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Pase 4 <br />Form W-9 (Rev. 3-20241 <br />2-The United States or any of its agencies or instrumentalities' <br />3-A state, rhe District of Columbia. a U.S. commonwealth or tenilory' <br />or any oi th€ir political subdivisions or instrumenialities' <br />4-A foreign govemment or any of its politieal subdivisions' agencies' <br />or instrumentalities. <br />5-A corporation. <br />6-A dealer in securities or commodities required to register in the <br />United States, the District of Columbia, or a U.S- commonweallh or <br />territory. <br />7-A fulures commission merchant registered wlh the Commodity <br />Fulures Trading Commission- <br />8-A real estate investment trust. <br />I -An entity registered at all times during the tax year under the <br />lnvestment ComPanY Act of 1940. <br />10-A common trust fund op€rated by a bank under seetion 584(a)' <br />1 1 -A financial institution as defined under section 581' <br />12-A middleman known in the investment community as a nominee or <br />custodian. <br />13-A trust exempt from tax under section 664 or described in section <br />4947. <br />The following chart shoers typ€s of payments-lhat may b€ exempt <br />tromtact rp dithholding. the'ihart appiies to the exempt payees listed <br />above, 1 13. <br />lF the payment is for THEN the payment is exempt <br />for.., <br />. lnteresl and dividend payments All exempt payees except <br />lor 7- <br />Exempt payees 1 4andG <br />F-A dealer in securities. comrnodities, or dentative financial <br />insrruments Cnciuaing notinal principat contracts. futures, forwards' <br />"nJ <br />opUo*tin"t is rfuisrered ds such under the laws of the United <br />States or any state- <br />G-A real estate investrnent trust. <br />H-A resulated investrnent company as defined in section A5l or an <br />entity regiJtered at all tirnes dunng ffle tax year under fre lnvestrnent <br />Company Act of 1g{0. <br />l-A common trust fund as defrned in se.tian 584(al' <br />J-A bank as de{ined in section 5S1' <br />K-A broker. <br />L-A fust exempt from tax under section 66'l or described in section <br />4s47(al(11. <br />M-A tax-exempt trust under a section 4txlpi plan or section 457(9) <br />plan^ <br />Note: You may wish to consult wilh the financial instihrtion requesting <br />this form to determine whether lhe FATCA code andlor exempt payee <br />code should be completed' <br />Line 5 <br />Enter vour address (number, street, and apartment or suite number)' <br />Til;J;; th" reiuester of this Form W-g wilt marl your information <br />i"iurn=. ii*,i" .Udreis differs from the one the requester already has.on <br />il;:;#;NEW' at the top- lf a new address is provided' there is still a <br />chance the old address will be used until the payor changes your <br />address in their records. <br />Line 6 <br />Enter your city, state, and ZIP code- <br />Part t" Taxpayer ldentification Number tTlN) <br />Enter your TIN in dre appropriate box- tf you are.a resrdent alien and <br />vou dJnot have, and are not'eligibfe to get. an SSN' your TIN is your <br />ifqs lTltl. E^t"t ii in lhe entry spJce for lie Social secunty number- ll you <br />do not have an lTlN, see Hor,v to get a IlAl below- <br />lf you are a sole proprietor and you have an EIN' you may enter either <br />your SSN or ElN. <br />lf you are a single-member LLC that is disregarded,as.an entity <br />seoarate from its owner. enter lhe orrnels S$N {or EIN' if the ovrner has <br />iiE[rr tni] tlCtilassrfied as a corporalion or partnership" enter the <br />entity's Elt{. <br />Note: See What Nane and NumberTa Give flle 'Qeguester' later' for <br />furlher clarification of name and TIN ccrnbinations- <br />How to get a TlN. lf you do not have a TlN. appty- for one immediately' <br />i".ppfy%. "n <br />SSN. get Form SS-5' Application for,a Soclal Security <br />Card,'from your lccd 5SA office or get thisJorm online-at -r**.SSn.iou, You may also get this form by calling E0o-772-1213' U* <br />i"rm w-z."aoprication