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Fom W-9 {Rev. 3-2024)Page 3
<br />Certain payees and payments ate exempt from backup withholding-
<br />See Exenpt'payee coae,'latet, and the seiarate lnstructions for the
<br />Requester of Form W-9 for more in{ormation.
<br />See also Estabrrstr,,;4g U.S. status forpwryses of chapter 3 aN
<br />chapter 4 withholding, eailier.
<br />What ls FATCA Reporting?
<br />The Foreign Account Tax Compliance Act (FATCA) requires a
<br />participating foreign financial instiMion to report all U.S. acpount
<br />holders thai are specified U.S. petsons. Certain payees are exempt frcm
<br />FATCA reporting.-See Exemption frcm FATCA repoaing code. later, and
<br />the lnstructions for the Requester of Form W-9 for more infonnation.
<br />Updating Your lnformation
<br />You must provide updated information to any person to whom you
<br />claimed to be an exempt payee if you are no longer an exempt payee
<br />and anticipate receiving reportable payments in the future from this
<br />person. F6r example, ybu may nee<i t6 provide updated information if
<br />you are a C corporation that elects to be an S corporation. or if you are
<br />ho longer tax exempt. ln addition, you must fumish a new Form W-9 ff
<br />the name or TIN changes for the account, for example, if the grantor of a
<br />grantor trust dies.
<br />Penalties
<br />Failure to fumish TlN. lf you fuil to fumish your correct TIN to a
<br />requester, you are subiect to a penalty of S50 for each such fuilure
<br />unless your fuilure is due to reasonable cause and not to willful neglect'
<br />Civil penalty for false information with resPect to withholding- lf you
<br />make a false statement with no reasonable basis that resulls in no
<br />backup withholding, you are subiect to a 5500 penalty.
<br />Criminal penatty for fulsifying information. Wiltfully blsrfying
<br />certifications or affirmations may subiect you to criminal penalties
<br />including fi nes and/or imprisonment.
<br />Misuse of TlNs. lf the requester discloses or uses TlNs in violation of
<br />federal law. the requester may be sublect to cMl and criminal penalties.
<br />Specific lnstructions
<br />Line I
<br />You must entet one of the following on this line: do not leave this line
<br />blank. The name should match the name on yourtax retum.
<br />]f this Form W-9 is for a ioint account (other than an account
<br />maintained by a foreign financial institr"rtion (FF|), list first, and then
<br />circle. the name of the person or entity whose number you entered in
<br />Part I of Form W-9. lf you are providing Form W-9 to an FFI to document
<br />a ioint account, each holder of the accotmt that is a U.S. person must
<br />provide a Form W-9.
<br />. lndividual. Generally, enter the name shown on yout tax retum. lf you
<br />have changed your last narne without informing the Social Security
<br />Administration (SSA) ol the name change, enter your fitsl name. the last
<br />name as shown on your social security card, and your new last name.
<br />Note for ITIN applicant Enter your indMdual name as it was entered
<br />on your Form W-7 application, line 1a This should also be the same as
<br />the ftrme you entered on the Form 104O you filed with your application.
<br />. Sole proprietor. Enter your individual name as shown on your Form
<br />1040 on line 1. Enter your business, trade, or "doing br.siness as" (DBA)
<br />name on line 2.
<br />. Partnership, C corporation, S corporation, or LLC, other than a
<br />disregarded enlity. Enter the entity's name as shown on ihe entity's tax
<br />retum on line 1 and any business, trade, or DBA name on line 2-
<br />. Other entities. Enter your name as shown on required U.S. federal tax
<br />documents on line 1. This name should match the name shown on the
<br />charter or other legal document creating the entity- Enter any business,
<br />trade. or DBA natne on line 2.
<br />. Disregarded entity. ln general. a business entity that has a single
<br />owner. including an LLC, and is not a corporation, is disregarded as an
<br />entity separate fiom its owner (a disregarded entity). See Regulations
<br />section 301 .7701 -2(cx2l. A disregarded entity should check the
<br />appropriate box for the tax classffication of its owner. Entet the owne/s
<br />name on line 1. The name of the owner entered on line 1 should never
<br />be a disregarded entity. The name on line 1 should be the name shown
<br />on the income tax retum on which the income should be reported. For
<br />examde, if a foreiqn LLC that is treated as a distegarded entity for U.S.
