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o.*,llU'9
<br />(liev. Morch 202.1)
<br />D{pdrtDoDt ol tha T.dnsury
<br />ll:lcinal ficvonuo S!:ruica
<br />ATTACHMENT'F"
<br />Request for TaxPaYer
<br />ldentification I{umber and Certification
<br />Go to www.hs.govlFormWglor inatructions and the latest informatlon'
<br />Givo form to the
<br />requesler. Do not
<br />send to the lRS.
<br />Betore For .clntod to tho of Fonrl W-9, soo o/Form, bololv.
<br />'I Nflme ol ontity/indivlduBl.
<br />en;,!ty's finne on |lna 2.)
<br />nn entry ls requircd, {For a sols plopri€lor or disregflrded {ntllY, cntcr tha o\r/rler's rame on lhE 1, and qrter iho business,/dlsregardcd
<br />8usl,ross rlamc/Cis.caardod ontity ralnc, it diflorcnt lrom abovo.
<br />atoo6o
<br />co
<br />UElro>F
<br />OEz6
<br />aLo
<br />o{,arlt
<br />ooa
<br />4 Exomplions (codos 8PPIY only lo
<br />cortoin cnlhios. no! ind;Yidtlnls;
<br />s€e lnglruclions on lxoe 3):
<br />Excmot Alys codo (ii {nY) _
<br />fxeillplion froil Fo!{i$n Accorn)t Tax
<br />Cornplionca Act {fATCn} roFodiag
<br />code til any)
<br />fAppt;6s lo scca/rts mainlained
<br />dJtsrdo tilo unitod stal6s.,l
<br />Fequ€sier's nhine and addle$li (optlonaa)
<br />7 I sl n::aioi;|l inltntler{s) h€re {optiorl;r1')
<br />f trtef your TIN irl the appropriate box. The TIN provlded must match lhs llatre givell or) llne t lo $vold
<br />hackrrp rvithholdingl. Itoi;ndivicl,,als, !his is gonorally your socinl oocurlty nt:ntbor {SSN). llowovnr, for a
<br />n:skleni illicn, .;olri Fropriolor, or (llsrcgailJed oDlily, see tho lnslrtlclion$ for Pjtd l, iirlor. Fof olhtr
<br />erlities, it is yoitr eriployer identilicttlon nurnber (ElN). lf you do not hiva I rltrtnber, soe How lo get,r
<br />7tN, later.
<br />Ncto: lf the accoutlt is in tTlore ihon ono name, see tho instrucliolls for llno 1. Seo also yyhat NomD and
<br />NunrbD/ Io Givd ll,D Rcqrrcsk'r lor lrttlrjclines on whoso ntlmbol to entcr'
<br />or
<br />Under pe|alties of perjilry, I certity that:
<br />1 , 'l'he nrimber showr.r ot1 th:s lorrn is my correot taxpayor rdentif ication rrttmbcr (or I flm vJoiting for a numbor to bo issrred to meli and
<br />?. I *m not $ubjcci to bnckup withholding becaus* (a) I atn exompt from bnckup !'/ithlroldlrrg' or {b} I h{rvo not been nolificd by ihc lntemol Rcvonuo
<br />serv,ca (lRSi thnt I arn subiect to backup vithhotding ns a result ol a f{rilur6 tr: report atl interest or dividerr<ls' or (c) llie IRS has notllled me that I aln
<br />no ionger sirbject to backtlD \"ilhholding: elrd
<br />3. I am a U.S, cilizcn or olher U.S. ocrson (defined belo!v): arld
<br />4, Tlre FATCA codc(s) crrtered on this lortlr (if finy) inclicating that I am cxcmpt from FATCA reporting is oorrect'
<br />Certltication instructlons. You tnust cross out iicln 2 abovo if you havo becn notitl{}d by tho IRS that you aro currentlv subject to backup wilhholding
<br />transac!ions, itenr 2 does not apply. For mortgage interest paid'
<br />because you have failed to leport all interest and dividencis on your tax r6[urn. For real estale
<br />acquisition or abandonment of secured properry. cancellation of debt,contributio!-.s lo an individua!retirernent ananqement (lRA)' and, generally' paytnents
