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Form W-9 (Rcv. 3-2024)Pooc 3
<br />C,ertain payees and payments ar€ oxempt ftom backup whhholding.
<br />See Erempf iuyee codb, later, and the separate lnstuctions for the
<br />Requester of Form W-9 for more infonnaiion.
<br />See afso EslabJlshing U.S. stat s for purpo*s ol chaptet g and
<br />chapter 4 withholding, eulier.
<br />What ls FATCA Reporting?
<br />The Foreign Account Tax Comy'iance Act (FATCA) requires a
<br />participaling foreign fnancial institr.rtion to report all U.S. account
<br />hold€rs that are specified U.S. p€rsons. Cerlain payees are exempl trom
<br />FATCA reporting. See Exemp&bn ftom FATCA rapoding code,later, and
<br />the lnstrucliofls for lha Requester of Form W-9 for more infonnation.
<br />Updating Your lnformation
<br />You must provide updated information to any porson to whom you
<br />claimed to be an exempt payee if you are no longer an exempt Payee
<br />and anticipate receiving reportaHe payments in the future lrom this
<br />person. F6r example, ybu may need to Fovide updaied information il
<br />you are a C corporation that elects to be an S corporation, or if you are
<br />no longer tax exempt. ln addition, you musl fumish a new Form W-9 if
<br />the name or TIN changes for the account. for example, if the grantor of a
<br />granlor trust dies.
<br />Penalties
<br />Failure to fumish TlN. lf you fail to fumish yottr conect TIN lo a
<br />requester, you are subiect to a penalty of $50 for each such failure
<br />unless your failure is due to reasonable cause and not to willlul neglect.
<br />Givil penalty lor lalse informalion with respecl to withholding. lf you
<br />make a falsd statement with no reasonable basis that resuhs in no
<br />backup wilhholding, you are subiect to a 5500 penalty.
<br />Criminal penalty for falsifying inlormation. Willfully hlsifying
<br />certifications or affirmations may subject you lo criminal penalties
<br />including fi nes and/or imprisonment.
<br />Misuse ol TlNs. lf the requester discloses or uses TlNs in violation ol
<br />federal law, the requester may be subject to civil and criminal p€nalties.
<br />Specific lnstructions
<br />Line I
<br />You must enter one of the following on this line; do not leave this line
<br />blank. The name should match lhe name on your tax retum.
<br />lf this Form W-9 is for a joint account {other than an account
<br />maintained by a foreign financial institution (FFl)), list fint, and then
<br />circle, the name of lhe person or entity whose number you entered in
<br />Part I of Form W-9. lf you are providing Form W-9 lo an FFI to document
<br />a joint accounl, each holder of the account that is a U.S. P€rson must
<br />provide a Fom W-9.
<br />. lndividual. Generally, ent€r the name shown on your tax retum. ll you
<br />have changed your last name without informing the Social Security
<br />Administralion (SSA) of the name change, entet your first name, the last
<br />name as shown on your social security card, and your new last name.
<br />Note lor lTlN applicant: Enler your individual name as it was entered
<br />on your Form W-7 application, line 1a. This should also be lhe same as
<br />the name you entered on the Form 1040 you liled with your application.
<br />. Sole proprietor. Enter your individual name as shown on your Form
<br />1o4o on line 1. Enter your business, trade, or'doing business as' {DBA)
<br />name on line 2.
<br />. Padnership, C corporation, S corporation, or LLC, other than a
<br />disregarded entity. Enter the entity's name as shown on the entity's tax
<br />retum on line 1 and any business, lrade, or DBA name on line 2.
<br />r Other enlilies. Enter your name as shown oa required U.S. federal tax
<br />documents on line 1. This name should match the nam€ shown on the
<br />charter or other legal document creating the entity. Enter any business,
<br />trade, or DBA name on line 2.
<br />. Disregarded entity. ln general, a business entity that has a single
<br />owner, including an LLC, and is not a corporation, is disregarded as an
<br />entity separate from its owner (a disregarded entity). See Regulations
<br />section 301.7701-2(c[2l. A disregarded enlity should check the
<br />appropriate box lor the tax classification of its owner. Enter the owne/s
<br />name on line 1. The name of the owner entered on line I should never
<br />be a disregarded entity. The name on line 1 should be the name shown
<br />on the income tax rettjm on which the income should be reported. For
<br />example, if a foreign LLC thal is tteated as a disregarded entity lor U.S.