ior lFslndrwdtnl Tarpayer ldentfi cation <br />i,ilb;,i;ar,btior an ltlN, or Form SS-4. Applicaton-for Emplover <br />ldentification tiuinuer. to apply for an EIN- You can apply for an EIN <br />online by accessinE the trRS websrte at rvww'its"go#EflV' Cio to <br />iii.ii.go*$""r; to uiew, dormlca4 or prinl Form W-7 attdlar Fotm <br />6S+. *iyou c"n go to !rrr4/w-rrs-gavrQddFams to placean order and <br />nau. fo.tri W-z ani/or Fonn SSi rnailed to you wilhn 15 hrsrness <br />days. <br />lf vou are asked to complete Form trV-9 but do not have a TlFl' app{y <br />foi a'ff f,f ana enter'Appliird For" in the space for theTlN' sign.and date <br />il; form, <br />""d Stt it to nt tequester- Foiinteresi and dividend <br />oawnents. and'certain payments made vrith respect to readily tradable <br />in;u";;.G. you will generally have 6o days lo gel.a TIN and give tt to <br />rhe reouestei before iou are subiect to backup rvilhholding on <br />;;;"-;rr Td 6odal,r rule does not apply to other types of paymenls' <br />V"ii *iif O. subiect tobackup withholding on afl such payrnents until <br />you provide your TIN to the requester- <br />Note: Entering "Applied Fof means that you have already 99ql1ed fg3 <br />TIN or that voil iniend to apply for one roon' See also E-9tab/rsn11O l!'S <br />ii"iri r"iirirp".ii ir "'nairiti <br />e *d chaptet 4 wtthholding' eanier' for <br />"rf,"n Vou-*JV i"stead beiubiect to'ttilhhotding under chapter 3 or 4 of <br />the Code. <br />Caution: A disregarded U.S. entity thal has a foreign owner musl use <br />the appropriate Form W-8- <br />through 1 1 and all C corPorations. <br />S corporations must not enter an <br />exempt Payee code because theY <br />are exempt only lor sales of <br />noncovered securilies acquired <br />ta 2012. <br />transactions Exempt payees 1 through 4'. Earter <br />and <br />. Payments over <br />be reported and direct <br />s5,000! <br />required to <br />sal€s over <br />Generally. exempt Payees <br />1 through 5.r <br />Exempt payees 1 through 4.. Payments made in settlement of <br />payment card or third-Party <br />network transactions <br />I See Form 1099-M|SC, Miscellaneous lnfornration, and its instructions' <br />2 However, the following paymenB made to a co-rporation and <br />,.*Gbi" on Form 109;g'-MiSC are not exempt from backup <br />*i-tfrnotaing, medical and health care payme-nts, attomeys'fees. gross <br />proceeds i"id to an attorney reportable under section 6045(fl' and <br />payments for services paid by a federal executlve ag€ncy' <br />Exemotion from FATCA reporting code. The following codes identily <br />o.u""'" th"t "t" "xempt <br />from reporting under FATCA' These codes <br />loiiu io *r"on= submitting this form-ior accounts mantained outside <br />"Flr,l, ilriit.a Sr"tes bv ceriain foreign financial institutions. Therefore. rf <br />;;;;iGft,fl,n'q thi" lotm for"an account you hold in the United <br />btat*", yourn"y leave this field blank. Corsult with thep€rson <br />i"or..tino this iorm if vou are uncertain if the financial institution is <br />"rBi""i t""tt""" requirements. A requester may indicate lhat a code is <br />noi'requit O by providing you with aForm W-9 with-"Not Applicable'.(or <br />;ilfi;i;; ilit:ti;) dt;red on the line for a FATCA exemption code- <br />A-An organization exempt from tax under section 501(al or any <br />individuat ritirement plan as defined in section 7701(aX37)' <br />B-The United States or any of its agencies or instrumentafities" <br />C-A state, lhe District of Columbia, a U.S- commonwealth or <br />territory. or any of their political subdivisions or instrumentalities' <br />D-A corporation the stock of which isregularly traded on one or <br />more estabiished securities markets' as described in Regulations <br />section 1.1 472-1(cX1l{i}- <br />E-A corporation that is a member of lhe same expanded af{iliated <br />g.*p "" a torporation described in Regulations section 1'.1472-1(cX1)iil' <br />Kittitas County Agreement for Services (rev' 5/7a/25l, <br />Page 2O of 24