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AfiACHMENT'D"
<br />,",,,lllf-9 Request for TaxPaYer
<br />ldentification Number and Certification
<br />Go to wu ,v,itsgo vlFomwglor instuctions and ths lalest information'
<br />Give form to the
<br />requester. Do not
<br />send to the lRS.{B€v. March 2024)
<br />Doparlmml ol lho TmGury
<br />lntomal Rcvolluo
<br />gefor€relatad to the of Form W-9, see ?uPcsc o{ Fom,beilow
<br />,1n gnlry is required.lFor a $le prcprielor or disregnrded *lrty cntcr ihe o\vns's nffi oo lirc 1 dd enler ihe businesvdis.egardcdFar
<br />I Nme oi entityrnd,vidual
<br />eniity s nffg oF line 2 )
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<br />2 Susi.sss nme/disregsdod onaity .mo, rf drllcront lrom abovo'
<br />SigoatuG ot
<br />U,S. p€Eqn
<br />4 ExomptioPs {codos aPP}Y st to
<br />ceriain cniiliE, not i.dividudjs;
<br />ss lnslnrc{igns s Psge 3):
<br />Exmqt PaYw ?odq fl *Yl .*_--
<br />Exmpllon ksn Foreign Account Tax
<br />Co6plimce Acl (FATCA) rspo.lilg
<br />codo {il 0Y)
<br />Apgtias lo lccpnls mainlained
<br />ersiCo ihe uniled Sta.E-)
<br />I sl &ctunl .umb"rfsl hera {oplionrt
<br />EntsI your TIN il) the appropriats box. The fiN providsd must match ihe name given on line 1 1o avoid
<br />backuP wilhhoiding.For Individuals, this is gen6/alh/ your social security numbor (SSN). Howovar, for a
<br />resident alien, sole Proprietor or disr€arded eniity. seo lhe irslructions for Parl I, ialer. Fot olher
<br />enliti6, il is your employer idmliiication n!mb€r {ElN}. lf You do not have a numb€r, see Hos to gel a or
<br />7'lN, late..
<br />Nots:lllhoaccountisinmorethanonenams,seeiheinstrucfionsfor|ins1'Seealsw/'e.Namsafid
<br />|lumbor To Givo lho Requoster for guid€lines on whosa numbel 10 enltr'
<br />3. I am a U.S. citrzen or othet U.S. pxson (defined Delow); and
<br />4. The FATCA code(s) eniered on this iorm {if any) indiating lhat I am exempl kom FATCA reponing ;s cor'ect
<br />C€r{ltica'lion instruoliom' You must cross oul itffi 2 above il you have bsn 0olilled
<br />youf tax rstum. Fol realbecauso you have lajied to reporl all intsresl and dividmds on
<br />acquisihon or abandontnsnt of secured prop€rty'cancellation of dsbt, conlributions io
<br />olher thm inlBrest and di!idond:i'ate not lho cdrtilication, but
<br />Sign
<br />Here
<br />Under penalties of pequry' I certity thal:
<br />1 The numbsr snown on this form js my coltecr iaxpayel rdentification number (o' I am waiting ior a numbet to b€ issued io me); and
<br />2. I am nof subject to backup wlhhold;ng becauss {B) I am exempl lrom backupwithholding' ot (b} i nave not been nolitied by ihe lntemzl Sevenua
<br />s*rvice (lFS) lhat I am subjtrl to backup wilhholding as a.6ult oi a failu.e to teport a!l interest or dividends' or (c) lhe IFS has noiilied me lhal I am
<br />no longe/ sub,ect to backup wilhholding; ild
<br />Rgquste/3 nanl€ snd addr4s (optloneJ
<br />Dats
<br />General Instructions
<br />Sslion.eferences ate to the lntemal Revenue Code unless olherv/ise
<br />noted.
