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ATTACHMENT "E"
<br />Form W-9 Request for Taxpayer Give form to the
<br />(Rev March 2024) Identification Number and Certification requester. Do not
<br />Department Revenue Service of the Treasury Go to wimmirs.govfFormW9 for instructions and the latest information. Send to the IRS.
<br />IntoRov
<br />Before you begin. For guidance related to the pl qxM of Form W-9, see Purpose of Form, below.
<br />1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's rame on line 1, and enter :he business/disregarded
<br />entity's name on line 2.)
<br />2 Business name/disregarced entity name, if different from above.
<br />3a Check the appropriate oax `or federal lax classification of the enlilyiind-dual whose name is entered on line 1. Check
<br />only one of the following seven boxes.
<br />❑ Individual/sole proorietor ❑ C corporation ❑ S corporation ❑ Partnershio ❑ Trust/estato
<br />❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
<br />Note: Check the "LLC" box above and, in the entry 5p,1CO, enter the appropriate code (C, S, or P) for the nut
<br />classlllcation of the LLC, unless it is a disregarded artily. A disregaded artily should insload chock the fiWoprlato
<br />box for the tax classification of its owner.
<br />❑ Other (sae instructions)
<br />31b If on line 3a you checked "Partnership" or'Trust✓estate," or checked "LLC" and entered "P- as its tax classification,
<br />and you are providing Iris form to a partnership, trust, or estate in which you have an ownership interest, check
<br />Ihls box it you have any foreign partners, owners, or beneficianes. See inslrucilons . . .
<br />Address (number, street, and apt, or suite no.). See Instructions,
<br />6 City, state, and ZIP code
<br />7 L at account numbers) here (optional)
<br />Number
<br />4 Exemptions (codes apply only to
<br />certain entries, not individuals.
<br />see instructions on page 3):
<br />Exempt payee code (if any)
<br />Exemption from Foreign Account Tax
<br />Compliance Act TATCA) reporting
<br />code (if any)
<br />(Applies to accounts maintained
<br />outside the United States.)
<br />Requester's name and address (opliona!)
<br />Enter your TIN in the appropriate box. The TIN poolrlded must match the name given on line 1 to avoid JSoclat security number
<br />backup withholding. For indivfduabs .this is generally your social security number (SSN). However, fora — m -
<br />resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
<br />entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or
<br />TIN, later.
<br />Employer Identification number
<br />Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
<br />Number To Give the Requester for guidelines on whose number to enter.
<br />Under penalties of perjury, I certify that:
<br />1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to Ire); and
<br />2. 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Intemal Revenue
<br />Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
<br />no longer subject to backup withholding; and
<br />3. 1 am a U.S. citizen or other U.S, person (defined below); and
<br />4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting ;s correct.
<br />Certification instructions. You must cross out item 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 all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (.IRA), and, generally, payments
<br />other than interest and dividends, you are not requirud to sign the certification, butyou must provide your correct TIN. See the instructions for Part 11, later.
<br />Sign signature of
<br />Here I U.S. person Date
<br />General Instructions
<br />Section references are to the Illtemal Revenue Code unless otherwise
<br />noted.
<br />Future developments. For the latest information about developments
<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 Inodi ied to clarity how a disregarded entity completes
<br />this line. An LLC that is a disregarded entity should check the
<br />appropriate box for the tax classification of its owner. Othenvise, it
<br />should check the "LLC" box and enter its appropriate tax classification.
<br />New line 3b has been added to this form, A flow -through entity is
<br />required to coinpiete this line to Indicate that it has direct or indlrecl
<br />foreign partners, owners. or benefu:tarfes when it provides the Form W-9
<br />to ttrmther'=low-tninl:gh entity in which d has an ownershlp interest. This
<br />change is intended to provide a flow -through entity with information
<br />rmyarding the status of its indirect foreign parivem. owners, or
<br />t e .elicfanes, so that it can satisfy any applicable reporting
<br />requirements. For example, a partnership that haS any indirect foreign
<br />pariners may be required to complete Schedules K-2 and K-3. See the
<br />Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
<br />Purpose of Form
<br />An individual or entity (Form W-9 requester) who is required to file an
<br />information return with the IRS is giving you this form because they
<br />Cal. No. 10231x Form W-9 (Rev. 3-2024)
<br />Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 14 of 20
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