|
Fa= W-9 ;Rev. �' -2024r
<br />Part 11. Certification
<br />To establish to the withholding agent that you are a U.S. person. or
<br />resident alien. sign Form W-9. You may be requested to sign by the
<br />withholding agent even K item 1-1, or 5 below indicates otherwise.
<br />For a joint account. only the person whose TIN is shown in Part I
<br />should sign (wher, required). In the case of a disregarded entity, the
<br />person identified on line 1 must sign. Exempt payees. see Exempt payee
<br />code. earlier.
<br />Signature requirements. Complete the certification as indicated it,
<br />iteins I through 5 below.
<br />I . Interest, dividend, and barter exchange accounts opened
<br />before 1984 and broker accounts considered active during 1983.
<br />You must give your correct TIN, but you do not have to sign the
<br />certification.
<br />2. Interest, dividend, broker, and batter exchange accounts
<br />opened after I W and broker accounts considered inactive during
<br />1983. You must sign the certification or back-up withholding will apply. If
<br />you are subject to backup withholding and you are merely providing
<br />your correct TIN to the requester. you must cross out item 2 in the
<br />certification before signing the form-
<br />3. Real estate transactions. You must sign the certification. You may
<br />cross out item 2 of the certification.
<br />4. Other payments. You must give your correct TIN, but you do not
<br />have to sign the certification unless you have been notified That you
<br />hate previously given an incorrect TIN. "Other payments" include
<br />payments made in the course of the requester's trade or business for
<br />rents. royalties, goods (other than b;ft for merchandise), medical and
<br />health care services (Including payments to corporations). payments to
<br />a nonemployee for services, payments made in settlement of payment
<br />card and third -party network trarilsactims, payments to certain fishirrg
<br />boat crew members and fishertnen, and gross proceeds paid to
<br />attomers (including payments to corporations)
<br />5. Mortgage interest paid by you, acquisition or abandonment of
<br />secured prop", cancellation of debt, qualified tuition program
<br />payments (under section 529), ABLE accounts (under section 529A),
<br />IRA, Coverdell ESA, Archer MSA or HSA contributions or
<br />distributions, and pension distributions. You must give your correct
<br />TIN. but you do not have to sign the certification.
<br />What Name and Number To Give the Requester
<br />For this tune of account. I Give name and SSN of:
<br />1. Ind vidual
<br />The individual
<br />1 Tv�* or more individual iloint account)
<br />'he actual owner of the account or.
<br />other than, an aaccount mamtarried by
<br />it cornbin,-,c funds. the first individ,al
<br />a,, FFi
<br />-n the accoi mtt
<br />3. Two or more U.S. persons
<br />Each holder of the account
<br />(loint account maintained by an FFI)
<br />4. C�ustodiai account of 3 nunor
<br />The minor2
<br />I'Unilarm G.A to Minors Act)
<br />5. a. T,7,,e usual revocable savings, trust
<br />The grantor-truslee
<br />(granter is also trustee)
<br />b. So-called trust account that is not
<br />The artuai owner'
<br />a legal or valid tract under state bw
<br />6. SoA.e proorietorshill or disregarded
<br />7 he wme-r-1
<br />entity ovined by an x4wdwi
<br />7. Grantor #us' filing under Optional
<br />The grairter*
<br />Filing Method 1 (see Regulations
<br />section 1
<br />Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 17 of 19
<br />Page 6
<br />For this type of account:
<br />Give name and EIN of:
<br />Disregarded entity not cr,ned by ar
<br />The
<br />inAivid A,
<br />9. A valid trust, estate, or oe,-,,cn trust
<br />Legal entiNl
<br />C. Cwponxtro, or LLC efectng corporate
<br />T?-.,e corporation
<br />status on Form E-8-42 or Form 2553
<br />1. Associavon. c=ub, reel is s. &f.arirable,
<br />The orgari=atcri
<br />educational, or other W-exempt
<br />organizator.
<br />12. Partrietsinio •:,r nut-rnefrbw LLC
<br />The partnership
<br />13- A broker or registered noin'twe
<br />The broker or norr. inte
<br />14, Account with the Departrw. t of
<br />The public entity
<br />Agr4Vturex, the narrle& a public
<br />entity ".such as a state or iczal
<br />gcvm—rrnAnt, school dz-trict. or prisoni
<br />that receives agricultural program
<br />payrrm-nts
<br />15. Grantor trust filing Form '041 of
<br />Tree trust
<br />under the Optional Filling Method !,
<br />requiring Fonn I C49 !see Regutations
<br />section !A71-4(bjf2r9i&;8))-
<br />* List first and circle the name of the person whose number you furnish,
<br />if only one, person on a joint account has an SSN. that person's number
<br />must be furnished.
<br />Circle the minor's name and furnish the mnoes SSN.
<br />You mus
<br />t show your individual name on line 1, and enter your business
<br />or DEIA name, if any. on line 2. You may use either your SSN or EIN (if
<br />you have one)l but the IRS encourages you to use your SSN.
<br />List firs', and circle the name of the trust estate, or pension trust. (Do
<br />not furnish the TIN of the personal representative or trustee unless the
<br />legal entity itself is not designated it, the account title.)
<br />`Note: The grantor must also provide a Form W-9 to the trustee of the
<br />trust.
<br />- For more information on optional filing methods for grantor trusts, see
<br />the Instructions for Form 1041.
<br />Note: If no name is circled when more than one name is listed, the
<br />number will be considered to be that of the first name listed.
<br />Secure Your Tax Records From Identity Theft
<br />Identity theft occurs when someone uses your personal information,
<br />such as your name, SSN, or other identifying information, without your
<br />perTnission to commit fraud or other crimes. An identity thief may use
<br />your SSN to get a job or may file a tax return using your SSN to receive
<br />a refund.
<br />To reduce your risk:
<br />• Protect your SSN,
<br />• Ensure your employer is protecting your SSN, and
<br />• Be careful wheir, choosing a tax return preparer.
<br />If your tax records are affected by identity theft and you receive a
<br />notice from the IRS, respond right away to the name and phone number
<br />printed on the IRS notice or letter.
<br />If your tax records are not currently affected by identity theft but you
<br />think you are at risk due to a lost or stolen purse or wallet. questionable
<br />credit card activity, or a questionable credit report contact the IRS
<br />Identity Theft Wthne at 8W-90&-4490 or submit Form 14039-
<br />For more information, see Pub, 5027, Identity Theft Information for
<br />Taxpayers.
<br />
|