhmugh 5.2
<br />2*The United Siales or any of its agencies or inetumenlalities.
<br />8-A state, lhe District oi Columbia. a U.S. commonwealth ort€nitory
<br />or any of thdr political subdivrsrons of instumentalities.
<br />4*A loreQn govemment or arry of it6 politioal subdivisbns, agencies,
<br />or instumentaliltes.
<br />5-A coporatbn.
<br />6-A derl€r in s€cltlilies 6r commodtiee required to rsgister in the
<br />Unf€d SlaleB, he Dbbicf of Columb{a. or a U.S. commonweslth or
<br />teniory,
<br />7*A firtures commis$ion merdE rt regbtered with the Commod'rty
<br />Futures Trading Commission,
<br />8-A real estale invesftnent tust.
<br />9-An :ntity registered at all times during the tax !,ear under the
<br />lrwestmeil CornpEny.AEt of 1940.
<br />10-A common tsust fund operated by a bank under section 584{a). '
<br />11-A fuancial insdilEn 6 defin€d undersection 581,
<br />1?-A middlEman known in the irwaslment communityasa nominee or
<br />custodian.
<br />I3-A trust exempt lrom fax tllder section 6&t or described in section
<br />4947.
<br />The fcllowlng chart shows tyFes of psymsol9 that may b€ exsnpl
<br />ftom backup withboldrr€. The chaa apfliee to fie exempt palle€s fisled
<br />Pase 4
<br />F*A dealer in s€curities, commodtieg or derivalive finanoial
<br />Instrurn€nte (rncludin-o norional principal contracts. {urures. fonrvards,
<br />and oprions) tilat is rEgistered as such under the b$a of th6 United
<br />States s arry slate.
<br />G-A real eslate irv€tsnent0usl
<br />l-l*A rcgulstsd invesbnenl company lx] ddned in s€ction 851 or rl
<br />Enlity reebtered al alltirn€a dJing the la( ycar undg $e lrpeslmerl|
<br />ComFany Ait of lg.1o.
<br />l*A common tust lund as defined in i€ctlon 54.{(a),
<br />J-A bank as defirrcd h seclion 581.
<br />K-A broker.
<br />L-A fust exempt fom to< under soctio{r 084 or deecrbcd in section
<br />{s47(ax1}.
<br />M-A tax-exempt trust under I section 4{}3{b} /an or eection 45(g}
<br />"- plan
<br />Note: You may wish to conELft with the fuaflcial ins{ihnion requesting
<br />lhis form to determine wherher rhe FA'ICA code and/or exe.fipt payee
<br />code should be completed.
<br />Line 5
<br />Enie{ your address (number. slreet. srid €panmenl or $rte ntfib€4
<br />Thi! is vrtlere the requester of this Fo.m W-9 will mail your informaion
<br />refums- ll thrs address clrfiws fom the one the reqLEster already has on
<br />lile, emei'NEW" d the top- f a new ad*ess i9 provided, there ls strll a
<br />chance dre old addresb willbr used mtil lhe gayor changes yol
<br />address in tpir recotds"
<br />UnE 6
<br />Enler llour city, state, and ZP co&.
<br />Part l. Taxpayer ldentification Number fIlN)
<br />Enter yorr TIN h tre appropriate bor. lf you ae a rerilent diet ard
<br />you do not have, ard are not eligible to get, an SSN. your TIN b your
<br />IRS fflf,l. Erner it in lhe enlry +8ca for llr Socid seeurity ntmber. ll you
<br />do nol have m nlN, eee lbw to €Ef a 7Il, bel€w.
<br />if pu ae a sole prryrietor ard you have an ElN, you may enter either
<br />yowSSN or ElN.
<br />lf pu are a sirEle'member l"Lo that is di8regarded as En ennry
<br />separAefom hs ownef. enterli€owne'/s SSN lor ElN, rf the o,y/ner ha
<br />ona). lf the LtC b classih€d as a corpoestion or garmership. €nter lhe
<br />entity'sElN.
<br />i{o!e: See Whal Narne nd llwrlDarTo efire ttc @t*lrir,}*e4tor
<br />fi.rtrnr chdfrcation ol neme ild TIN cofibindlslg.
<br />How to g€* a Tlll. lf lrou do mt have a TlN, ryf for one imrnedlarely.
