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<br />Form W-9 (R€v.3-2024)
<br />Certain payees and payments are exempt from backup wilhholding-
<br />See Exempt'payee coAe,'latet, and the separate lnstructions for the
<br />Requeoter of Form W-9 for more information-
<br />See also Estabtishing IJ.S. status for putPoses of ehapter 3 and
<br />chapter 4 withholding, eadier.
<br />What ls FATCA Reporting?
<br />The Foreign Acccunt Tax Compliance Act (FATCAlequires a
<br />parlicipating foreign financial institution to report all U.S. account
<br />irolders thaiare specifed U.S. persona. Certain payees ae exffipt from
<br />FAiCA reporting.'See Exemptiin hom FATCA reponing code, later, and
<br />the lnstruitionsJor the Requester of Form W-9 for more infonnalion'
<br />Updating Your lnformation
<br />You musl provide updated information to any pelson to vrhom you
<br />claimed to be an exempt pay€e if you are no longer an exemPt payee
<br />and anticipate receivin! reportable payments. in the futtrre from this
<br />oerson. For example, yiu may need t6 provide up'dated information if
<br />vou are a C corporation that elects to be an S corporalion. or if you are
<br />no longer tax eiempt. ln additon, you must fumish a new.Form W-9 if
<br />the naire or TIN chhnges for the account, for +xample, if the grantor of a
<br />grantor trust dies.
<br />Penalties
<br />Failure to fumistr TlN, lf you fail to fumish your correct TIN lo a
<br />requester, you are subiect to a p€nalty of $50 for each such.failure
<br />unless youi failure is due to reasonable cause and not to will{ul neglect'
<br />Civil penalty for false in{orrnation whh respect to withhokling' lf you
<br />make a falsri statement with no reasonable basis thal results in no
<br />backup withholding, you are 3ubject to a S500 penalty.
<br />Criminal penahy for falsifyittg information. Willtully falsifying
<br />.
<br />certifrcatirins or iffirmations may subject you to criminal penalties
<br />including fi nes and/or imprisonment.
<br />Misuse of TlNs. lf the requester discloses or uses TlNs in violation of
<br />federal law, the requester may be subiect to civil and crrminal penalties.
<br />Specilic lnstructions
<br />Line 1
<br />You must enter one of the following on this line: tlo rrot leave this line
<br />blank. The name should match the name on your tax rBlum.
<br />lf this Form W-9 is for a ioint account (olher than an account
<br />maintained by a foreign financial institution (FFl)), list first. and then
<br />circle, the name of the person or entity whose number you entered in
<br />Part I of Form W-9. lf you are providing Fsrm W-9 to an FFI to dacument
<br />a joint account, each holder oi the accbunt that is a U-'S- person must
<br />praide a Form !V-9.
<br />' lndiviclual. Genera.lly, enter the name shown on your tax retum- lf you
<br />have changed your last name without informing lhe Social Security
<br />Administrition 1SSA) of the name change, enter your first name. the ta3t
<br />name as shown on your social security card, and your new last name.
<br />Nc:te lar lTlN applicant: Enter your individual name as it was enlered
<br />on your Form W-7 application, line 1a. This should also be lhe same as
<br />lhe name you entered on the Form .1040 you filed \'\tith your applicslion'
<br />. Sole proprietor. Enter your individual name as shorvn on your Form
<br />1040 o; fi# 1. Enter youi business, trade, or "doing business as" (DBAi
<br />nanre on line 2.
<br />' Padnershirr. C corporation, S corporation, or LLC, other than a
<br />disregarded'entity. Enter the enlity's name as shown on lhe enlity's tax
<br />retunion line 'l and any busineee, trade, or DBA name online 2'
<br />. Other errtities. Enter your name as shown cn required U.S- tderallax
<br />documentg on line 1. This name should match the name shown on the
<br />ihxter or olher legal document creating the entity. Enter any business,
<br />trade, or DBA name on line 2.
<br />. Disregardeel entity. ln general, a business entity.that has a single
<br />owner, -ncluding an LLC, and is not a ccrporation, is disregarded as an
<br />entiN separate -from its owner (a disregarded entity). See Regulations
<br />section liot.ZZO1 -2(c)(2). A disregarded entity should check the
<br />aoorooriate box for thb iax classification of its owner- Enter the owner's
<br />n"rn" on line 1. The name of the owner entered on line 1 shr:uld never
<br />be a disregarded entity. The natrte on line 1 should be the name shown
<br />on the inc6me tax rehth on which the income should be reported. For
<br />lF the entitylindividtral on line {
<br />isa(n)...
