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Form W-9 (Hev.3-2024)Page 5
<br />Part ll. Certification
<br />To establish to lhe withholding agent lhat you are a U.S. person, or
<br />resident alien, sign Form W-9. You may be requested to sign by the
<br />withholding agent even if item 1, 4, or 5 below indicates othen,/ise.
<br />For a joint account, only lhe person whose TIN is shown in Parl I
<br />should sign (when required), ln the case of a disregarded entity, the
<br />person identified on tine 1 must sign. Exempt payees, see Exempt payee
<br />code, earlier.
<br />Signature requirements. Complete the certification as indicaled in
<br />itemslthrough5below.
<br />l. lnterest, dividend, and barter exclrange accounls opened
<br />before 1984 and broker accounts considered active during 1983.
<br />You musl give your correct TlN, but you do not have to sign the
<br />certification.
<br />2. lnterest, clividend, hroker, and bader exchange accounts
<br />opened after 1983 and broker accounts considered inactive during
<br />l08i!. You must sign the cedification or backup withholding will apply. lf
<br />you are subject to backup withholding and you are merely providing
<br />your conect TIN to the requester, you must cross out item 2 in the
<br />certification before signing the form.
<br />3. Real eslate transactions. You must sign the certificalion. You may
<br />cross out ilem 2 of the certification.
<br />4. Olher payments. You must give your correct TlN, but you do nol
<br />have to sign the certification unless you have been notified that you
<br />have previously given an inconect TlN. "Olher paymenls" include
<br />payments made in the course of the requesler's trade or business for
<br />rents, royaities, goods (other than bills for merchandise), medical and
<br />heahh care services fncluding payments to corporations), payments to
<br />a nonemployee for services, payments made in settlemenl of payment
<br />card and lhird-party network transactions, pay-ments to certain fishing
<br />boat crew members and fshermen, and gross proceeds paid to
<br />attomeys fncluding payments to corporations).
<br />5. Morlgage interesl paid by you, acquisition or abandonment of
<br />secured property, cancellation of debt, qualified luition program
<br />payments {under section 529}, ABLE accounts (under section 529A),
<br />lRA, Coverdell ESA, Archer MSA or HSA contribulions or
<br />distributions, and pensiorr distributions. You must give your correct
<br />TlN, but you do not have to sign lhe cerlification.
<br />What Name and Number To Give the Requester
<br />For lhis of accounl:Give name and SSN of:
<br />1. lndividual
<br />2- Two or more individuals (ioint accountl
<br />olher than an account maintained by
<br />an FFI
<br />3. Two or more U.S. pesons
<br />foint account maintained by an FFI]
<br />4. Custodial account of a minor
<br />0Jniform Gift to Minors Act)
<br />5. a. The usual revocable savings trusl
<br />(grantor is also lrusteef
<br />b- Socalled trusl account that is not
<br />a legal or valid lrust under stale law
<br />6. Sole proprietorship or di*egarded
<br />entity ov/ned by an individual
<br />7. Grantor bust filing under Optional
<br />Filing Method 1 (see Regulations
<br />srclion 1.671 -a{bX2Xi}(A})"
<br />Kittitas County Agreement for Services (rev.5/7a125)
<br />Page 20 of 23
<br />For this of account:
<br />8. Oisregarded entity not owned by an
<br />individual
<br />9. A valid trusl, estale, or pension lrust
<br />10. Corporalion or LLC elecling corpoate
<br />stalus on Form 8832 or Form 2553
<br />11 . Associatioo, club. religioss, chuilable,
<br />educational, or other tax-exetnpl
<br />organizatbn
<br />12. Parlnership or mufti-mernber LLC
<br />13. A koker or registercd nominee
<br />14. Account with the Department oi
<br />Agricullure in lhe name of a public
<br />enlity (such as a state or local
<br />govemmenl, school dbtrict, or prisonl
<br />lhat receives agriculfu ral prograrn
<br />payments
<br />15. Grantor lrusl filing Fm 1041 or
<br />under lhe Oplional Filing Method 2,
<br />requiring Form 1099 (see Regulations
<br />section 1.671 -4(bl(2Xi)(BD"
<br />Give name and EIN of:
<br />The owner
<br />Legal enlibd
<br />The corporalion
<br />The organization
<br />The parhership
<br />The broker or nominee
<br />The public enliry
<br />The actual owner of lhe account or,
<br />if combined funds. the first individual
<br />on the accountl
<br />Each holder of the accounl
<br />The minor2
<br />The grantor-lrusteel
<br />The actual owner!
<br />The orvneF
<br />The grantor'
<br />The lrust
<br />! List tirst and circle the name of the person whose number you fumish.
<br />lf only one person on a joint account has an SSN, that person's number
<br />must be fumished.
<br />2Circle the mino/s name and fumish the minor's SSN.
<br />lYou must show vour individual name on line 1. and enter vour busine*s
<br />or DBA name, if ahy, on line 2. You may use eithet your SSN or EIN (if
<br />you have one), but the IRS encourages you to use your SSN.
<br />{Ust first and circle the name of the trusl, estate, or pension trust. {Do
<br />not fumish lhe TIN of the personal representative or trustee unless the
<br />legal entity itself is not designated in lhe account lille-)
<br />'Note: The grantor must also provide a Form W-9 to the trustee of lhe
<br />trust.
<br />" For more information on optional filing methods for grantor ttusts, se€
<br />ihe lnstructions for Form 1041 .
<br />Note: lf no name is circled when more than one name is listed, the
<br />number will be considered lo be that of lhe first name listed.
<br />Secure Your Tax Records From ldentity Theft
<br />tdentity theft occurs when someone uses your pen;onal information,
<br />such as your name, SSN, or other identifuing information, without your
<br />permission to commit fraud or other crimes. An identity thief may use
<br />your SSN to get a job or may file a tax tetum using your SSN to receive
<br />a refund.
<br />To reduce your risk:
<br />. Protect your SSN,
<br />. Ensure your employer is protecting your SSN, and
<br />. Be careful when choosing a tax refum preparer.
<br />ll your tax records are affected by identity theft and you receive a
<br />notice from the lRS, respond right away to the name and phone number
<br />printed on the IRS notice or letter.
<br />lf your tax records are not cunenlly affected by identity theft but you
<br />think you are at risk due to a lost or stolen purse or wallet, questionable
<br />credit card activity, or a questionable credit report, contacl lhe IRS
<br />ldentity Theft Hotline at 800-908-4490 or submit Form 14039.
<br />For more information, see Pub. 5027, ldentity Theft lnformation for
<br />Taxpayers.
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