<br />To apply for an SSN, get Form SS-5, Applicrlioo lo a Social Secldly
<br />Cud. ftom yorr local SSA ot$ce or g6t tts lorm ofllie.l
<br />www.SSAgov. You nay dso ger rhb lorm by afrg*tn-n2-r?19. Us€
<br />Form ltV-?. Application {or IRS lrdvrdr.dTa4ayer tdentificarbn
<br />Numb€r. to epply for an lTlN, or furm S94. Agl&:atiro for Employer
<br />ldenlifcation l,ltnnber, to apdy br sn ElN. You cen apply for an EN
<br />onfine by accessirg lhe FIS *ebsite al uwvl.its"goe6t'1, @ fo
<br />w|vrv.irs.goe/FonrE to view. doilnlod. or prht Form W-7 ard/or Form
<br />S$4. Or, you can go lo wlrrw.its"gavlOtdcrfcrrns to dace an ord€r and
<br />trave Fo.m W-7 andor Form S94 mdled io lEU wi$h 15 h.sfuress
<br />dsys.
<br />lf )ou are ask€d to comdgte Forn W-9 but do not have a TlN. +ply
<br />lor a TIN 3fld ents 'Anpl'ed For" in th€ space for lhe TlN, sbn and date
<br />thg form. and glw tt lo lhg rsql€stsr. F(r nferesl ard dvidend
<br />paym€fl1s. ard certain paym€nts nnde wilh respect to rc ily Fadable
<br />instumenls. ygrr wil g€nerdly haw 60 days to gsr a TIN ard gi\re fi to
<br />the equesle' ba-iore you are e.6Fct to backup wilhhol&ng on
<br />paymehts. ft€ 6o-&i nrle do*hor eppty to itertypes o:i payrnenrs.
<br />You h4ll b€ suliectfo backe witffiddnE on dl such payments urtil
<br />you provide 1ow TIN to the r€qu€sl€r.
<br />l{ote: Entenng 'Applied For" means ha pu hare already apptiad for a
<br />TIN or rhat yco irtend- to rp0ly for on€ som. See also Fstabf$iirg U. S.
<br />statJs for FUrposes of eleper 3 aN clqts/r I witlilroffiry, €€'fui , tcr
<br />when yorj may rEtead be $6lect to withholdng urder chapt€r 3 or ! ol
<br />the code.
<br />Cautioru A dixega fu U.S. entfty frat las a fodgn owrer must use
<br />lha appropriate Form w{.
<br />1
<br />. PaymenE owr 0600 required to
<br />be r€poned and drcct sares ovEr
<br />s5.OOO'
<br />and
<br />pa!'ment
<br />networft
<br />made in settlemed ol Erenpt payrees 1 trorrgh 4.
<br />1 S6e Form 1099-tUlSC, Miscelhneous krfonnathn, and its instnrclbns.
<br />! Howeuer, the follfl,ing paymenls rrde to a coeoratim and
<br />reportaHe on Fsm log8-MISC are nol exemg trom backup
<br />withholdir€: medicalard hdth care payments, aflorn€ys' l€es, $oss
<br />procseds pdd to 3n attomey €por€bh wrdv section 60a5{fl. and
<br />payrnents for servbes pad by a fedenl execr.tive agenry,
<br />Exenption lrom FATCA reporthg code, The foflovirg codes identify
<br />paye€s thal are er€rnpl trorn r€porling trder FATCA'Ihse codes
<br />apply to persons submitting this fum br accounts maintdn€d outside
<br />of the United Stal$ by certdn fordgn fimnaal institutions. Ttlerelore, il
<br />you are only submitling this lom for an accorrd yott hold in the United
<br />States. you rnay learre lhis field blank- Consdt with tle person
<br />req.restirg Sris lorn i{ you re uncerlain if the finarrcial insliMion b
<br />sulject to thes€ r€qiernents. A requester may irdoale that a code is
<br />not r€quirEd by provi&rg you with a Fam W-g wilh "Nol Appficatfe'{or
<br />any similar indication) enter€d on the trne ls a FATCA ocernpdon code.
<br />A-Ao organizatan ex€mpt itom tar under s€clion 501(al or eny
<br />iofvrdral rebemert plan as defircd in s€ction f01(alF7l.
<br />B-The United Sfales or any of its agencies q irsturcntalities.
<br />C-Asieb, the Distict of Columbb, a U.S. commonweafth or
<br />tenitory, or any of thei political s$dvisions or LBtsuBEDtalities.
<br />D-A corpor$on lh€ sfsd( ol which is regdady lred Efl one F
<br />rnore esEfshed secuilles mar*e!s, as deccribed rn Regulations
<br />section I . t.r7z-l (c!(lif!.
<br />E-A corporation tlet is a mer6er of lhe sann o<panded alfiliated
<br />group.N' a copordlion descdbed in Regulcrli:ns sectiqr 1.1472-l(c[ll{1,
<br />Kittitas County Agreement for Services (rev.5/14125)
<br />Page 16 of 19
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