<br />THEl.l check the box for
<br />C,orporatron Ccrparatton-
<br />. lndividual or
<br />. Sole proprielorsfiip
<br />lndtrr'idual/sole proprielor
<br />. LLC classffied as a patlnership
<br />for U-S. federat tax purposes or
<br />. LLC that has fled Fomr 8832 or
<br />2553 elecdng to be taxed as a
<br />corporation
<br />Limited li$ility companY and
<br />enter the appropriate tax
<br />classification:
<br />P = Parhsship.
<br />C = Ccorpolation, or
<br />S = 5 corporation.
<br />Partnership Partnership.
<br />. TrusVestate Trustrestate.
<br />examole. if a foreiqn LLC lhat b treatd as a divegarded entity fat U'S-
<br />federi i; purpo#s has a sirqb owns that is * U.$- peson, the U'S'
<br />orvner's naineis required tc be prodded on line 1. [f the direct owner of
<br />lfre entity is also a disregarded enlity" enter the fitst owner that is nal
<br />disregarded for federal tax p,urposd Enter ttre div*garded entity's
<br />nr*ion l{ne 2. lf tlre cwrer of Src disrega'ded mtity is a forelgnperson'
<br />the owner must complel* an appropriate FDrm tff-6 imtead of.a Form
<br />W-s. Ttiis is the cass even i{ ttre foreign p€rson has a U-S. TIN'
<br />Line 2
<br />lf you have a busines nanre, trade narn*, DBA narne, or disregaded
<br />entity name. enter it 8n lifie 2.
<br />Line 3a
<br />Check the appropriate box on line 3a fer ltre U.S" f*deral tax
<br />classification'of tire person $rhcse name b entered on lina 1- Check only
<br />one box on line 3a.
<br />Line 3b
<br />Check this box i{ you are a partnership {lrnc{rrding an LLC classified as a
<br />oartrrership for U.S, tede{al tax Furpos€61" lri€t flr €state lhat has any
<br />ioreign partnem. cwnels. or L'eneftciaries. and you are prornding thrs.
<br />fam-to'a oartnership. trust, Dt €slate. in uiirich ?ou have an ownership
<br />interest. Vou -ust iheck the box on tri"re 3b 'f yau recd"re a Form W-8
<br />(or documentary evidencei frorn any pattner, or,rmel or beneliciary
<br />establishing toreign stalus ,:r l{ you receive a Fom tY-9 fmm any
<br />partner, odner' oi beneficiarl'tlrat has checked the box cn line 3b'
<br />Note: A partnership that provides a Fsrm !S-9 and checks box 3b may
<br />be required tc ccmplete Schedulee K-2 afid K-€ lForrn 1065]" For mre
<br />inforrnation. s*e the Parlnership lnskuc&:ns for Schedutes K-2 and K-3
<br />{Form 1065}.
<br />ll vou are reouired to comr;'lele line 3b h;t fail to do so, yau may not
<br />r"r*ir* rn" ir*ot ation neceissry to file a c*nect infornadon retum with
<br />the IRS or fumish a gonect palee statement to your parhers or
<br />beneficiaries. See. for example" seclions 6€96, &7?2' afrd fr7?4 tor
<br />penafties that maY aPPlY.
<br />Line 4 ExemPtions
<br />tf vou are etefiptfrcrn backup wilhholdmrgi ar,1'or FAtrCA reporting,
<br />*rit*r in *tt
<br />"pp'topriate
<br />spacd on f;ire a an'y csd4si lhat rnay apply to
<br />yBu-
<br />Exempt payee code.
<br />. Generalfy, individuals tindujirg sole prcprirelors'l are nfll exe$pt lrorn
<br />backup 'dthhotding.. Excepl a3 provided belots. corpara{iuns are exempt fiom- backup
<br />withholiling for certain payments, includir€ interest and ditidends-
<br />. CorDoralions are not exempt itam bro*up witfthrJding for paymentg
<br />mioL1n settlement of payrneirt card or thinl'-parfy nstwor$( uanaactions-
<br />. Carrrlratiana are not exertlPt tt6ff' bac*lp witf*rolding with respect to
<br />ettomlys'fees or gross prceieds peidl to aitotr€'/s. md corporations
<br />that prJvide medc?l or healtr care ser*ices arre not exempl with respect
<br />to paym€nta reportable on Fcrm T0gsJ{tl$"
<br />The folloruing codes identdy payees that are er'empl fmrn hackrp
<br />wilhholding. Enter the appropriate code in tfi* space on line 4'
<br />'l -An organization exempt trom tax urnder section 5o1[at. any IRA' or
<br />a cuslodialaccount under seclion 403ffi11 lf the accounl Rtisfies lhe
<br />requiremeats of section 401(4{21-
<br />Kittitas County Agreement for Services (rev.5/14/251
<br />Page L7 of 22
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