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,.,,n lllf'9 <br />(nav. Milch 20241 <br />Doparlmonl of lhg Tro68ury <br />ATTACHMENT'D" <br />Request for Taxpayer <br />ldentification Number and Certlflcation <br />Go lo www,irs.goylFonnwg tor ln8?uollons and tho lstest lnformadon. <br />For rolatod lo ihe of Form W-9, seo o( Form,below. <br />I Name ol ontity/indlvldsal. An enlry l8 requi od. (Fo{ a sole propristor or disrogerdcd enlaty, onlor lhe orvne/s nsmo m llno 1. dd enler tho buslnoss"/dlsrogardsd <br />6ntty's oamo on lino 2.) <br />2 SusinG$ mmaldisretordod ontily nsno, il ditto,ont hom abovo. <br />4 Exmptions (codoe opply sly to <br />corlain ontltl6, mt lndivlduals: <br />se lnslruclioN on page 3): <br />€xompt pays codo (lt 8sy) <br />Give form to the <br />rsguogter, Do not <br />eend to the lRS. <br />Foooo-I <br />olE <br />R8 <br />ET <br />EE <br />4orc <br />goI <br />E,t <br />Exqnpllotr trom <br />ComplimcoAct <br />cods (il ony) <br />Fo0ign Aeount Tar <br />{FATCA} roporting <br />(Applics lo accognts nointdinad <br />outside lho Unilod Staaas, <br />Requesler'& name snd addrss (optionst <br />7 t.rst rccounl numbo(s) h.,a (opliona0 <br />Ent€r your TIN in lhe appropdate box. ThE TIN provided must match lhe name given on line I to avoid <br />backup withholding. For indlvlduals, this is gonsrally your social socurity number (SSN). Howevor, for a <br />residenl alien, sol6 proprietor, or disr€gatdod 6ntity, soo th6 instructions for Pad l, laler, For other <br />entlties, it is your smployer idenlitication number (ElNl. lf yo! do nol havs, numb€r, gee How to get a <br />frrv, lat6r. <br />Noter lf lhe account is in moro than one namo, gee the instructions for line 1, Soe also Whal Namo and <br />Number To Giva lhe Requasta/ for guidolinos on whoso numbor lo enler, <br />or <br />Undsr penalties of periury, I cedify ihal: <br />1. The numb€r shown on thi3 form is my corroct taxpayor idontification number (or I am waiting for a numbor lo bs issuod to mo): snd <br />2. I am not subjeci to bsckup withholding becauso (a) I am oxempt from backup withholding, or (b) I have nol beon nolified by tho lntsrnal Rovonuo <br />Sewice {lRS} that I am subiect to backup wilhholding as a result of a lailure to report all interest or divid€nds, or (c) th€ IRS has nolilied me thst I am <br />no <br />'onger <br />subiect lo backup wilhholding; and <br />3. lam a U.S. cilizen or othor U.S. person (dofinod below); and <br />4. The FATCA codets) ontor€d on thig lorm (if any) indicating that I am 6x6rnpt from FATCA reporling is correcl' <br />Cortlllcstlon lngtruc-llons, You musl cro.es oul itom 2 abovo ll you havo be€n notlfied by lh€ IRS lhat you aro cutrontly sub.ie€t to backup wilhholding <br />you. tax rolurn, For .oal oslals kansactions, item 2 doss rloi apply. For mortgage inlstost paid'b€cauBs you hav€ lail€d lo t€porl all intorest and dividgnds on <br />acquisition or abandonrnont of secured prop€rty, cancellalion of debt, conLibutions to an individuai <br />9r Chock ths approprialo Oox ts t€dara, tax classificalion ot lhs ontilylindrvidual rvho0e n{mo is €lllfred on lins '1. Ch6ck <br />only ono of lho following s€von boxos. <br />ff lndividuausotoprogriolor f| Ccorporatton I Scopuatlon I Partmntrip f] Trusvsstdto <br />f] LLC, Entor tho tax cltr$sificatlon (C . C cotpor*llon, S . S corpotatlon, P = Padno.rhipl <br />NoL: Chtrk th€ "LLC" box abova and, ln rhs cnlry spac6, enlot the apptopdara codo (C, S, o. P) tor the lax- <br />ctas$ltication ot tho LLC, lnloss ll ls a dlsraoardod dllfiy. A dlsrogardad onlily thoud imload chock tho approt'iolo <br />box tor tho iax clasgifcation of its oMor. <br />n othw (Bs inslructions) <br />3b It on line 3a you chocked "Padnorship" or 'Irusv6$l&te." or €heckod "LLC" ond enttrod "P" 6s iG lox dosslficalion, <br />trd you m providing this lom to a psnn66hlp. lMt, d ostate in whicar you have an ownershap ints63l, chsk <br />this box It yo$ lrave rny toralgn padngB, ownsB, ot boneficlerls. See insltuclions <br />5 Add€$ (number. str6t. and apl. ot saile no.), S€€ instruclionE' <br />0 City, slsto. and ZIP codo <br />ldentification <br />numbrt <br />Part I <br />Employor ldontltlcrtlon numboa <br />Part ll <br />other than into.est and <br />Slgn <br />Here <br />ar6 nol to lhe but must <br />Slg.stut! ot <br />U.S. porlon Doto <br />General lnstructions <br />Ssction r€t€rences are to th6 lntemal Revatrue Code unless oth€rwise <br />noted. <br />Futuro dovalopmonts. For the latest intormalion aboul devglopmonts <br />relaled lo Form W-9 and its instruclions, such as legislslion enacted <br />after th€y w€re publbhed, go lo www.irs.govJFomw9, <br />What's New <br />Lin€ 3a has boen modilied lo clariiy how a disregarded sntity compl€tes <br />this lin6. An LLC that is a disr€gardod entlty shottld check lhe <br />appropriale box lor the tax classification of its ownor. Olherwise, it <br />should ch€ck the "LLC" box and eRl€. ils appropnate lax classification. <br />Now iine 3b has be€n add€d to lhis fofm. A flow-through enlily is <br />required to complele lhis lino to indicate lhat it has dit€ct or indirect <br />loreign partners, owrets, or b€n€ficiarios when it ptovides the Fonn W-9 <br />to another flow-through ontity in which it has an ownership interost. This <br />chango is intonded to provlde a flow-through entity wilh informalion <br />rogarding the stalus of its indirecl foroign parlnors, ownors, or <br />beneliciaries, so that lt can satisfy any applicable,6porting <br />rsquiroments, For example, a partne.shlp that has any indirect loreign <br />partners may b€ requirod to complote Schedulos K-2 and K'3. Seo the <br />Partnorship lnslruclions for Schedulos K-2 and K-3 (Fonn 1065). <br />Purpose of Form <br />An individual ot ontity (Fonn W-9 roqusstor) who is roqulrod to lile an <br />information r6lum with lhs IRS ie givlng you thi$ forrn becauae they <br />Cal. No. lO?31X <br />Kittitas County Agreement for Services (rev.5/M/25) <br />Page 13 of 19 <br />Form W-9 tRov. 3-2024!