R2026-005 - Laserfiche WebLink

Home Browse Search

Page 5 Form W-9 (Rev.3-2024) Part ll. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Fomr W-g. You may be requested to sign by lhe vrithholding agerit enen if item 1 ' 4, or 5 below indicates othervrise' For a ioint account, onlv the person whose TIN is shown in Part I should sign (when required). ln'the case of a disregarded entity' the person id-entified on line 1 must sign. Exempt payees. see Exenpl payee code, exlier. Signature requirements' Complete the certification as indicated in itemslthrough5below. 1. lnterest, clividend, and barter exchange accounts opened before l9g4 and broker accounts considered active during 1983' You must give your correct TlN. but you do not have to sign the certification. 2. lntergst, divi<Jend, broker, and barter exchange accounts onened after 1983 and llroker accounts considered inactive during iii83. iou must sign the certrfication or backup withholding will apply' tf you are subiect tobackup withholding and you are merely providing vorr con"ci TIN to the requester, you must cross out item 2 in the iertilication before signing lhe lorm. 3. Real estate transactions. You must sign the certrfication' You may cross out ilem 2 of the certification. 4. Other payments. You must give your conect TlN. but you do not have to sign the cerlification unleds you have been notified that you have previously given an inconect TlN. "Other.payments" include o"u.!nt" maa'ein the course of the requester's trade or business for rerits, royalties. goods (other than bills for merchandisel, medical and health cire services (including payments to corporations). payments to a nonemployee for servlces, payments made in settlement of-payment-ard and' thiiO-party network'trdnsactions. payments to certain fi shing boat crerri meniberi and fishermen, and gross proceeds paid to attomeys (including payments to corporations). 5. Mortgage interest paid by yorr, acquisition or abandonment of secured olooertv. cancellation of debt, qualified trrition program piv-*nt'= (uhdei section 529!, ABLE accotrnts (under section 529A)' iRA, coveraelt ESA, Archer MSA or HSA contributions or <listributions, and pension distributions. You must give your conect TlN, but you do not have to sign the certification- What Name and Number To Give the Requester The irust 'List first and circle the name of the person whose number you fumish. lf onty one person on a joint account has an SSN. ihat person's number musl be fumished. :Circle the minor's name and fumish the minor's SSN' 3 You must shors vour individuat name on line 1 . and enterlrour business oi beA ni;u:-ii ahy, on iine e You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN- {List first and circle the name of the trust, estate, or pension trust' (Do not fumish lhe TIN ol the per:onal representalive or ttustee unless the legal entity itself is not designated in tlr€ account litle'i 'Note: The grantor must also prcvide a Form W-9 to the trustee of the trust. " For more information on optional filinE methods for grantor trusts, se€ the lnstructions for Form 1O41" Note: lf no name is circled when more than one name is listed' the number will be corsidered to be that af lhe lirst name {isted' $ecure Your Tax Records From ldentity Theft ldentitv theft occurs when someone use€ your p+rsonal rnformation, "uCn "L yor. n"-e" SSN. or oiher idendfrling rnformation- wilhot't your permission tc comrnit fiaud sr other crirne€t- An identity thief may use your S$N to get a iob or may file a tax return ustng your SSN to receive a refund. To reduce your risk: . Protect your SSN. . Ensure your employer is protecting your SSN. and . Be careful when choosing a tax return p(eparet. lf your tax records are affected by identity heft and yorr receive a notice trom the lFtS, respond right away lo the narne and phone number printed on the IRS notice or lette.r' lf ,rour tax records are not cun*nlly affected by idenlity theft but you rninfi Vou are at nsk due to a lost or 6roien purse'or r'vallet, questronable credifcard activity. or a quoJtronable credlt repoit contact the IRS ldentity Theft Hotiine at 800-908-4490 or s{rbmit Fonn 14039" For more information, see Pub. 5g2r" ldenttty Theft lnfonnation for Taxpayers- For this of account: 8. Disregarded enfu not owned bY m individual 9- A valid lrust. estate. or peffion tnst 10. Corporatioft or LLC elstinE corFcaB statrs on Fom 8532 or Fsm ?553 11 , Assmiatim. €lub, reltgiils' chtrrtable' educatioml. or othe! ta-*xemPt organiatbf, 12. Padnership or muftimmber LLC '13- A koker or r€qisteed nominee 1.t. Acmunt with lhe OeFartrn€flt of Agriafture in the name of a Fublic entity (such s 3 state or lmal govemmal, school diskict' or prison| that r*ceives agriculbrral Pmgrm Payments '15. Grantor tust {ilhg Fm 1${t ot under the Optional Filing l.lethcd 2. requiring Form 1O99 (se 9egulatiom section 1.671 -{{bXz}dl(B}I" Giv6 name and EIN ol: The owner Legral entityt The *uporalion The mganintion The ptrlntrship The broker or nominee Ihe public milty For this of account: 1. lndividual ?. Two or more indi';iduak tjoint accouot| other than an account maintained by an FFI 3- Two or more U.S- Persons ijoint account maintained by an FFI) .1. Custodial account of a minor {lJnifom Gift to Minors Acl} 5. a. The usu:l revomble xvings trust (grmior is also trwtee| b- Sealled ttust accent that is not a legal or valid tct under state laYl 6. Sole proprietoFhip cr disregrded mtity ovrned by an individual 7- Granlor Fust 6ling under Aplanal Frling lvlethod 1 (see Regulatrons s*cten 1.671 -4{bi(2}{il(Al}" Giue name and S$N of: The actual owner of th* accouot ol. if combined funds. &e fisl individual on thE accountr Each hqlder of the acccunl The minoF The grsttr-lutee' The aclusl ournerr The ovrneF The grator' Kittitas County Agreement for Services lrev. 5/14/25]| Page 2L of 24