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ATTACHMENT "D"
<br />- Request for Taxpayer Give form to the
<br />Form
<br />(Rev. March 2024) Identification Number and Certification requester. Do not
<br />Department of the Treasury send to the IRS.
<br />Intomal Revenue Sorvico Go to wwwJmgov/FormW9 for instructions and the latest information.
<br />Before you begirt_ For guldvtco related to the eurpato of Form W-9, see Purpt>so of Form, below.
<br />1 Name of entdyAndividuat. An entry is required (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business(disregarded
<br />entity's name on line 2.)
<br />2 Business name/disregarded entity namo, d different from above.
<br />3a Check the appropriate box for federal tax classdicafion of the entity/ndividual whose name is entered on line 1. Check
<br />only one of the follow�ng seven bozos.
<br />❑ Individual/sola proprietor ❑ C corporation ❑ S corporation ❑ PlunnershlD ❑ Trust/estate
<br />❑ LLC. Enlor the lax doSS111 A1lan IC = C t:orpgtrdion, S = S t:orporul'on' P - pamcrshi
<br />Note: Cheek U*'Li cox abofrff and, In the catty space, erupr the ,lppm prtple gala (C. S, W Pj'nr IP+':!c
<br />clit,%0pCatfon of lire IAC, unless it Is a llfafeguhTod efflity. Aduog:WOW entity she:. d inatnad i irOck Ir,a ,tzit:rapni
<br />box for the tax classification of its owner.
<br />❑ Other (see instructions)
<br />3b If on lino 33 you chocked "Partnership" a "Trust/estate; or crocked "LLC- and en tared'P- ns its tax classification,
<br />and you ve provicmg thts torn to a oannership, :fast, Or estate in which you have an ownersnip interest, check
<br />this box 4 you have any !onion panhers, owners, or benetierares. See instructions . . . . El
<br />Address (number, street, and apt, or suite no). See insimctlons.
<br />e City. state, and ZIP code
<br />7 L st account number(s) here (oplional)
<br />4 Exemptions (codas apply only to
<br />certain entities, not individuals;
<br />see Instructions on page 3):
<br />Exempt payee code Cif any)
<br />Exemption from Foreign Account Tax
<br />Compliance Act TATCA) raporligg
<br />code (if any)
<br />(Applies to accounts maintained
<br />outside the United States-)
<br />Requesters name end address (opllona,)
<br />Enter your TIN in the appropriate box. The TIN provided must match the name given on fine 1 10 avoid L
<br />backup withholding. For individuals, this is generally your scclal security number(SSN). However, fora E
<br />resident alien, sole propriBtar, or disregarded entity, see the instructions for Pan I, °ater. Fat other
<br />eni ilie$. Ft is your employer Wentlffcation number (EfN). It you do not have a number, see Now ro get a or
<br />TIN, later.
<br />Note: If the account is in more than one name. see the instructions for line 1. See also What Name and r
<br />Number To Give the Requester for guidelines on whose number to enter.
<br />ty number
<br />IT—] -
<br />Under penalties of perjury, I certify that:
<br />1 The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
<br />2. 1 am not subject to backup withholding because (a) I am eitarmpl from backup withholding, or (b) I nave not been nolfbed by The Intemul Revenue
<br />Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) fhe IRS has Willed me that I am
<br />no longer subject to backup withholding; and
<br />3. 1 am a U.S. citizen or other U.S. person (defined below); and
<br />4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
<br />Certification instructions. You must cross out item 2 above If you have been notified by the IRS Ihat you are cwferllty subject to backup withholding
<br />because you have failed to report all interest and dividends on your lax return. For real estala lransactiom, item 2 doas not apply. For rnortgage ir"reil paid,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retire rer arrangerrew ORA). ard, generally, paymes^s
<br />other than interest and drvidords. you are not mpuired to sign the certification, but you rnw provide yot.r ccri. TIN. Soo 1F.e •n 1-cliors for Pant It. ':ri
<br />Sign Signature of
<br />Here I U.S. person Date
<br />General Instructions
<br />Section references are to the Internal Revenue Code unless otherwise
<br />noted.
<br />Future developments. For the latest information about dovelopments
<br />related to Form W-9 and its instnlctions. Such as legislation enacted
<br />after they were published, go to www,irs.gov/FormW9.
<br />What's New
<br />Line 3a has been modified to clarify how a disregarded entity completes
<br />this line. An LLC that is a disregarded entity should check the
<br />appropriate box for the tax classi6CSlion of its cWrW. Otherwise, It
<br />should check the "LLC" box and enter its approptiate tax classification.
<br />Cal. No. 10231X
<br />Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 13 of 19
<br />Now fine 3b has been added to Ihis form. A tlOw-through entity is
<br />required 10 compute this Ilre to indicate that it has direct or ir•cirect
<br />loiaign Wrtars. Owners_ or oerxliciartes+oW. it provides the Form W•9
<br />to nnOlhof %mv.1fro ugh a ttfty in watch it has art ownership .nt,3 sl. This
<br />change is intended to provide a flow -through entity with informalon
<br />rogvd'ng the status of its indirect to•oign panrcrs. owners. or
<br />aerefic a-tes. so 'hat it ca=t satisly any applicWill reporting
<br />requirements. For example, a partnership that has tiny indirect areign.
<br />paanrors mi be required to Loirpillfe SVIM Lrle7 K-2 and K-3. See I h a
<br />Partnership inrrtrucIliens For Schedules K-2 and K-3 (Form ID65).
<br />Purpose of Form
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />information return with the IRS is giving you this form because they
<br />Form w-9 (Rev, 3-2024)
<br />
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