<br />federil tax purpo*s has a single owner that is a U.S. person. the U-S.
<br />owne/s name is required to be provided on line 1. lf the direct owner oi
<br />the entity is also a disregarded enlity. enter the first owner that is not
<br />disregarded for federdl tax purposes. Enter the disregarded entity's
<br />name on line 2. lf the owner of the disregarded entity is a foreign person,
<br />the ovmer must complete an appropriata Form W-8 instead of a Form
<br />W-9. This is the case even if the foreign person has a U.S- TIN.
<br />Line 2
<br />lf you have a business name, trade name, DBA name. or disregarded
<br />entity name. enter it on line 2.
<br />Line 3a
<br />Check the appropriate box on line 3a for the U.S- federal tax
<br />classification of the person whose name is entered on line 1" Check only
<br />one box on line 3a
<br />Line 3b
<br />Check th's box if you are a pattnership fncluding an LLC classified as a
<br />partrrership for U.S. federal tax purposes), trust, or estate that has any
<br />foreign parhers, owners, or beneficiaries, and you are providing this
<br />form to a partnership. trust or estate, in lvhich you have an ownership
<br />interest Vou mtrst check the box on line 3b if you receive a Form !\l-8
<br />(or documentary evidence| from arny partnet, owner, or beneficiary
<br />establishing loreign status or if you receive a Form W-9 from any
<br />par$rer, owner. or beneficiary that has checked the box on line 3b.
<br />Note: A partnership that provides a Form W-9 and checks box 3b may
<br />be required to complete Schedules K-2 and K€ (Form 1065). For more
<br />information, see the Partnership lnstructions for Schedules K-2 and K-3
<br />(Forn 1065).
<br />lf vou are required to complete line 3b but fail to do so, you may not
<br />receive the info'rmation necessary to file a conect information retum with
<br />the IRS or fumish a coflect payee statement to your partneG or
<br />beneficianes. See. for example, sections 6698, 67?2. and 6724 lor
<br />penafties that may apply-
<br />Line 4 Exemptions
<br />lf you are exempt from backup wilhholding and/or FATCA reporling.
<br />enter in the appropriate space on line a any code(s! that may apply to
<br />you-
<br />Exempt payee code.
<br />. Generally. individuals fincluding sole proprieto,s) ate not exempt from
<br />backup rt ithholding.
<br />. Except as provided below, corporations are exempt trom backup
<br />withholdng for certain paymenls, including interest and dividends.
<br />. furporations are not exempt irom backup withholding for payments
<br />made in setdement of payrnent card or third-party network transactions.
<br />. Corporations are not exempt ftom backup withholding with respect to
<br />attomeys'fees or gross proceeds paid to attomeys, and corporations
<br />that provide medical or health care services are not exempt witfi respect
<br />to payments reportable on Form 1099-M|SC.
<br />The following codes identify payees that are exempt frorn backuP
<br />withholding. Enter the appropriate code in tfie space on line 4.
<br />1 -An organization exempt fiom tax under section 501(a), any lRA, or
<br />a crctodbl account under section !K)3{bX7) if the account satisfies the
<br />requirements of section ao1(0(2).
<br />Kittitas County Agreement for Services (rev.5/L4/251
<br />Page 15 of 18
<br />. Trust/estate
<br />Partnership
<br />. LLC classified as a parherhip
<br />for U.S. federal tax purposes or
<br />. LLCthat has filed Form 8832 or
<br />2553 electing to be taxed as a
<br />corporation
<br />. lndividual or
<br />. Sole Droprietorship
<br />. Corporation
<br />lF the entity/individual on line I
<br />3s a(n) .. .
<br />Trust/estate.
<br />Partnership.
<br />Limhed liability company and
<br />enter the appropriate tax
<br />classification:
<br />P = Partnership,
<br />C=Ccorporation,or
<br />S = S corporation.
<br />lndividuaysole proprietor.
<br />Corooration.
<br />THEN check the box for
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