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Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 13 of 19
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<br />2 Business.name/disrngardedl 011tM1:y name. if diffBrRr1t frorn above.
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<br />4 Exomplior,s (codGSapply only to
<br />certain entities, not in-dYvidl1ais;
<br />see lnstroctkms on page 3):
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<br /> .£
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<br />Compliance Act (FATCA) roporting
<br />code (if any)
<br />CL O
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<br />(Ap{)li�s to,'?'C:COJ.Jflts maintri!_in�cJ
<br />outside the United States.)
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<br /> Requester's name Mel address (optionaQ
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<br />5 Adcl,es, (numbe , street, Md apt. or uite no.). See instructions.
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<br />Taxpayer Identification Number (TIN)
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<br />3a Check the appropriate box lor federaltax classilication of the en�ryfindlvidoal whosen e is entered on line 1. Check
<br />only one of trn, fQ!lowlng seven boxes. □ lndividlual/sore propriotor □ G corporatior1 □ S corporation □ P.artoorship □ Trust/estate
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<br />classification of the LLC, unless it is adiwegarded entity. A disregard entity should instead check the 8J)proprlate
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<br />ATTACHMENT “E”
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<br />Form W•9
<br />(Rev. March 2024)
<br />D<,partmont of the Trnasury
<br />lrritemal R@venue ServiC8
<br />!Request for Taxpayer
<br />Identification Number and Certification
<br />Go to www.irs.gov/FormW9 for instructions and the latest info·rmat'ion.
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<br />Give form to the
<br />requester. Do not
<br />send to the IRS.
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<br />backup withholding. For individuals, this is generally your social security number (SSN). However, for a
<br />resident alien, sole proprieto:r, or disregarded entity, see the instructions for Pa.rt I, later. For other
<br />entlties, it is your employer identification number (EIN). If you do not have a nutnber, see How to get a
<br />TIN, later.
<br />Note: If the account is i11more·than one name, see the instructions for limi 1. See also What Name and
<br />Number To Give the Requester for guidelines on whose number to enler.
<br /> Certification
<br />Under penalties of perjury, I certiify that:
<br />I Em1>loyer'identification numi>er
<br />1. The number shown on this form is my correct taxpayer identification number (or I am wa1ting for a number to be issued to me); and
<br />.2. I am not sub,ject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not beer, notified by the Internal Revenue
<br />Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividend's, or (o) the IRS has notified me that I am
<br />no longer subject to backup withholding; at1d
<br />3. I am a U.S. citizen or other U.S. person (deNned below); and
<br />4. The FATCA code(s) entered on this form QI any) indicating that I am exempt from FATCA reporting is correct.
<br />Certification ins1ructiions. You rnust cross out itern 2 above if you have been notified by the IRS that you are currently subject to backup withholding
<br />because you have failed to report ali interest and dividends on your tax return. For reai estate transactions, item 2 does not apply. For mort91age interest paid,
<br />acquisition or abandonmen,t of secured property, cancellation of debt. contributions to an individual retirement arrangeme11t (IRA), and, generally, payments
<br />-other than interest and dividends, you are not requirnd to sign the certification, but you must provide your correct TIN. Soothe instructions for Part II, later.
<br />Sign I Signatur<> of
<br />Here , U1.S,,porson Dal ..
<br />General Instructions
<br />Section refererices are to the Internal Revenue Code unless otherwise
<br />no•ted.
<br />Future developments. For the latest information about d'eve'lopments
<br />related to Form W-9 and its instructions, such as legislation enacted
<br />after they were published, go to www.irs.gov/FormW9,
<br />What's New
<br />Line 3a has been modified to clarify how a disregarded entity completes
<br />this line. An LLC that is a disregarded entity should check the
<br />appropriate bo.x for the tax classification of Its owner. Otherwise, it
<br />should check the "LLC'" box and enter its appropriate tax classification.
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<br />New line 3b has been addedl to this form. A flow-through entity is
<br />required to complete this Ii e to indicate that it has direcl or indirect
<br />foreign partners, owners, or beneflcia�ies when rt provides the Form W-9
<br />to another tlow-thrm,gh e 11ily in which it has an ownersh,ip interest. This
<br />chang,e;s intended to provide a flow-through entity with information
<br />regarding the status of its i direct lor,eign partners, owners, or·
<br />beneficiaries, so lhat it can satisfy any applicable reporting
<br />requirements.. For example, a partnership that has any indirect foreign
<br />partners may be required to complete Schedules K-·2 and K-3, See the
<br />Partnership lnsbructions for Schedules K-2 and K-3 ,(Form 1065).
<br />Purpose of Form
<br />An indivl:dual ore lily (Form W-9 reque$ler) who Is required to file an
<br />information rett1m with lhe IRS is giving you this form because they
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<br />Cat. No. 10231X Form W-9 (Rev. 3-2024)
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