<br />led€ril tax purposes has a single owner that is a U.S. person, the U.S.
<br />owner's name is required to be provided on line 1, lf the direct owner of
<br />the entity is also a disregarded entity, enter the first owner lhat b not
<br />dbr€garded for tederal tax purposee. Enter the disregarded entity'e
<br />name on line 2. lf the owner of the disregarded entity is a foreign person,
<br />th€ owner must completE an appropriate Form W-8 instead of a Form
<br />W-9. This is the case €vsn il the foreign person has a U.S. TlN.
<br />Llne 2
<br />lf you have a business narne, trade name, DBA name, or disreganded
<br />enlity name, enter it on line 2.
<br />Line 3a
<br />Check the appropriate box on lina 3a for the U.S. federal tax
<br />classificalion of the person whose name b entered on line 1. Check only
<br />one box on linE 3a.
<br />Line 3b
<br />Check lhis box il you are a pattnership fncluding an LLC classified as a
<br />partnership tor U.S. lederal tax putposes), irust. or estat€ that has any
<br />foreign partrrers, owners, or bEnefciaries, and you are providing this.
<br />formlo a partnership, trust, or estate, in which you have an ownership
<br />interest. You must dheck the box on line 3b il you receive a Form W-8
<br />(or documentary evidence) from any partn€r, owner, or beneficiary
<br />establishing loreign status or it you receive a Form W-9 from any
<br />partner, owner, or beneficiary that has checked the box on line 3b.
<br />Note: A parlnership lhat provides a Form W-9 and checks box 3b may
<br />be reguired to complete Schedules K-2 and K-3 (Form 1065). For more
<br />information, see the Partnership Instructions for Schedules K-2 and K-3
<br />(Form 1065).
<br />lf you are required to complete line 3b but lail to do so, you may not
<br />receive the inlormation necessary to file a conect information retum with
<br />the IRS or fumish a corecl payee statement to your partners or
<br />beneficiaries. See, for example, seclions 6698, 8722, and6724lor
<br />penalties that may apply.
<br />Line 4 Exemptions
<br />lf you are exempt from backup withholding and/or FATCA reporting,
<br />eriler in the appropriate space on line 4 any code(s) that may apply to
<br />you.
<br />Exempt payee code.
<br />. Generally, individuals {ncluding sole proprietors) are not exempt from
<br />backup withholding.
<br />. Except as provided below, corporations are exempt from backup
<br />withholding for certain payments, including interest and dividends.
<br />. Gorporations are not exempt from backup withholding for payments
<br />made in setilement of payment card or third-party network transactions.
<br />. Corporations are not exempl from backup whhholding with resp€ct lo
<br />attomeys'fees or gross proceeds paid to attomeys, and corporations
<br />that provide medical or health care services are nol exemPt with respect
<br />io payments reportable on Form 1099-M|SC.
<br />The lollowing codes identify payees that are exempt from backup
<br />withholding. Enter the appropriate code in the space on line 4.
<br />1-An organization exempt from tax under section 501(a), any lRA, or
<br />a custodial account under section 403(b)t7l if the account satisfies the
<br />requirements ot section 401(f)(2).
<br />Kittitas County Agreement for Services (rev.5l74/251
<br />Page 16 of 19
<br />lF rhe entity/individual on line 1
<br />is alnl .. .
<br />THEN check the box for
<br />o CoDoration Corooration.
<br />. lndivilual or
<br />. Sole proprieloGhip
<br />lndividual/sole proprietor,
<br />r LLC classilied as a partnership
<br />for U.S. federal tax purposes or
<br />. LLC that has filed Form 88ii2 or
<br />2553 electing to be laxed as a
<br />corporation
<br />Umited liability company and
<br />enter the appropriate tax
<br />classification:
<br />P - Partnership,
<br />C=Ccorporation,or
<br />S = S corporation.
<br />. Partnership Partnership.
<br />o TrusUestate Trust/eslats.
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