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Form W-9 (Rev. 3-2024)
<br />Part II. Certification
<br />To establish W the withholding agent that you are a U.S. person. or
<br />resident alien, sign form W-9_ You may be requested to sign by the
<br />withholding agent even if item 1. 4, of 5 below indicates otherwise.
<br />For a joint account, only the person whose TIN is shown to Part I
<br />should sign (when required), In the cage of a disregarded entity. the
<br />person identified on line 1 must sign. Fxempt payees, see Fxempf payee
<br />code, earlier.
<br />Signature requirements. Complete the cerification as indicated in
<br />items 1 through 5 below.
<br />1. Interest, dividend, and barter exchange accounts opened
<br />before 1994 and broker accounts considered active during 1983.
<br />You must give your correct TIN, but you do not have to sign the
<br />certification.
<br />2. Interest, dividend, broker, and barter exchange accounts
<br />opened after t983 and broker accounts considered inactive during
<br />1983. You must sign the certification or backup withholding will apply. If
<br />you are subject to backup withholding and you are merely providing
<br />your correct TIN to the requester, you must cross out item 2 in the
<br />certification before signing the form.
<br />3. Real estate transactions. You must sign the certification. You may
<br />cross out item 2 of the certification.
<br />4. Other payments. You must give your correct TIN, but you do not
<br />have to sign the certification unless you have been notified that you
<br />have previously given an incorrect TfN. "Other payments" include
<br />payments made in the course of the requesters trade or business for
<br />rents, royalties, goods (other than bilts for merchandise). medical and
<br />health care services [ncluding payments to corporations), payments to
<br />a nonemployee for services, payments made in settlement of payment
<br />card and third -party network transactions. payments to certain fishing
<br />boat crew members and fishermen, and gross proceeds paid to
<br />attorneys (including payments to corporations).
<br />5. Mortgage interest paid by you, acquisition or abandonment of
<br />secured property, cancellation of debt, qualified tuition program
<br />payments (under section 5291, ABLE accounts (under section 529A),
<br />IRA. Cove rdelI ESA, Archer MSA or NSA contributions or
<br />distributions, and pension distributions. You must give your correct
<br />TIN, but you do not have to sign the certification_
<br />What Name and Number To Give the Requester
<br />For this type of account:
<br />Give name and SSN of:
<br />1. individual
<br />The individual
<br />2. Two or mare individuals (joint aceo untl
<br />The actual owner of the account or.
<br />other than an aepwnt maintained by
<br />if combined funds, the first individual
<br />an FFI
<br />on the account'
<br />3. Two of more U.S. persons
<br />Each holder of the account
<br />(joins account maintained by an FF1)
<br />4. Custodial account of a meter
<br />The minor2
<br />g,lnitorm GM to Minors Act
<br />5. A. The usual revocable ravings lrus!
<br />The grantor -trustee-,
<br />(grantor is also trustee)
<br />b. So-called trust account that to not
<br />The actual owner'
<br />a begat or ward trust under state law
<br />F. Sate proprietorship or disregarded
<br />The owner'
<br />entity owned by an individual
<br />7. Grantor trust filing under Optional
<br />The grantor
<br />Firing Method 1 (sea Aegulatiom5
<br />section 1.671-4(b)l2)(1(A))"
<br />Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 18 of 20
<br />Page 5
<br />For this type of account:
<br />Give name and EIN of_
<br />a. Disregarded entity not neared by an
<br />The owner
<br />individual
<br />9. A valid trust estate. or pension trust
<br />Legal entity-1
<br />10, Corporabon or LLC electing corporate
<br />The corporafion
<br />status on Form e832 or Fwm 250
<br />11. Association. dub, mNious. rlaritable.
<br />The efgan:mtion
<br />ddUC9hPnal, or other tax-exempt
<br />grown ttior!
<br />12. Pw%wship or muitr-membar LLC
<br />The partnership
<br />1a. A brother or registered nominee
<br />The broker or norninee
<br />14. A DWM with the Department of
<br />The public entity
<br />Agriculture it the noun- of a public
<br />entity (such as a state or local
<br />government school district, or prison)
<br />that receives ypicultural program
<br />payments
<br />is. Grantor trot fifing Form 1D41 or
<br />The trust
<br />under the Optional Filing Method 2.
<br />requiting Form 1099 (see Regulations
<br />section 1.8T1-4JbX2XPW)1"
<br />List first and circle the name of the person whose number you furnish.
<br />It only one person on a joint account has an SSN, that person's number
<br />must be furnished,
<br />2Circle the minor's name and famish the minor's SSN.
<br />'You must show your individual name on line 1, and enter your business
<br />or DBA name. it any, on line 2. You may use either your S a EIN fif
<br />you have one), but the IRS encourages you to use your SSN.
<br />`List first and circle the name of the Irust. estate, or pension trust. (Do
<br />not fumish the TIN of the personal representative of trustee unless the
<br />legal entity itself is not designated in the account tile.)
<br />Note: The grantor must also provide a Form W-9 to the trustee of the
<br />tmr9t.
<br />"For mare information an optional filing methods for grantor trusts. see
<br />the Instructions for Form 1041.
<br />Note: If no name is circled when more than ore name is listed, the
<br />number will be considered to be that of the first narne listed.
<br />Secure Your Tax Records From Identity Theft
<br />Identity theft occurs when someone uses your personal information,
<br />such as your name, SSN. or other idea l fy rig information, without your
<br />permission to commit fraud or other crimes. An identity thief may use
<br />your SSN to gat a job or may fit at tax return using your SSN to receive
<br />a refund.
<br />To reduce your risk:
<br />• Protect your SSN,
<br />• Ensure your employer is protecting your SSN, and
<br />• Be careful when choosing a tax return preparer_
<br />If your tax records are affected by identity theft and you receive a
<br />notice from the IRS, r3spond right away to the name and phone number
<br />printed on the IRS notice or letter.
<br />If your tax records are rot currently affected by identity t1hiett but you
<br />Ihink you are at risk due I a lost or stolen purse or wallet questionable
<br />credit card activity. or a questionable credit report. contact the IRS
<br />Identity Theft Hog ine at Boo-908.4490 or submit Form 1 :D39.
<br />For more information, see Pub_ 5027, Identity TYteft Information for
<br />Taxpayers.
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