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<br />ATTACHMENT "E"
<br />Request for Taxpayer
<br />ldentlflcatlon Numbor and Certlllcatlon
<br />go lo vrrx.*u'(//lfufittru lof lmfucflolrr ltxl thc llt tt h{otmlrbn.Deorltrranr of lhalrus(l
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<br />bacat !a you hayr tsil€d to rtpod rI inl{ cl std
<br />aagul,ritirn a sbrfldmrf€nt ot rutod plop€tty,
<br />oltfl ttr.n lntotssl sd
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<br />Cmplme Act {fATC } reiNaiq
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<br />, a$ln6! n$t!/66r9eflAod fidry nstr's, il dfcffil l'olh abot6.
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<br />Entcf yo{jr TlN hl thc apprcgddr box Th€ IN trwld€d mu.t rnalch lhr nelnc git/!f|o{r In I lo rvold
<br />Uuct u'p *ffrotAing. foi hitvtUuaC. Si! ir gonirmly yo111 soclal eocurtly numberlgSNl' llowwet' lora
<br />re,riA"irt att n, sote?ofrriAor, or dkrogdrdod odtily, r€6 tft€ insltuctbn! tor Ptd l. blr.. For otp
<br />cnlllhr. it lc yorr urptirycr ioonti1caton numb.r (ElNr. lt you do not hsvr I nrnnb.r, s.a Los !0 €El t
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<br />]lob: f ths Ef@un b h trFl! thrll olro namo, lee ilre hstruclioN lor fine 1. Soe also y/tlat t{nttc end
<br />Mrmbgf-To Gim art8 fluquesl6r lor guidelinoi oi tYfiGo ilmbe. to eolor.
<br />ttxbf p.ndtlrs ot prri'.ry, I c.r{tY thst
<br />t. Tho rumbcr rhovrft on this fonn is my corGct $xpaye/ idon0ficttlon number (o( I am walthg hr a tx'lmbs. to be isEu€d lo m4)i and
<br />2. I am not subiect to backup withhdding bocsus€ (!) i am .xempl trc!! bqckup wllhholdhg, d O) I hnco not b€on trc{ified by tho lntrtnal Ro{onue
<br />s.rvh61RslthltI*n.t*+*rouilifitu}trti&f*.to,inolataiturct'oreportarlS'ierairordivkhnds,otlc)thrlRshasnotlfi€dmlh.tIsm
<br />rE rongs? *rbiet lo bcc'ilp w{trholdng; and
<br />3. I am r U.S. cilizen or othst U,S. t€r3on (d€ffnsd Delosl: end
<br />4. Tha FATCA co.lqs) enreed on $i$ lorm {if any} iMJicrllng lhat I am exanpl lmtn FATCA repo.ilng 6 colffil.
<br />C.riilc.toll tllftusdofi, you tfliEt esssl it€tn 2 So€flyou hre been nolfied by lho lR:i thst lrou ro curft'llly 6utri6ct to bac:l0rP wilhholding
<br />dlYidandr on
<br />celcelbtirn
<br />yosr lo( ralum. For 'rrlol dsbl, conlrib$ionr to
<br />tho
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<br />General lnstntetions
<br />S€cilon lsterenc€3 e€ to th€ lntgmel Bevaue Code unlBls otlErvdsa
<br />not€d,
<br />fllnlrr dlrloFtrlltl Fot tho ht6t infornaton a$oul dowbpfl!€flts
<br />?rht d lo Fo.m W-0 md lt3 insltucrio$. s{ch ai hli3blim rtlactsd
<br />a{rsr trcy wer. publBlred, go to n^ew. ft.govlFdmlt't9'
<br />tl€$/ lho 3b ?ta3 boal addd, lo this ttrtn. A novr"thtough onrity b
<br />ruouired lo cqnotrlc lhls lh6 to lndGeta lhal il l€r di/€c{ ol lndhrct
<br />ioritd pe/tnelg, oumsr, or b€neffdatLs t{h'en lt pr$ddes q! Fory y'0
<br />ro ariuier flow-mouoh Gntity in whldl itlles an or,no{sniP interc3t.Ihir
<br />chongo is inlondod tJpro/Hi a llrru'tht€r€h sntily with inforrrntlct
<br />rooardins lho Dlllun ol il3 itditrcl fof'ign ptfbla s' owfiorE, tr
<br />udrcficia-nes. 30 urt lt cen rarlrly any epf,llc$b .eportlng
<br />r.arke(r,€ntr, Fot at(amplg, I pgtio.rilp lh6t hr3 any hdiraci foolon
<br />oariners mav Uo rsqdtei to complota Schodulgs K'2 and K-3, SeG tho
<br />barrnechip inttructions tor Sc{ndula K'2 end K-3 {Fom 1065)'
<br />Purpos€ of Form
<br />lMrat'e New
<br />Uno 3a nes been modiilad to chrily hotv 8 die/oganded entlty somdsi.s
<br />thi! [tr4, An l-LC lhal lr e di.$getdod otrtlty tlould ohoah ftr€
<br />dpprwiEt! bor ls ih€ tax chcrlficaliotl o[ its ownet. othtrwii€, il
<br />ririutO ct"oct ttrr 'LLC' bor ard ar!13 rtrF apptoprifits tax clascifiedlo'n.Afi indMdrd r gnltty (Ftrn W'9 Tsqus8to{) who is €quM lo
<br />inlo(mdion rCun win tno tnS ir givi,tg ytu thit lorm bocars€
<br />lIe arr
<br />they
<br />of Formto
<br />ff hdvdrhfs$oproclstor I ccpan:ion fl Scorporairm I lurnenp fl tncuecloto
<br />D LLc, [nlo rlm tu chrslllcation i6 ' C wgndbr, $ '' 3 i:'tpxallxr' P " Prtmshp]
<br />faolc Chsl ltD '1.{-C' hor tbwc ed. h lip nlty rt*t tild t}t tpfhplhl" cffle lC, S, d F} Lt tht irt
<br />cianlfi*lim or frc LfC, mtx il ir e drsgsdeo-dthy. A diinosdod stilv irldrU indard ch€d. lhd lolyoFdcl6
<br />bdr iot irc tsa clsl{cdon at ilt ffillf .
<br />u c^trtyifr$lrhsl s,t{r6 frfl{ B filtr(l ur [m l. Cltr|rclwftcrlrdlol lh!
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<br />tt'P'tAr afirsllcoilo4.itE-llc"d ct,lal(od oatffedandiltlina0nclrad(€d ot 'lMU6tde.Sotlqr 'Pf,tr'o,8hip'
<br />f,dhtvt nla.Git,twltla.trh cntcl6ldltor*hi6hn }!{rlr1dI8tlonnttoitlomr'l,pr'th}lhp,)au 9&lldno SdinstMlbEt*rrlicltrlc.ow56.aIt{r bdr lwc Felrdt,16u $y tdrlgd
<br />I AddH rF!. d *tl" m.l. Sddret.
<br />6 Cky, 1a!4. md ZIP cod.
<br />Part I
<br />Part ll
<br />Cal- No, l@3lx
<br />Kittitas County Agreement for Services lrev' 5lL4/251
<br />Page22 of 28
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