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Paqe 3
<br />C€dain oavee3 and payments are exernpt flom backup $r4hholding'
<br />SJ ii.#t;f A;t;e ioJa,'tater, and lhe s€iarate lnsiruchons lor the
<br />Requestei oi F6rm W-9 for more informalion'
<br />See also €sEbrb hi ng Ll.S. slatus fol' pl,@os€s of chaPter 3 end
<br />chapter 1 t\ilhhhlding, eafiar-
<br />What ls FATCA RePorting?
<br />The Foraion Account Tax C,omplianc, Act (FATCAI requires a
<br />o"rri.;oatinq foreiqn financial rnslitulion 1r) report all U'S' account
<br />ffi;;;;;iil "iecrllecl
<br />u.S perion6. Certain payees are *xempt frorn'i;T;;6;;;$-se. Ci*n,priin hom FArcAnportins 19de' laler' and
<br />ift"'fn#iItion""for the Requ$ter of Form W-9 for more informalfon'
<br />Updating Your Information
<br />You must provide updated informaton lo any petson lo whom you
<br />claimed to be an exempt payee if you are no longer an exempt payee
<br />irJi"ti.ipit* ,tceivini rip6rraH6 Paymsnls.in the tuture {rom this
<br />iniin. i5**"nrple, y-ou may neeci td provide updated rnform-ation rf
<br />irou nt* a C co.Poratron that elects to be an S corpomtioo' o( ll you are
<br />l; ;;;;; i"* "i*nlpr.
<br />ln addition. you musl iumish a new Form w'e if
<br />ir,r i,iii- ii tir'r ihlnges {or lhe account, for example' if the grantor ol a
<br />grantot trust dies.
<br />Penalties
<br />Failure to fumish TlN. lf you fail to fumish your conecr TIN to a
<br />,*L""t*t, vou are subieci to a penalty of S5O {or each such farJure
<br />,"i"*t v""i taf"ts rs due lo reasonabie ccuse and nol lo rvrllful neglect'
<br />Civrl oenaltv tor falso inlornralion willt respect to withholding' lf you
<br />niakoa {alsd slatemenl vJilh no raasonable basls thal r€Eulls in no
<br />backup withholding, you are subiect to a 5500 p€natty'
<br />Criminal penafty for fatsifying informalion' Wltfulty ialsifying-
<br />""rl'ni"ri6n"
<br />ot
<br />"ffirmations
<br />may subiect you to crimina' penahies
<br />including fi nes and/or imprisonmenl.
<br />Misuse of TlNs. lf the requester discloses or uses TlNs in violation of
<br />i;;n;;, Ft"quester'may be subiect to civil and criminal penalties'
<br />Specific lnstructions
<br />Line I
<br />You must enter one of lhe following on this line; do not leave lhis line
<br />blank. The name should match the name on your tax relum'
<br />lf this Form W-9 is for a ioint account (oiher thil an account
<br />nraintained by a lor*ign finincial rnslitution tFFl)}. ftst first' and.then
<br />li*i*, iii" n**" oi lhi person or entity ','Jhose numb€r you €ntered in
<br />Firt i'oi fo-t W-9. ll vou are provirting Fomr $/'9 to an FFI to document
<br />njoi^ti."or"t each flolder of ihe acc-ounl lhat is a U S petson rnust
<br />provide a Form W-9.
<br />. lndiuidual. Genera.lly, enter the narne shown on yorlr bx tsttrm' lf you
<br />f ra*" "Gnged
<br />your taii name withotrt informing lhe Social Security
<br />l?*iiilit"il*issA1 ol thu nu*u "hanga'
<br />enter yout firsl name' lhs last
<br />nime ai snot*n on your social security card, and'/our n91'/ iast rienre'
<br />Note for lTlN applicant Enter your indtvidual narne.as il w-as entered
<br />on vour Form W-7 application, line la. fhis should dlso be lhe sa'rne as
<br />ittu'nit* vo, entutid ou the Fo.m lodo you filed rvrth your applicauon'
<br />. Sole prot:rietor. Enler your individual name as shovrn on your Form
<br />r i,io .[i,^" i . E"t"1 voui busin"ss. trad€' or 'doing bostne$s as" IDBA]
<br />name on line 2.
<br />. Partrrerslrio. C cornoration, S corporalion, or LLC. olher than a
<br />,ti;;;;;;;;",;^titv. dniei ihe inrrlv'd nanre as sho\r' on lhs enrit!''s tax
<br />rutu**on line 1 anil any business, trade, or DBA name on line 2'
<br />. Other entities. Enter your name as shown on required U'S- federal tax
<br />aocu."ni" on line t. This name should malch the name shown on the
<br />;ffi;;;th;/i[at aoiutn"nl
<br />"reating
<br />the entitv' Enter anv business'
<br />trada, or DBA nam€ on line 2.
<br />o Disreqarded entity" ln general' a business entity thal has a single
<br />"*'""r,
<br />i""f"ai^g "n
<br />LlC, i"U is not a corporalion, is disregarded as an
<br />"nr'tu *oarare irr:nr ire o\rner (a drsregarded entity)' See Reg.ulatlons
<br />i*cL''on io r. I lOl .?(c\l2l. A disrtgarded *ntity should check the
<br />rooioorlt" box for'the iax classification ol rti owner' Enter the ovnels
<br />"!i." ",i
<br />rin" l. The narne of lh€ orvner entered cn line I should oe'rer
<br />u* " .lis.eaarAed eniitv' The name on line 1 should be the nam* shorTn
<br />ii il.e iffi;;i;iteirm on ,',i'icrt lha income shou{d be (eporled For
<br />Fom W-9 (Rsv.3-2024)
<br />Kittitas County Agreement for Services (rev' 5/74/251
<br />Page 15 of 19
<br />lF the entitY/individual on Iine I
<br />is a(nl ..
