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Pa4e 3
<br />Fo(m W-9 {Fl.v. 3-262'll
<br />Cerralnpayeesandpa},mgntsa'ee(cnlolffombacfiuptythholdinq.s;i;;#ip;v". c'oio 'lsre',;n;-rha seiareta lnsrnmtrons ror rh+
<br />ilJi,l*it* oi16^ W e (or rnorg rnforrnation'
<br />See also C:tabris,lng U S tlpt"s lar putps+s of ciapler l f,'l;Li
<br />chapte( 4 rvithhaldng. eadier'
<br />What ls FATCA RePorting?
<br />fhe Forergn Acccunt Tax Comf'ance Art (F'\iCAl teqrlres .r
<br />^-..;.,'.-r;^^ r.vpinn frnancrel,nst,tution to repan ail J S dccdunt
<br />f, :i ffi 1#l ,I lil;ilUb' ; ;-ons o.-'t"n pavT : 3-' :,eli{pr'r'T
<br />cAr.A randrrrno Soeg.*,tordn tion FA1CAniporung cd{'/c' lstcr' an'J
<br />'11',llll5u"l!i":il;.q;;;-; "r
<br />Form w'e iur ntors intamtarior'
<br />Updating Your lnforrnation
<br />Yor: must pr,:vr'le updaled infornratron to rny Per3on lo tlhom. you
<br />"lo*J io U* ir: +,(amFt payee if you are n') lortgff an +i(empt paYea
<br />;;i;;;;;,t rec:i'ring riporrabre pavme''is.in fre rutur--iro;n tnrs
<br />oerson. For +rarnpla. yo' -"y n-uiili providJ upoared'ntormatirrrr ;f
<br />:.,:j,; ;-c i"rtot"rinn rtrar jteas lo be an 5 corpoation -or
<br />rf vor are
<br />H'i.ffi i";"Jffii-i" "iain'^ l'" must fr:mrsh a nerv,Fom w'e rf
<br />iL"-ilil;;in;i,!ng:r fo, rr'e ti"ounr' for *'amplo 't the grantor of a
<br />grantor trust dies-
<br />Penalties
<br />F.rilure to funrish flf{. li vertr farl to (unrsh vour "t1:-."l.lTl 3,"ilul;; yo,, *= *ui"ti to s oenaltv ol S50 far each';uch iadurs
<br />s141ggg 'i6g1 idtlule rs due to ruJonabie cause Jnd rlo( lo rvrilhrl n"'qlecl'
<br />i,*l'p",trftV lor lalse inlornration sJltll respect to witirlr,olrting' li lo t
<br />i"f.'Ju ,"r"i $talJmml ltlh nc reason'lbld basls that r:rtllls ''r 10
<br />iaiti,lirurrhn,:r.ling. you are suqeci io d 55uc lenaliy'
<br />Crirninal Pcnalry for talsiryrng lrlonrraliorl' lllilllir}ly fals!llog
<br />;;;;;;iff- qr iifi*caair'ni sav:rtibiect you i'] tr'mtna! p*nallr€s
<br />{]{{isJlng tltlPg Sntjuo/ !lllorlsrlFmenl'
<br />Mrsuse ol TiN5 lf lh;: rgQsesi4t tlissios*s oi rsl: TlFls in:r<:lat on :i
<br />i:.d':cal iarr'. lh. feqcestrr *^y lt ti'Ul""r lo ct|';l ?trd q4tr{o'li p+cdtr+-s.
