|
Form W-9 (Fev.3-2024)Pase 4
<br />2-The United Slates or any of its agencies or instrumentalities.
<br />3-A state, the Oistrict of Columbia, a U.S. commonwealth or lenitory
<br />or any of ther'r political subdivisions or instrumentalilies.
<br />4-A foreign govemmonl or any of its political subdivisions. agencies,
<br />or instrumenlalities.
<br />5-A corporation.
<br />6-A dealer in secutities or commodities required to register in the
<br />United States, ihe District of Columbia, or a U.S. commonweallh or
<br />tenitory.
<br />7-A futures commission merchant registered wilh the Commodity
<br />Fulures Trading Commission.
<br />8-A real estate inv€stmsni trust.
<br />9-An entity registered at all times during the tax year under lhe
<br />lnvestment Company Act of 1940.
<br />10-A common kust fund op€rated by a bank und€r section 584(al.
<br />1 | -A financial institution as defined under s€ction 591.
<br />12-A middleman known in lhe investment community as a nominee or
<br />custodian.
<br />'13-A trust €x€mpt trom tax under seclion 664 or described in section
<br />4947.
<br />The following chart shows types of payments that may be ex€mpt
<br />from backup withholding. The chart applies to the exempt payees listed
<br />above, l through 13.
<br />lF the payment is lor THEN the paymenl is exempt
<br />lor. . .
<br />o lnterest and dividend payments All exempt payees except
<br />tor 7.
<br />transactions Exempt payees 1 through 4 and 6
<br />lhrough 1 1 and all C corporations.
<br />S corporations must not enter an
<br />exempt payee code because they
<br />are exempt only for sales ol
<br />noncovered securities acquired
<br />to 2O12.
<br />r Barter transactions Exempt payees 1 through 4.
<br />and
<br />. Payrnents over $600 required lo
<br />be reported and direct sales over
<br />9s,0001
<br />. Payments made in s€ttlement of Exempt payees 1 through 4.
<br />payment card or third-party
<br />network transactions
<br />I See Form 1099-M|SC, Miscellaneous lnformation, and its instructions.
<br />2However, tha following payments made lo a corporation and
<br />r€portable on Form 1099-MISC are not exempt from backup
<br />withholding: medical and health care payments, attomeys'fees, gross
<br />proceeds paid lo an attorney reportable under section 6045(0, and
<br />payments for s€rvices paid by a federal executive agency.
<br />Exemption from FATCA repoding code. The following codes identi!
<br />payees that are €xempt from reporting under FATCA These codes
<br />apply to persons submitting this form for accounts maintained outside
<br />of the United States by certain foreign financial institutions. Therefore, if
<br />you are only submitling this form for an account you hold in the United
<br />States, you may leave this field blank. Consult with the person
<br />requesting lhis form if you are unc€rtain if the financial instiMion is
<br />subiect to these requirements. A requester may indicate that a code is
<br />not required by providing you wilh a Form W-9 with 'Not Applicable" {or
<br />any similar indication) entered on lhe line for a FATCA exemption code.
<br />A-An organization exempt from tax under seclion 501(a) or any
<br />individual retirement plan as defined in section 7701lal(371.
<br />B-The United States or any of its agencies or instrumentalities.
<br />C*A state, the District of Columbia, a U.S. commonwealth or
<br />lenitory, or any of lheir political subdivisions or inslrumentalities.
<br />D-A corporation the stock of which is regulady traded on one or
<br />more established securilies markets, as desc.ib€d in Regulations
<br />section 1.1 a72-1 (c)(1 )(i).
<br />E-A corporation that is a member of the same expanded affiliated
<br />group as a corporation described in Regulaiions section 1.1a72-1(cf(1)fl.
<br />Kittitas County Agreement for Services (rev.5/Ml25l
<br />Page 15 of 19
<br />F-A dealer in securilies, commodities, or derivative financial
<br />inslruments fincluding nolional principal contracts, futures, fonvards,
<br />and options) that is registered as such under the laws of the United
<br />Slates or any state.