<br />FLlur€ dsvelopmsnts. For th€ laiesl informaljof, aboul develcpments
<br />,"f"i"a ro forrn W-g and ils inslruclions' such 6l€islalion enacted
<br />ailer they were publisned, go la **e/.i$.govlFotttlwq'
<br />What's New
<br />tj e 3a has bren moditied to clarily how a disregarded enlity completss
<br />this lire. An LLC that is a ciisregardod snliv should check the
<br />oooroodut" oox for the tax claisification of ils owns. Olhe^visc' it
<br />ifiiuii cr'e.i< the "t LC" box tnd ente' tls appropnale lax classrlication'
<br />Naw lin8 3b has b*n addad lo lhis fom' A flow-lhrough enlily is
<br />roq;'*.f tc, a:c!!rlriel€ tili:. lire lo it'4icata lt'ilf :l lli):; j::r4';l ol it ciroct
<br />lof*rd,r ;!l4t'fit!. c?llers' or oereticialies
<br />"'rhel!
<br />li provideS ihe l;oni !v-9
<br />l;';;i";,i;.; lrnrl,-'"to,.slixnr'ry,d whicil I hes 1r" ovrl\c,shrt, rrlirrasr' This
<br />""nonoe
<br />is nt"nOeO ro-provide a llow-through entity v'ith jnfoilnation
<br />,u""r"c rrJ lhe SLalus ol rts l (Jirst 'o'eign p.'tt|ors. o&tlrjr:;' or
<br />"ri'"t. .i'"", so that il cari ril;sfy drr'/ appliJxt'id 'o!forlilq
<br />rsq!ifer-ents. Fol axatnpla, a pilnl)orship ihi]t ril3-lr1/ xJ r,6cl rcrelgn
<br />ral,'nrs may be'cquired to cootplctD Scic€!r{c'ii (-l'nl'rl K-3 S* lhB
<br />PadnershiP lnstrqcl;ons lor Scheduies K-2 3'd (':' lFom lub))
<br />Furpose of Forrn
<br />,cn indlvidual or snti:y (Fcrm W-9 requ6ter) 4ho rs requrrDd lo lile an
<br />inlormation relum "riih
<br />lhs IRS i3 givir'9 you ihis iorm b':cause Iney
<br />onl/ ono ot tho lol{ow.ng s{tr botos
<br />fl Indiyiduat/slopBlriotor I cccrpoiulon t] scorpotalio' l: Pa"treEhiD ! t;ustlostatc
<br />I LLC. intc. lhelanchssiticallon {C " C@Podils, S = 3@tptrallo^' P = Padrersbip)
<br />Not!:CheckO€"Li,i:'Lcxaboveand inllrrl{'l!'lsr)itE.silf':l! lt$'oi}rialoclr's{C'$ rrt" i}t|!'ri'nr
<br />cta3eifcatloil ot thn l;_C, untss il is'aii;,.1 i ,:".f',rirti. i ,f. ",,,;rr,l,;ri rcrry shc,''{i ineki;x, if'nrk lr.l 't3f;,totialo
<br />ircx for itt€ ifr clsif€tion 9f i"€ ownet
<br />tr Olhw(ssinskuctjons)
<br />..vhoR narne i9 sltred on lne 1- Chrck3s Chwk ibe trppeptiale bcl i6 (adatal l3x claa3rlicirlion ol ihd eoltyrndivrduel
<br />s'P'tsits cjqssifiqtion,0nd"LLC'€nte.edor cheked'lrusU€iat€,on 3ilin€chtrkod "PfftnaFhip"3b '/ou chekinler41,whicn have ownecr jparir16:r;lnl9 youlolarl&)1:l!urilt:i,.tl'€you t{ovcln9ud insltucliof,9Smlbi rlrcirl4t.lhis box Itratlx l)E' I
<br />Addre$ inlrmber, 5tr*l ed apt, or suii6 no ). Se in$!ruclions.
<br />6 Crt/, etate. md ZIP codo
<br />numbgrPart I
<br />Pari
<br />Cal. No. 102:]'X
<br />Kittitas CountY Agreement for Services (tev' 5/14/25l,
<br />Page 13 of 19
<br />icm Y/-t Eev.3'2024)
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