<br />Specific lnstructions
<br />Line 1
<br />Yoil !:trl$l ;flt"r try 'lf ii!* ioll'lt'nlJ tQ lht: llfta: {lo noiigala'th'g ir6'
<br />i,Gf. ii .' nanla;hodrj nair:h {l't-i Ra'rr' .1u :Jcur igx rsirrtn
<br />li 0rs Forrlr lvi t .i i{it d !/J6t r'':oilni iolh*r ihi;n *: :cclr'll
<br />*;;;;; !;:t t icr.;4n iinan':'sl tilsutirrior {FFi}!' lisl ri'sl' and-'i"i
<br />crl:0q l&a aam* ri iF: pgflot] u! tnlriy rrhosl lutr''b:r you zcured rt
<br />Psri ici i:+rnr tiV'9. li y';r: art Jruvlr'ttrrQ Furm F/--q to r FFl I/i :k':1!{i1+il1
<br />:il;,?'l;;;i--u"n l*tjt" oitn't actourrl ihi! ir I U i c;ryrn mrsl
<br />pfrero.: a Foan !1-t.
<br />. t.Eiiul,lu"t. (;tn{riY +ttit lht ntfi'l 3ht\':n 'fn ycur ia" €ufi; :: :i'-'''
<br />hEqe ahaft?ad ?oLd lasl ratne rrthoui rnioGnrnQ lh* So'€l ;icuftV
<br />,,fi;;,;J';it; lss'ri'i trt. ndmr ^hanQ+ rrrr: Tour hrsl adnrr'- fi":J3i
<br />;;;;;-.ho",ri lft y4ut ;{}cral ';'-'r'ity-:atd d''d vcsi ti-i""as! fta'1*
<br />Nole to. fllN ap;:lic,rnt: Fntlr ''urir tn(!rllduirl latne b- rI gq: +al*rtd
<br />on ,trrut F o(B i.r,l . ; JpFITC anori. lirrp I a ihis shoqrld slStr b+ !h+ 9inr4 "!"
<br />;i"';;:,t. '; ,r,,"ro-'i ot {h- i4.nr lo-lo you iifq<J viriii i'it( eqqi-^at$r
<br />' Sole,trofrnetcr. frlt;r tot:t t'ldNtduJl oarn-i ?s ;ttc:"n on J')!(r"rl lt
<br />t1)Jo on ttne I EfiiPl 'f4tl{ t'='n*tt t'att* or -deun'; busrn+;:; a;- tl i:'l't
<br />name on lns 2.
<br />, ParlnL'rillll)' U rjotpora!lon' S cot Irotaliotr' nr i-L C' clirat llian :}
<br />drsre<latrlo<l *nirty. tni-r tt *if't'' j ikrllr€ 15 :b]ttn orr !h* ?nni' i lan
<br />I*r-n?'o^t ! :nil lny t'usr'1*ss' iiace' cr oEA r'Jflie':rt lfl; ?'
<br />'Otlrer+ttiitie$,€f;|*f'.]tlrnil]l+Js3h.J1T.i4n.l.],'iill].gd$S'idaGt!;'';;;;;;;;;;t' r trri'= 'a'nt :lrtul(r real'h :he ilant* :horrn on 'h:
<br />;;;;;;;:;ih"t ,!g.rl 'Jncitnrgit !:r?alrnq the tr-ltiti LnI:=' raii b{j"qlt?i
<br />irade, or DBA name on llne 2
<br />. 9is161lat tlerl Blltlty, ll' qqir!'{ -Jt a hu5nrrgs inllty thet has a sind=
<br />;;',:. jn:,1;;;;;,;'r.-ii -. l"a '* "or 3 {"rPoratrorr' rs d'sr"'!l':j':'t at r"
<br />;;i;;; ;ro-r,t ir,nt ,l:' ov,n+r (a 'Jtst v1iltJe4 ctrlilil S+* REgulaxcr''
<br />l,iii",' it r I iot 2(t:,{?}. A rlisi+<lrdtd ird(y drould dh.:i' lh*
<br />#;;;,; tr:, tor th* re' ':l'rssrt':airon cf rl5 o!'Jner' Fniir !h{'r!'nri: i
<br />.liriu'.," t'n* l. [h. nam" 'ri th+ r"'''ogr 6rller{l tn !in* ! Ehsuid rav-r