<br />olhor than intcrest and are not io th6 corl;ficailon, btJt musi conoct TlN. Soc lho;nstructions for Part ll, latar,
<br />Sign Signtturo of
<br />DatoHereU.S, porson
<br />General lnstructions
<br />SoctioD refe:'eltces are to the llltertlal Flevenue Code unless othen'.'ise
<br />rrotcd,
<br />Futuro dovolopmonts. Fol lho ifltcsr informitlion dbolrt dovclopmcnts
<br />rehted to Fonrr \ry'g illtd itri instructiorls, $tlcll ait legislatiort elacted
<br />afier rhey \Tere pttblisiled, go to u414,v is.govll'orml /9,
<br />What's New
<br />tlne 3B nas boert rnoditierj to clarrtv how a d'sregarded ontity completes
<br />lhls lint. An t LC lhnt is a o'srtoarclcd entity shot,ld check lhe
<br />npproDrinto hox fol lhr tnx ohlssific&tiorl of il9 o\\'n(lr. C)lhenvise, it
<br />siroulci cneck the "LLC" box olld eni6r itn appropr;3te lax classiflcntloo'
<br />Noyr' iinc 3b has bocn nddod lo this fonn. A tlow-through enlity is
<br />reqLrired to cornplete this lilre to indrcate that it has Cireot or il\direct
<br />{oriign pa.tners, o\(uefs, or beneticiaries when it provides the Fonn W-9
<br />to arittncr ftowtirmugh cnlity in which it has nn ownership interest' fhis
<br />chnnt;a iu rntondcd to-providt-' a flolv-throtllrh antily !'/llh :nformation
<br />r(lgirri,ilg lllo slirttls of rls itldircct iornign partttors, ownors, or
<br />bel:elicis-r,ss, so lhat it can sat sfy alry applicable reporlirrg
<br />reqillror'!1onts, [:or example, ll parinership that hRs any lndirscl tor€ign
<br />onrlners rnoy bo reqtliroc, to complelo Schedulos K-2 nnd K-3' Soa lhe
<br />Purlrxrf$hip instn:cliorrs for Scherltrles K 2 nncj K.3 {Fonn 1065)'
<br />Purpose of Form
<br />Arr hrrJlvirlunl or oniity (Fonn W-9 requrrstcr) who !s rcqukod to llle an
<br />intorlnation return wilh tne IRS is giving you this fortn b€catlse thay
<br />only oDe of l!l+ lollowitl$ sovoll boxcs
<br />f] hdlviduavsoleprcpdotor fJ Ccorpora:iorr I Scorpo:olior: I Partnom'nio f] Tnlst/estnto
<br />f] l-I.C. Fnter tho lax cl^$sincaiiotl tC ,, C corFoftltiorr, S ' S cottnrallon. P ' Prdnarship)
<br />Nole; Check tile "LLC' box atxlve ald, itl lbe e'ltry spacB' Brlter lh€ $|propriale cods (C' S' or-P) lor jh€ lu
<br />{lrlsificallon of th{} LLC, urrlass il is a ritstqln'At'd-rartlty. A cJisrcaart}ui ont tl' s}'ouiti iIslca(l chrx)k tba niproprlaia
<br />box lor'!he ts cl$silicntion ot it3 o\'/rlor.
<br />n Oths/ (sae iilslrucliorrs)
<br />3e Chek lhs Approprial6 i$x 'or fs(loral isx clirssi{ic;lliort ol !he enirlyrindir{fi}Al \thosc n8[]e is Qfll6red on lille 1 Chcck
<br />3b ll on linc 3a you chOckcd'Pannefship' or " l (;st/cslnto," or chockod "LLG" flnd o|isod 'P" 3s rts tu classifimtion'
<br />aad yorr are providifo llis {oral lO o partns.shlp, ir(lsl, or eslile in which you hnve ad ov/nerslip rnle'6si' ch*k
<br />this liox il you have aiy loreign prtlrlero, ovfiers' or beosliciarise. SEF itlslr$cliolrs tr
<br />5 Address (rruml)ei, streel, arld itp! of EUil6 no). See lrlslructions
<br />I C:i, statc. and ZIP codo
<br />NumberParl I
<br />Part
<br />Cat. No, lo:!3'1X
<br />Kittitas County Agreement for Services (rev- 5/L4/25)
<br />Page L6 ol 22
<br />Fom W-9 (ncv- 3-2024)
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