<br />G-A rcd estale invegtrnent trusl.
<br />H-A regulated investrnenl company as defined in seclion 851 or an
<br />entity registered at all times dudng the tax year under the lnvestrent
<br />Company Act of 1940.
<br />l-A common trust fund as defined in section 584(a).
<br />J-A bank as defined in section 581.
<br />K-A broker.
<br />L-A trust exempt from tax under section 664 or described in section
<br />4e47(a)(t).
<br />M-A lax-exempl lrust under a s€ction 403p) plan or seclion .l.57{g}
<br />plan.
<br />Note: You may wish to consult wilh the financial instilution requeating
<br />this torm to determine whelher the FATCA code and/or exempl payee
<br />code should be completed.
<br />Line 5
<br />Enter your address (number, streel, and apartment or suite number).
<br />This is whera the requesler of this Form W-9 will mail your information
<br />retums. ll this address differs lrom the one the requester already has on
<br />file, enter "NEIM at the top. lf a new address is provided. there is stilla
<br />chance the old address will be used until lhe payor changes your
<br />address in their records.
<br />Line 6
<br />Enter your city, state, and ZIP code.
<br />Part l. Taxpayer ldentification Number (TlN)
<br />Enter your TIN in lhe appropriate box. lf you are a resident alien and
<br />you do not have. and are not eligible to get, an SSN, yourTlN is your
<br />IRS tTlN. Enter it in the €ntry space for lhe Social security number. lf you
<br />do nol have an lTlN, see How to get a IIN below.
<br />ll you are a sole proprietor and you have an ElN, you may enter either
<br />your SSN or ElN.
<br />lf you are a single-member LLC that is disregarded as an enlity
<br />separate from its owner, enter the owne/s SSN (or ElN, if the owner has
<br />one!. lf the LLC is classified as a corporation or partnetship, ent€r the
<br />entity's ElN.
<br />Note: See What Name and Number To Give the Requester,later, for
<br />further clarification of name and JIN combinations.
<br />llow to get a TlN, lf you do not have a TlN, apply for one immediately.
<br />To apply for an SSN, get Form SS-5, Application for a Social Secudty
<br />Card, from your local SSA of{ice or get lhis form online at
<br />www.SSAgov. You may also get this form by calling 80o-772-1213. Use
<br />Form W-7, Application for IRS lndividual Taxpayer ldentification
<br />Number, to apply for an [TlN. or Form SS-4, Application {or Employer
<br />ldentification Number, to apply {or an ElN. You can apply for an EIN
<br />online by accessing the IRS websile alwww.irs.govlFlN. Go to
<br />www.irs.govlForms to view, download, or pdnt Form W-7 and/or Form
<br />have Form W-7 and/or Form S94 mailed to you within 15 business
<br />days.
<br />lf you are asked to complete Form W-9 but do not have a TlN, apply
<br />for a TIN and enter "Applied Fol" in the space for the TlN, sign and date
<br />the form, and give it to the requester. For interesl and dividend
<br />paymenls, and certain payments made with resp€ct to readily lradable
<br />instruments, you will generally have 60 days to get a TIN and give it to
<br />lhe request€r before you are subject to backup withholding on
<br />payments. The 60-day rule do€s not apply to other types of payments.
<br />You will be subiecl to backup withholding on all such payments until
<br />you provide your TIN to the requesler.
<br />Note: Entering "Applied Fof means thal you have already applied for a
<br />TIN or lhat you intend to apply for one soon. See also Establishing U.S.
<br />status for purposes ol chapter 3 and chaptet 4 withholding, earlier, for
<br />when you may instead be subiect to withholding under chapter 3 or 4 of
<br />the Code.
<br />Caution: A disregarded U.S. entity that has a foreign owner musl use
<br />the appropriate Form W-8.
<br />Generally, exempt paye€s
<br />1 through 5.2
|