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Form w-9 tF'v. 3-20241 Certain payees and payments ar9 exempt from backup %Yilhholdtng See Exenrpr wYee code. later, and lha separate irkslructions V the Requester of Fenn W-9 for more rfarmation Sae also Establishiito U.S. status for purposes of chapter 3 and chapter ivithholding, earlier - What Is FATCA Reporting? The Fore ign Acccuni Tax Compha nee Act (FATCAj requl—a panicipa ling Foreign financial institution to report all U.S. account holders that are 3Pectfiact ii-S. persen5. Certain payees are exempt from FATCA reporting. sea F-ramprion from FA TCA reporting cede. later. and the Instructmns for tha Requester of Form 1N-9 for more mformafion- Updating Your Information You must provtde updated information 10 any person to whom you claimed to be an exempt payenz if you are no longer an e'.rempt payee and anticipate receiving reportable payments in the future from this person. For example. you may need to provide updated. informaliOn If you are a C corporaton that elects to be an S corporation. or 0 you are no longer tax exempt In addition, you must famish a new Form `N-9 if the name or TIN changes for the account. for oxampte. rf the grantor of a grantor trust dies_ Penalties Failure to furnish TiN. it you fad to furrvsh your correct TIN [o a requester- you are subject to a penalty of S50 for each such radur= unless your failure is due to reason able cause and not to wilful negfect. Civil penalty for false information ►AIh respect to withlnolding.If you make a fafst 518iemeni •rn[h no reasonable: bass that results in no bacltup withholding. You are subject to a S500 penalty, Criminal penalty for falsifying information. Willfully fals&,dng certifications or affirmations may subjecl you to criminal penalties incltid<ng Ines andfor mPrisonment. Misuse of TiIVs. If trte re-queSter discloses or uses TNs in violation of f•=det-at fav+, ih+ requester may be -subjum to civil and criminal penalties. Specific Instructions Line f you must enter one of 16a following on this line: do not leave this line blank. The name Should match iha name on your tax return. If. Links Form IV-9 ;3 fer a joint air-aunt;other than an accourn mainlasn ed to/ a foreign financial institution ff l)j. list first. and then ctrcia. the name of Itre person of enlny whose-tumbsr you entered in pert i of roan W-9. if you ar= providing Fort W-9 to an FP1 to dOdwment it pin[ aceaunt each notder of the account [hat as a U. S. P?F,90 i rinks[ prowde a Form %V-9- lndivrdetai. C+aPI rr-ey 5nter the name sf'akn 4n your tax r--Wm- If you have changed your fast nanr- without informing Vie Social 3`uny Admintsuation [SSA} of thname change. en.£' your first name. the Pas[ name as shvr n our tour social security card. and your new tw nainf- Note for ITIN app%cant& Enter your uedvidu3t name as it wad catered on your Form W-7 application. line f aL This should also be the -ants ar the name you-nter_d on the Form t0.t4 your feted with yc, u application • sole proprietor. Ent- your individual name as ahov:n on your Farm t t7 0 on flee S Entet four busyness, trade- or 'doing busaress a. 08AI name on line 2- • Partnership. C corporation. S corporation. or LLC, Other titan a disregaded entity. Enter 014 en[e[y', name as shnvm On 'be sn4itis tax return on Una t and any business, trade. or 09A name an We 2. • Other entities. Enter your name 3s shown on mired V.S. federal tat. documents on line 1- This name should match [he Hanna sham On th7 cnanet or other legal document creating the entity. Enter any tlusiness. trade, or DBA name on line 2. • Disregarded enmity. in gen•-MJ. a business entity that has a sir, gtf oviner, including an LLC. and rs not a corporauon. is disregarded as 3n anaty separate from its owner [a dtsrayarclad endtyl-See R.agulauons section 3o 1, 701.2(CM, A disregarded entity should checks tha appropriate W^ for tin` taw classe6calion of its owner. Enter the Ov rcr'= .