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5 <br />Part ll. Certification <br />To eetablish to the withholdirg agent that you at€ a U.S' person' or <br />reddent slien, rign Form W-9. You nray be reqlested to sign by fie <br />wittrholdrg agent even if ilem 1, 4, or 5 b€low lldcdes olheirvis€. <br />For alrint accoun! on[ the penon whoseTlN is shown in Part I <br />should iign (when requircd). In tfie case of a disr€gErded efltity' the <br />persm idhfied on line 1 ttttst sign. Exempt peyees , w Exempt We <br />cdqearter, <br />Signature reqdrements. CdnPlete the cerlification aa indirted in <br />iterns 1 thrcugh5 below. <br />l. hnerest, dividen4 and barler erchange accourls opened <br />betorc lg0l and brokor accoonts considered actiYe during {983. <br />YqJ mLtst give your conect TlN, but you do not have lo si;n the <br />cerlification. <br />2 herestiliuideil4 broker, ald barter exchange accormts <br />oened after l9&l and broker account$ comidered inactiue dudng <br />li)&l. vou must sign the cerlification or backup witrholding will apply. lf <br />you are suhrieot to backup wi&holding and you are mere[ pqvifing <br />lorr coneci ltt to the requester, pu must or6s out itetn 2 in the <br />cerlific4ion before signing the fom. <br />3. Rerl €state transactions. You must sign tle certificalion- You rnay <br />crcs flrt itern 2 of the certification. <br />4. Olher paynBlts. You must give your consct TlN, but you do not <br />have to sfurr ihe oertification Unless you have been notified that you <br />have prevbuslv oMen an incorrect TlN. 'Othet Paym€nt8" include <br />pavm'ents maOi:'in the coun€ of tha requesler'i iiade or business lor <br />ieic, royalties, goods (orher than bills tor nrerchandse), modical and <br />heahh care services fncludng pqrrnents to corpotatiltns), papnents to <br />a mnemfloyee lor services, peytn nts rnede in setdemenl ol_paymem <br />carC anO thiirt-mrtv r€twort'trjnrrctiotB, paynenls io certah fishing <br />bet crew meniberi and fshetrnen, and gmcs ptoceeds paid to <br />aitorneye fnchdiqg peym€nts to coryorationsl. <br />5, llortgFge int€rEt paid by you, acquisiuoo or Sadonment ol <br />sccurcd propcrty, eancc$ation of debt, graFfied tuitidr prograrn <br />pavnrenti (rirdrf seclirn 5291, ABLE acc'oltnle lurlder sectian 52041' <br />iRi CoyerUen gSn' Archer MSA or HSA contsbstions s <br />dietfrutions. and pemion &tibulions. You nnrst give yolr corest <br />TF'I, but you do mt have to sign the cettificalion. <br />Fo.m W-9 (Rev 3-2024) <br />What Narre and Number To Give the <br />Forfiis acgount Giyenanre and <br />For lh'rs <br />notowrnd by m owner <br />9, A ralil tl6i" o$alo, s pension hr$t <br />10. Corporaiim q IIC olcctinf cotPtrate <br />etdBd Fm8&l2qFom2653 <br />11. Ascialion, dub, nlbidrs, ehritable, <br />edreliond, or olhs ta(-eamFt <br />orgmialin <br />12. P.IlE€hb ot multim€tnber ILC <br />13, A h(!r c regbiorEd noflirc <br />14. Acmwlt wilh fie Deprtrnat of <br />Agrid.