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Form W-9 {Rev.3-2024}Page 5
<br />Part ll. Certification
<br />To establish to the withholding agent that you are a U^S. person, or
<br />residenl alien, sign Form W-9. You may be requesl€d to sign by the
<br />wilhholding agent even if item 1, 4, or 5 below indicates othenatise.
<br />For a joint account, only the person whose TIN is shown in Part I
<br />should sign {when required}- ln the case of a disregarded entity, the
<br />person identified on line 1 musl sign. Exempt payees, see Exempt payee
<br />code, earliar.
<br />Signature requiremenls. Complete the certilication as indicated in
<br />itemslthroughSbelow"
<br />1. lnterest, dividend, and barter exchange accounls opened
<br />bafore 1984 and broker accounts considored active during 1983.
<br />You musl give your correct TlN, but you do not hav€ lo sign the
<br />certification.
<br />2. lnterest, dividend, broker, and barter exchange accounts
<br />opened after 198it and broker accounls considered inactive during.-
<br />1983. You must sign the certiftcation or backup withholding will apply. ll
<br />you are subject to backup withholding and you are merely providing
<br />your conect TIN to the requester, you must cross out itern 2 in the
<br />cartification before signing the form.
<br />3. Real estate transactions. You must sign the c€rlitication. You may
<br />crose out ilem 2 of the cerlilication.
<br />4, Olher paynrents. You must give your conecl TlN, but you do nol
<br />have to sign the certification unless you have been notified that you
<br />have previously given an inconect TlN. "Other payments" include
<br />paymenls madeln the course of the requester's trade or business for
<br />rents, royalties, goods (olher than bills for merchandise), medical and
<br />heallh care services {including payrnents to corpcralions), payments to
<br />a nonemployee for services, payments made in settlement of paymenl
<br />card and third-party network lransactions, payments to certain fishing
<br />boat crew members and fishermen, and gross proceeds paid to
<br />attomeys {including payments lo corpo,ations}.
<br />5. Mortgage interest paid by you, acquisilion or abandonnrenl ol
<br />secured property, cancellation of debt, qualilied tuition program
<br />paymentS (uhder section 5291, ASLE account$ {under section 529A},
<br />IRA Coverdell ESA, Archer MSA or llSA contribulions or
<br />distvibutions, and pension dislributions. You must give ycur conect
<br />TlN, but you do not have to sign the cettitication.
<br />What Name and Number To Give the uester
<br />For this of account:Give name and SSN of:
<br />individual
<br />For this of accourt:
<br />8- Oisregarded enlity not owned by m
<br />individual
<br />9. A valid trust, 6slnle, or peFion lrust
<br />10. Crporation or LLC electing corporaie
<br />stallj3 on Fm 8832 ar Fcrm 2533
<br />11 . Associaiion, club, religiotis, chxilable.
<br />educational, or othet lil-ersnpl
<br />orgranization
<br />'12. Partnaship or multrmernber LLC
<br />13. A brokor or regislered nminee
<br />14- Accounl wilh the Depsrlmffl ot
<br />Agriolture ir lhe namc ol a public
<br />entily {such as a slate er local
<br />govemmenl, schoal dbtrict, or prisl
<br />thal :eceives agriculfual program
<br />paymentg
<br />15. Grantor lrust filing Fm 1o41 or
<br />under ihe Oplional Filing Melhod ?.
<br />requinng Fom 10€{l {see Regulatiom
<br />section 1.671-a(b[2Xil€l)"
<br />Give nanre and EIN of:
<br />The owrcr
<br />Lagal entity{
<br />Tle corporation
<br />The ceganization
<br />The partrersitip
<br />The brokar or nominea
<br />The public entity
<br />The minors
<br />The grantor-lrustee:
<br />The aclual ownerl
<br />The owneF
<br />The grmtor'
<br />Kittitas County Agreement for Services (rev.5/L4/25)
<br />Page 18 of 20
<br />The ttust
<br />'List first and circle the name of the person whose number you fumish.
<br />lf only one p€rson on a ioint account has an SSN, thal p€rson's number
<br />must be fumished.
<br />:Circle the minor's name and fumish the minor'g SSN.
<br />rYou must show vour individual name on line 1. and enter vour business
<br />or DBA name. rf ahy, on line 2. You may use eilher your SSN or EIN (if
<br />you have one), but the IRS encourages you to use your SSN.
<br />! List lirst and circle the name of lhe trusl. eslale, o. pension trust. (Do
<br />not lumish the TIN of the personal representalive or trustee unless the
<br />legal entity itself is not designated in the account litle.)
<br />'Note: The grantor must also provkle a Form W-9 to th€ trustee of lhe
<br />trust.
<br />'. For more information on optional filing methods for grantor ttusts, s€€
<br />the lnstructions for Form 1041.
<br />Note: ll no name is circled when more than one name is listed, the
<br />number will be considered tc be that of lhe Jirst name listed.
<br />Secure Your Tax Records From ldentity Theft
<br />ldentitv theft occurs when som€one uses vour p€rsonal information,
<br />such a's your name, SSN. or olher rdentrfyi'ng iniormation, without your
<br />permission to commit fraud or otfter crimes. An identity thiel may use
<br />your SSN to get a job or may lile a tar( return using your $SN to receivs
<br />a refund.
<br />To reduce your risk:
<br />. Protect your SSN,
<br />r Ensure your amployer is prolecting your S$N, and
<br />. Bo careful when choosing a tax relum preparer.
<br />lf your tax records are affected by identity theft and you receive a
<br />notic€ from the lRS, respond righl away to !h€ name and phone number
<br />printed on the IRS notice or letter.
<br />It your tax records are rnt currenily affected by identity theft bul you
<br />thinli you are at risk due to a lost or stolen purs€ or wallet, questionable
<br />creditcard activity, or a qu$tionaHe credit report. contact the IRS
<br />HenfifyTheft Holline at 800-90&4490orsubtnit Form 14039.
<br />For more information, see Pub. 5027, ldentity Theft lnformation for
<br />Taxpayers.
<br />1- lndividual
<br />2. Two or rcre rndividuab {.ioint rccwnt}
<br />other than an mcoun! mairlained by
<br />an FFI
<br />3. Two or more U.S. percns
<br />6oint amml maintained by an FFI)
<br />4. Custodial sccount ol a mirr
<br />(Jnilom Gift to Mkrors Acl)
<br />5. a. Tha usual revocable mvings tust
<br />(granltr is ds Iru3tee)
<br />b. So-.alled aud accilnt thal is not
<br />a legal c valid trwt unds stale las
<br />6. Sol€ proprielomhip s disregarded
<br />entity owned by an irdividual
<br />7. Granlor trust filing under Optional
<br />Filing Method 1 (se Fegulaliong
<br />ffi tion 1.671 -4{bX?XiXA))"
<br />The aclual owner of the accmnt or.
<br />il combined funds. the isl individual
<br />on the accountl
<br />Each holder of the rccount
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