<br />THEN check lhe box for
<br />Conoralion.
<br />. lndividual or
<br />o Sole
<br />I ndividuat/sole ProPnietor'
<br />. LLC classified as a parlnershiP
<br />for U.S. federal tax PurPoses or
<br />. LLC that has filed Form 8832 or
<br />2553 electing to be taxed as a
<br />corporation
<br />Limited liability ctmPany
<br />enter the apPropriate tax
<br />classification:
<br />P = PaftenhiP,
<br />C=Ccorporation.or
<br />and
<br />5=S
<br />. TrusVeshle TrusVestate-
<br />exarnple, if a for+ign LLC thdl is treited ds a drveg€-rd€d cnhty. tor U'S'
<br />ftrIeml Lax DurDoses nas a snqtJo*ner ttut
<br />'s
<br />a ti's person' ihe U'S'
<br />;;;;;-?il-;Lq''.aio ud ptovtdect on line,r' lf (he drrecl owner o'
<br />irr* lntit" i" aso a dLrcqarded enlrty, enter tlre firsl orvner lhat b not
<br />ilt;;;il;;t fte'at-&i putposei Ente' th€ distegerded entitv's
<br />;";;;; line 2. lf the orvner ofihe divegarded enlrry 's a lor4rgn p€{son'
<br />iii,'tl;;H;i ;;;pr-;i; ;;il;.p-ti no'-''v's if !u:d-oi: Fo*
<br />W.9. This rs lhe case even i, the lorei€n p4rson has a u'> l lN'
<br />Line 2
<br />lf vou have a business natne, trade name, DBA name' or disreganded
<br />"titity
<br />nam", enter it on lina 2'
<br />Line 3a
<br />Ctleck the appropdals box on line 3a for the U'5' ledeml tar ^.;tffifi;;il;i lf,a pErson r',t ose oarne b enlered on line l' Check only
<br />one box on line 3a
<br />Line 3b
<br />ch*ck lhrs box if vou are a pattnershrp flncluding an LLC classified ae a
<br />oartnersllo for U.b. federal tex purposes), trusl' or *stale lhal has any
<br />i';;;;;;;;*. owne.s. or benefiiran+s' and y':u are providing lh's.
<br />i;i;:;;t;;'o t*rt. ot n"tut*. rn vhich vou hav? an ovmership
<br />iii;,esi.'ffiil;i Jne"[]nJuox on trne 3b if v6' recirve a Form sl-a
<br />tor docum+ntarv erTdence) frorn an'/ patlfler, ovJnst' or b-en*fictary
<br />sstablishrnq lcrerqn stalus or if you receive a Fofm !v-9 rom any
<br />;;;;;;i;-;. ;i uenenuary rhar h&e ch€{hed rhe box on lrrre 3b
<br />Note: ,1, oafirr€rshro lhal proudes a Fonn W-9 and ch*cks box 3b rnay
<br />;;;;;I;;;";molete Schedul=s K-2 and K-3 (Form 1065l For more
<br />il;*lli,;; t".;;I pirrn'ersnrp rnelruclions ior Schedules K-2 and K'3
<br />(Form 1065).
<br />lf vou are recurred io complete lne 3b bu: larl to d{} so' you may not
<br />r";;t;;'fi;';i;;ut'o" ^-"'d.",y to file d corr+cl 'nfotmahon retum unlh
<br />lhe IRS or fumish a corect payee slalement to your paqlf-gr
<br />i"-"iln"iiti"". S*Joiexa-'pt6' seaions 669s' 6722' 4\d 6724 lot
<br />penalties lhat may aPPIY-
<br />Line 4 ExemPtions
<br />lf you are sxenlPt k.]m backup wtfihololog 4d/or FATCA reporting'
<br />enter In th+ aFptopnat€ space on line r an! c<'dei's) lhat may apply tc
<br />you.
<br />Exempt payee code-
<br />. $qn6rally, individuals {includrng ssle ptop't€tof3i at+ act exampt lront
<br />backup withholding.
<br />. Ercepl as provid-'d belorv' corporations ate +refnpt flombecklp
<br />*ittrnoiii.ng flt
<br />"ertain
<br />payments' includinq rnt€r€61 and dividends'
<br />' co'mGltotls ale Rot cxelnpl ironl backup v/'lhholdrng for payrnents
<br />rnJUe in r"-nf *r*nt o{ payment cdrcl or lhird-9a,ty n€tworfi lmnsacllorrs
<br />. CorpCrations ar€ no! elefnpt lrorn backop urilhholding vrilh fEsp€cl fu
<br />anomsvs' leas ot qtoss proce€ds pald to attomayS' and corporations
<br />ifi"l",,j"ia* .".liil or n"attt care services are not exempl with rEsp€e t
<br />to paym€nts reportable on Form 1099-MISC-
<br />The followinq codes identifu payees thal are exempt from backup
<br />wilhholding. Eiter the appropriate code in the space on lrne 4'
<br />I -An organi:slion exemPt fmm tan trnder seclion 501(ai' any IFA' or
<br />u.ustoOiaiae"ount under'ssclion 'lo3tbi{7l tf lhe account satrsfies the
<br />requirements of seclion 4o1$e|
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