*tre in lhe nm of a Public <br />enlily (srdr s a ststs or local <br />gorcnmat school dstnct or grison) <br />fiat Ecetves agd:ttral progrm <br />payrnents <br />15. GErr{dtusrfihg Fm 1041 a <br />underllreoptfrnal FilirE Mdhod 2' <br />Gquiring Fotm loss (s Regublbns <br />scc'lion 1.671-{b}@ltdGD" <br />The organization <br />1 Ustfir* erd cirdetfie nanre of the pe€on whse nrrnberpu fumish. <br />{Doiie <br />'Note: The gratrtor must atso ProviJe a Form W-g to tfie truslee of the <br />ln st- <br />- For nrore ir$omdion on opdonal fifing mefrods for grantor tus6' see <br />the hstn.ctions for Fom 1(H1. <br />Notei lf no name is circled wtren mote lhan one name b lieted' tfie <br />number will be con{dei€d to be lhst of lhe first nane listed. <br />Secure Your Tax Records From ldenfity Theft <br />ldentiiv th€ft ac€N.rs when someone us€s yout persord tn*ormeton. <br />such ab rrou narne, SSN, or other ider*ilying infomation. withotfi your <br />oannissibn to conxnit fraud or othet crimes. An ldenw thle{ ony use <br />iour SSN to get a job or may file a tax rehrm usirg yow SSN io recdve <br />a refrmd. <br />To redrce yourrisk <br />r PfotectyouSSN, <br />. Ensure yorrenPloyer b prcreding youSSN, and <br />r Be carei.rl when chocing a tax retm prcpar€t. <br />ll your tax reffrds are afiected by rdentity theft and you tecdve a <br />rlot;e from the 1ffi. raspand nght aray fo fhe narne afid phon€ nutnber <br />printed on lhe IRS no*fox or lefter. <br />It FUr la.{ records are rot cmerdy aflected by ;defitity lhefi but you <br />thinli yn{t are at risk dte to E lost or stolen pu€e o. wa}let questionable <br />€rediicard.acllvity. or a qJstionablg 6odit rsport conEct lbe IFS <br />He{ility Th€ft fdine d 8tx}.s)8-4490 or subnit Fofln I 2l0tr)- <br />Fsmse informdiorr see Pub.5027, ldenli$Theft lnlormation for <br />Tartpayets- <br />Give name and EIN <br />Legd enlityl <br />Thc csporation <br />The prtrsship <br />The bmfts or nom"lrre <br />the public enliB <br />The tust <br />lf only ore person on ajoht account hs an $5N, rhat person's number <br />mu$befrnni*Ed. <br />2 Chcle lfre minor's name and fumish lhe ndnor's SSN, <br />rYou must slrow vour indivrdtral narne on lin€ 1, ard enret Your btrsirless <br />or DtsAname. rl a'ny, on 6ne 2. You may use etlher your <br />-SSll <br />or EIN (tf <br />you har€ oneL but tre IFS encourages you to use ytur SSN' <br />rList fif$t md cirde the narne of the trust estate, ot Pensim tru6t- <br />notfumi$ tha Tlll of the pesonal repfes$tdive or tustee tflless <br />legal entity itsef is not designated in the ffiutrt litb') <br />1. <br />2. Two q mc hdividuak ftint contf <br />oder lhan m rcwnr mhtained by <br />o FFI <br />3-TwocmeU-S.pem <br />ooinl ffit mahtained by m FFI) <br />4. Custodid accomt of a mha <br />(ljni[om Gift io MinonAcl) <br />5. a. The ugual esHe svhgB h5t <br />(grsnlor 'B dso truEte€) <br />b. S+eled tst *ont lhat is rct <br />a lcaral or valil brrt md* state bw <br />6, Soh poprierorship or disregaded <br />srtity ouned byan hdivi&al <br />7, GrNnlortnrst filing mder Optional <br />mhg Meftod 1 (see Regulatiorre <br />sec{im 1.671-4{bx2)ft(A)r <br />The actual oms of lhe account or' <br />il unbined fun&, lbe fiBt individual <br />on the accountl <br />Eadr holder ofih€ accotnt <br />Themins? <br />The grantotrtusEct <br />Thcactulowl <br />The trncto <br />Thegranior' <br />Kittitas County Agreernent for Services (rev.5/t4/251 <br />Page 17 of 19