<br />i- . o,-t-.ltt,l-d +tltiiy Jll-r i'rt!rB ttn iin; I 5!ro'ld be'ihe ndrn* sh'$'''!l
<br />.r! it:e i.rrurr+ ttsi tetutn "u "ttntii itt* 'ntt"i'-" ;tttxki':rt rep':rted i:tr
<br />*r:rnpie. rl c m.eqn LLC l'lat 6 a*alg/' ls a ds'*?qt{erJ *-rtrt"' ft:r L i
<br />te'Jeril tnx tturpo3t€ has a e"dt";';; G;; a dS' p'erson-the'J S -
<br />;;;;;;; trqu:Ed to be f rouilec' on lirur-r ' lf tfte &El.cwn€r oi
<br />il'l:-l,;'ri] "i,'i "
<br />&*e-*; inirr. y:re' tu 6rsr nYDr *a! b rer
<br />d€rsg€tdert (orfudpral l:ry pur*!s' Fr'lrr lh€ 'is(egrrdnd +.tiri l
<br />name on fin+ -]. |i lfi# 'Jrv$?t €t:h* dEtESEC:d enllbl € r
<br />"rsjn
<br />i{rscn
<br />rh. c1'iner.nusi corr-Dltt: * ti"'#'-Ji-lJt iy 3;661'3 'tr'; c re
<br />#;:' ril ;*,4; a.*'r tr'J't-"qn 3d€t,n ftas a u s flil'
<br />Line ?
<br />tf vou ha'r* a bqgr*as tlime- ltaltt sfil!' 0€d nas+- x
<br />unlrry "a,t* ecler it ln ltn+ ?'
<br />Line 3a
<br />Ch*ck ihe appropctt€ ltr' 'ln Dr+ 3a'o< lt:+ U j i*:*rai ":r
<br />^"
<br />cfassifrr:atran of lte p*t-"o* *'l'os* itnit ls tnt*t"e :n 'rr'l i CI::'r ;)lllr'
<br />c I sreg:trrj 9.tr
<br />aoe box 9n iirie 3a-
<br />lF th" "nilt'/lndividual
<br />on line 1
<br />is a(nl
<br />TF{EN cfieck the box lar
<br />prDprietot-lnd'ridualgr:le" lndiviCual or
<br />" Sole
<br />. LLG c(assified as a pattnershiP
<br />ior U-S- federal tax PUrPaGes or
<br />. LLC lhat has filed Fotrn aa32 tr
<br />2553 electing tD tt€ laxed as a
<br />corporalion
<br />x1diJrnited liabilitY comPanY
<br />entet the apprcPtiate t&{
<br />classification:
<br />P = Fartnership'
<br />C = C cor!'aration'
<br />3 = S;orporalion-
<br />or
<br />ftu$/estate
<br />Line 3b
<br />'ll,.rj. !h6 bD^ fi jrjtt at+ a 31rr'{irut rr3J:lriding ar -Lil cl:rsii+iJ as I
<br />ladFat:hig iq lj:i iF{re{:Jl ,"" C'Jtf"o-ti lrusi- -' +513i'- i}'].'-ha-'' 1"
<br />ii,"; ;il;: nn,':oi'' :'+'l+{'l' *"tr 'nd itrr re'-ro rlc a ifte
<br />ionr ro 3 ?at142,;h\P t1*i - ==''-tt-".1-'1i.""1 :..*.:*i:ii;fis':
<br />,ntprss i. r' io .n!;i :iH e iil* :a1' ci
<br />;5,;:.. ;;;:-; ; 6*i.=ri a"r
<br />! ai .J+lx:?f il1t' :'rxl;rc+; f'on
<br />*,J,s,^,""-*ll" i't*t* t ;'-s''5''r'+ l:'xr: "v
<br />a it4n-3rv
<br />;;**;;';:*;' ';iet*n'"u' r'irr- has :h*:!'*rJ !h: =*r' : * in*'r1
<br />;{c{e: A t Jrll.{slrF fHi Pr+d+r 'l i *ii:: :'rt i v :1 t!l;'-: s tt t':'-' :t::
<br />::- :-;:;i".ra.rr+u ';:ir-rJ'-'Ls '' : 'itN-
<br />-i lra':*. ',l:::1 ':t ffii?
