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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!
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