|
Page 5
<br />oft
<br />Part ll. Certification
<br />fo esbblish lo the !"ilhholdirlg agenl lhat you a'e a U S person'.or
<br />;;?#;i;;. ;ri" i;o'' vlslvol mav be requested to s€n bv-th*
<br />;ilffiffifiili .".n
<br />'r
<br />irtt l"t' or i b''tovi indicates othe^{s+
<br />For a iorit naaor,rt. onty llro p€tson i''hoss flFl is shor"n r0 Patl i
<br />rh;'td'J;;i;"i';; t"qtr'retrl. rrr'rrre casc' of a distegatdt|-o:l'lyil*
<br />il;; it?';tlfi-; on tihe t ntust sign Exempt paye+s' 5e+ exe'npr 6$7;"
<br />code, aetlier.
<br />sion"t,rr" requirements, ComplEte the c€dmcallon as indicaled in
<br />ite-ms t hrough5 below'
<br />r. rnteresr, dividend, and barter ex;LXl?:J::i,:lt "#Ji3".
<br />?:'f tr":ffi ,:!i,l,Tifi ""if '"*:'mil;H;;i*;;'osisntne
<br />Fom W-9 (Fiev. 3-2024)
<br />What Name and Number To Give the
<br />For fris of account:Give name and SSN of:
<br />ot
<br />stify mt ovmnd b'r' s The oms
<br />e. Dkr€@rdrd
<br />indiuid@l
<br />and
<br />Legal enlit)y'
<br />The uporation
<br />The wgaizalion
<br />The pabxshiP
<br />The broks or nornmee
<br />The Public qtttY
<br />The tust
<br />9. A rdlid l^Eq edda, o' PeEim Fu+
<br />10. Corordtion or LLC otcdng corp-mte'-' .-a't;,s* E* g&3? ot F"mr 2la3
<br />11. Assciatis. club. €ligi4ils' chJ{'lble'
<br />pduatiorul' or oths lsfl sPl
<br />organizlhon
<br />'12- Put LrshiP d muttrnmb'-r LlC
<br />13. A btoker ot€g'BEad nminr
<br />14. a{cr6t Nith the ocpofinenl oI..
<br />arriotnst h tha name ot ! 9lDllc
<br />enritv {srdr s a ct*e orlocal
<br />l,i#tim-ar. :*oot dgorct' o' ptisn)
<br />flral r*crve agdcdhl'nl Progsn
<br />Paymsb
<br />ls Cfflot UBI ilhO io'm lO{l or
<br />mder $ra OPtional Fiing Melhod-2'
<br />.euirino Fom lGft (te Fcgu|omffi
<br />"Cdon
<br />1 .or t -nO)F)flts)l-
<br />2- fr,' or more ndinduab 0ornt ccFUnt)-- ot", ft- m aa-unl mrinllined bY
<br />m FFI
<br />3- Two or moru U.S. Por"oru''
<br />doint .*ount .dnlaned bY m FFI)
<br />{. Cus'todrd 3€ounl ol a minq
<br />{Unrfam Giil to Mincrs Acl)
<br />5. a. The Fual BYoehle svings b-wt
<br />(gr4tor is ars tsusteel
<br />b. S$60ed tEl acc@nt that is not
<br />a legal d vdH twt unds $ate lav'
<br />6- SoJe Frqpnetoship o. disrPgilded
<br />fllrlY olntd bY 4 sdrndual
<br />7- Gfflor trutl frfing under OPtional
<br />filina r\lethod I (sBe Fegulations
<br />a.:ri n 1,67 1 "t(bl(2'{0F))"
<br />trust.llio, .o." inro*ation on opLionai filing melhods for grantor tsusts' see
<br />thglru;hrqti665 {or Form t0'rl '
<br />Note: lf no oame is cilcled when mor6 than one name is lisled' $e
<br />#;#; ;i;;nsidercd to bts lhat oi lhe first narns listed'
<br />Secure Your Tax Records From ldentity Theft
<br />ldrniti,., lnti: .:cturs :,Jhtrt gom+f,3t irses lrollr tPir-{nal rnfolnlaliflrr'
<br />,;;i?;1,;;;;;.W'1,::,11";l::',llX.,l*;"'il*1,'l;'lil;;T'"T,jli'
<br />EEntussr()n ld :omnlll {l tuo cr o
<br />fi;'ii;i'il;;; rot, ,i 'nor
<br />Rl* a iu retur' usrrrii .1cur gsl'l 1.. tec+'!€
<br />a refund-
<br />To reduce Your dsk
<br />. Protecl your S.SN,
<br />" Ensurt you, emPloyer is Prot:cdng your SSN' and
<br />. e* .larnfvl !"hEn cho4s"19 3 ia^ reum pr*p&+r
<br />l, ,ou, ,* recorda' lre aiiected bT tdenltty th*f: attd vcu r*ct!'v: a
<br />J#"i.ff;:-i;i5' *=pontl ngiiJ*ii''o in* nant+ and ph€n; nurrrb€r
<br />pnflted on lhp IRS nouc€ '11
<br />letler'
<br />ll ..'our la.r t:col(J5 a:? not tuf'a^ll" itir':ltt! b' 'dentiv ih+fl tiut yos
<br />th,nh .,nc ar€ at riel: du€ to u totiit dt6ie" f 'lisa'or
<br />v'atter'.ru']slronacle
<br />ctqdri aard aclieiv. oru quttionuur*-"it'tiii r':'pnn corttacl th* lFlS
<br />}',iilt;:ft,"',,'lt ;';irl"i 'ti aco''loa'"reo rr subrnrr Fomr 1'ro3'r'
<br />-
<br />Oo, t,o." infonnattoo. i€e pu9 5c??' l{'*nttt'/ Thgit ln(ornlt}'n i'Jr
<br />Taxpayerg,
<br />The actual own€t of the aq@unt or'
<br />.
<br />if @mbined funds, he first indiudual
<br />on lhe acounll
<br />Fach holder of the account
<br />The minotz
<br />The Erutor'lruster
<br />The actual omerr
<br />The ovrner3
<br />The grmtor'
<br />Kittitas county Agreement for Services (rev ' 5/1'4/25)
<br />Page L7 of L9
|