<br />ritirr{i3lii, <:a i;;; iy.:n;r=iti tt-"'t-t'"'^" 'lt :::'i:lt$i:s /- : 4{\d !' ':
<br />.itm :ttti!
<br />!i:a{il ar+.*:{Urri 'trJi;3tt:']l;tt'\ri 3l' L'tr ;l' l3 'J+ i+' \'}u G! t-; nti'
<br />:;;5;: tj:i :n'rrltEit.:o lBltJ"*i to '-gt n :'F{i 'fli'll'53iion ":u; ' ;:'il
<br />llr- 1il5 or lsrsa' it:'lc:'l gt'f* t:J:i' cfli : -' u' ita.6+-'t':! '
<br />:;;;;; -*'t*o""tt'on- 5a;t1r-:ttr;*€' ii ? iiJ6;:tr':
<br />)t1-111\4t ih41 fia'g :i}'ri
<br />Line 4ExemPtians
<br />d r* 3l; 4'-Nfi nat ''a:' r[ a:tlr]f'Idl; -: rd'r::r il- --,l t,*t:' .'Q
<br />3r:l:. in r: t ::gpsat'urii t7o"''t' t'i t
<br />"i'1
<br />:t'-l: l t tr't: a' t i z'i?l i vJ
<br />'l{}1}.
<br />ir*xpt P.r;ee cxle'
<br />' {;:<xaqi avt.'.ltidt' 'it\'it-:L!ti;
<br />t'{: --:it]ai?irt: :;; l:;i +'lepi ira
<br />:*cilp rdFrtl'1"C
<br />'2,r4ttvr't'j:4i'ii'.i.Jr,i.f ,7*U1:r:;-::r:T;:r::k*
<br />-!,i jih{:tii..! ic !:{'.-as trrr;1r31
<br />$Jdr.d:,;. .l:*rr:rtt<*'. .tt* r]$i :-1*{}1pl ;:' lf, F r! Jg triht''':t {t'} - lj (. {
<br />*.i-l -oianaiil 't -ilfi:n( ^uc itr 1!,\trl; :?' ' :'l-a"r"'"ft't']t\fr?i
<br />, {:)rFq.?&orr:) v-,"er .rnnp'l ir:r t'a:t''p *'iirf'ot1t:.::! ::!;t",'e59-:r''r
<br />!l
<br />afla.irtri' irli*-.r'q"-ss tr"r-*::;:drl ?':
<br />'ttr'-"t'
<br />4\d :tt';4lt': jna
<br />ia'ai !rr;'.nJ: ,naaaal'rt neal*' '-l'*- qtr'r r" t'i 'rdle ' ' 2'''Li i{f tlg?-a":'
<br />,"'pio* ".,.,f,;'1Jil:P ff : '1q 'i:'lt-'
<br />"(l:ic
<br />ina ,nua, ".o "
<br />:oc:s irf:nail rui --+; rlaa
<br />.
<br />r,-
<br />.--
<br />' +1191 iftm Ita4 iop
<br />*,intlari* iii':r th* asf'rifrtr+: :''1'r r'l ih+ ;'-q;- rtn t "+'
<br />r -.1rr !q#,'-nlliin :a:(nFrt "' "' n' p'!ae iEi:Scn 5'-tt;'r'' vrr {Fl'i- ':r
<br />.1!:ts'x'cll?C,.1ru.1!!'drde's,rla:'!:l]3it]{.!::i:.1J.cci]Iit1.1'd51i'ail1.luiu'n^,*t. 'r {rio'rn lrll{tl :'i
<br />Kittitas County Agreement for 5ervices (rev 5/14/25i
<br />Page t9 of 24
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