-tame an line 1. The name of the owner entemd on tine I should rieaer be a disregarded entity The name on line I should be the name shown an the income tax return on .,ihch the income ghoold be reported. For Kittitas County Agreement for Services (rev. 5/14/25) Page 19 of 24 ,X3mpi� if a foreign i.LC tenet -:7YaLt d as d disregarded ent[ty for V'& federal tax purposeO ha_s a Angle amrer That rs a U.S. persm the U.S. osiers narre is requred to fx provided on Una 1- If the direct owner of the entity is also a c6sreq—k'a -tirr. ?sitar them first Myner dial. is not disregarded for federal is Purpose. Ether the disragard--d -MI&I s narne on lira 2. If 'ire swr>¢r ❑f ilre dra'!g Fdrrt Yrl 8 erus'4ad f ro the asn:tas must COMV � an appragr +N-9- This is tees case evert if tta lGrsign person has a U-S. TIN - Line 2 If you We a business name- trade name. 09A naqsP, or disregarded amity name- enter rtan tine 2. Line 3a Chet the appmpoaw bclx on Ere 3a far Me U.S. federal tax dassi5;atirrn of the person vrhose name is anIered on Une 1- Ckck Oink. - one box on tine 3a- Line 3b ChiiECc this box if you aka a pare-'hP (tnclud rLk3 an LiC classiRai as a aartrres5itrp for U.S. lederal lac purposes). tr W. 7r -state Ihat has an; foreign PaMw.- owner or b ra i-_- and you are € rowdin9 this faun to a pwinerstgp. ties[. Or esmte. n % hwh yLxr here an aerrseesl+np mlarsSL 'foV mug[ check the sad or- I*-- 3b f }ou --c v* a form 'U-S (or cff_ rznar; rnderre; frvrn any parro r. wmer. Or bare fi r'r �tabks" bmiym stares orii yodr rM'rxe a Fern 'h 9 ream srry panner. owner. ar berie-ricaany that hras chvsird the b�1< on line 3b- Note- A parUmfstup Ghat pfovkp3 a fora W-9 and cheris Lox 3o may b± ,!garbed tO cornpj{t Sthedulies; K - 2 and K-3 Wool" m S 164 F x more inrof-ration, ere the pan natsiuip instrercibor s :or 5ctaduleS ss-? arid K- 3 (Porn f4esi- If you are r=gwr-j to tv da:M y<su may act rscer.- tt:'tflfLkrrridteon:trC Cir'r M' a-Lorr?C!•nfonriailon r?t1: r•'i .VnSI the IRS x rurrash a ,*fact pave.= 5=t trrnwY to your parnels or bereeackM5-See.lot aiamptc-,= Wr56a`9o.6i'2. Vd672-.for penal— that wrap --ppey- Line 4 Exemptions tf ynre err ems; arrn tacS up m+ditrmtdin3 lw&or FA' :A depora, tg. entav m 1it a ria:e spat= an rev ; amf : cda�s) tftac :rW a"it; to !OU- Eim.fi Pt payee ealr. • Gerrreai4j iisdrndt css Fmdudrrt3 sat-=rnonetorsr are ME ex _met trom baci ispi rwlhf� C e,�cpt as prrsurded Wo[4 - C6tgn� �raeAetnrpf 6CM t-?00M v LhF,oFjing far c rrau: pafrxr ills aselrmq rrtar st end di -:I!,, co�s are not ex mp[ Tram backup withtw 6ng for paym=-at i made in aetde<ment of paym x+t -Ardor thief -party +Y=rrrais::r actlons • a7;-�iQr>31et ti am no[ ipf OVT U= baick` rl wltllho"'ng 'ha rPly'_f.7 if7 attomeys feu s gross fps paid to Ei"nrr�ys. errd ccrprxarbsns ,hat pnw de medical or h, aXth cam servic+s are n xt-MernjpI with respect to pa: +Ww- tits rapOnatr[e are Fxm 09? +dfSC. ih>✓ foliorung oil1 d ntliy 0,1"es titan ? ;' '"rTP[ from bacup vmL hotting Fetter th-- appropriate 00da at the s,Par tin "fle J. f -Ara argasr_dton ex, rMpt fresh tee' ur tj�r sacbaft Sol jal. any IRA or a cusmckal accormt under 5--Vwn 4MtthA-, I ,t :tit account -Owfi s iha egdiusrr Brits ; r sec aasi iff 3 [Ri-7i