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Form W-9 (Rev. 3-2024)
<br />Page 3
<br />Certain payees and payments are exempt from backup withholding.
<br />See Exempt payee code, later, and the separate Instructio nS for the
<br />Requester of Form W-9 for more information.
<br />See also Estabfishing U.S. status for purposes of chapter 3 atd
<br />chapter 4 withholding, earlier.
<br />What Is FATCA Reporting?
<br />The Foreign Account Tax Compliance Act (FATCA) requires a
<br />participating foreign financial institution to report all U.S. account
<br />holders that are specified U.S. persons. Certain payees are exempt from
<br />FATCA reporting, See Exemption from FATCA repining code. later, and
<br />the Instructions for the Requester of Form W-B for mere information.
<br />Updating Your Information
<br />You must provide updated infommat,)n to any person to whom you
<br />claimed to be an exempt payee i you are no longer an exempt payee
<br />and anticipate receiving reportable payrnertts in the future from this
<br />person. For example, you may need to provide updated information if
<br />you are a C corporation that elects to be an S corporation, or if you are
<br />no longer tax exempt_ In addition. you must furnish a new Form W-9 if
<br />the name or TIN changes for the account, for example, if the grantor of a
<br />grantor trust dies_
<br />penalties
<br />Failure to furnish TIN. If you fail to furnish your correct TIN to a
<br />requester, you are subject to a penalty of $50 for each such failure
<br />unless your failure is due to reasonable cause and not to 'willful neglect.
<br />civil penalty for false information with respect to withholding. If you
<br />make a false statement with no reasonable basis that results in no
<br />backup withholding, you are subject to a $500 penalty.
<br />Criminal penalty for falsifying information. Willfully falsifying
<br />certifications or affirmations may subject you to criminal penalties
<br />including fines and/or imprisonment.
<br />Misuse of TINS. If the requesterdiscloses or uses Tills in violation of
<br />federal law, the requester may be subject to civil and criminal penalties.
<br />Specific Instructions
<br />Line 1
<br />You must enter one of the following on this line; do not leave this line
<br />blank. The name should match the name on your tax return.
<br />If this Form W-9 is for a joint account (other than an account
<br />maintained by a foreign financial institution (FFf)). Hst first, and then
<br />circle, the name of the person or entity whose number you entered in
<br />Part I of Form W-9. If you are providing Form W4 to an FFI to document
<br />a joint account, each holder of the account that is a U.S. person must
<br />provide a Form W-9.
<br />• Individual. Generally, enter the name shown an your tax return, If you
<br />have changed your last name without informing the Social Security
<br />Administration (SSA) of the name change, enter your first name, the last
<br />name as shown on your social security Gard. and your new last name.
<br />Note for MN applicant: Enter your individual name as it was entered
<br />on your Form W-7 application, line I This should also be the same as
<br />the name you entered on the Farm 1040 you filed with your applicaton.
<br />• Sole proprietor. Enter your individual name as shown on your Form
<br />1040 on [[no 1. Enter your business, trade. or "doing business as" [DBA)
<br />name on line 2.
<br />• Partnership, C corporation, S corporation, or LLC, other than a
<br />disregarded entity. Enter the entity's name as shown on the entity's tax
<br />return on line 1 and any business, trade. or DBA name on line 2.
<br />• tither entities. Enter your name as shown on required U.S. federal tax
<br />documents on line 1. This name should match the name shown on the
<br />charter or other leg at document creating the entity. Enter any business,
<br />trade, or DBA name on line 2.
<br />• Disregarded entity. In general, a business entity that has a single
<br />owner, including an LLC. and is not a corporation. is disregarded as an
<br />entity separate from its owner (a disregarded entity). See Regulations
<br />section 301,7701-2(c)(2). A disregarded entity should check the
<br />appropriate box for the tax classification of its owner. Enter the owner's
<br />name on line 1. The name of the owner entered on line 1 should never
<br />be a disregarded entity. The name on line 1 should be the name shown
<br />on the income tax return on which the income should be reported. For
<br />Kittitas County Agreement for Services (rev. 5/14/25)
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<br />example, if a foreign LLC that is treated as disregarded entity for U.S.
<br />federal tax purposes has a single owner that is a U.S. person, the U.S.
<br />owner's name is required to be provided on line 1, If the direct owner of
<br />the entity is also a disregarded entity. enter the first owner that is not
<br />disregarded for federal lax purposes. Enter the disregarded entity's
<br />name on line 2. If the owner of the disregarded entity is a foreign person,
<br />the owner must complete an appropriate Form W-8 instead of a Form
<br />W-9. This is the case even if the foreign person has a U.S. TIN,
<br />Line 2
<br />If you have a business name. trade name. DBA name. or disregarded
<br />entity name, enter it on line 2.
<br />Line 3a
<br />Check the appropriate box on line 3a for the U.S. federal tax
<br />classification of the person whose name is entered on line 1. Check only
<br />one box on line 3a.
<br />IF the entity/individual on line 1
<br />THEN check the box for.. .
<br />isafn)...
<br />• Corporation
<br />Corporation_
<br />• Individual or
<br />Individuallsole proprietor_
<br />• Sole proprietorship
<br />• LLC classified as a partnership
<br />Limited liability company and
<br />for U-S. federal tax purposes or
<br />enter the appropriate tax
<br />• LLC that has filed Form 8832 or
<br />classification:
<br />2553 electing to be taxed as a
<br />P = Partnership,
<br />corporation
<br />C = C corporation, or
<br />S = S corporation.
<br />• Partnership
<br />Partnership_
<br />• Trust/estate
<br />Trust/estate.
<br />Line 3b
<br />Check this box if you are a partnership (icluding an LLC classified as a
<br />partnership for U.S. federal tax purposes), trust or estate that has any
<br />foreign partners, owners. or beneficiaries. and you are providing this
<br />form to a partnership, trust, or estate. in which you have an ownership
<br />interest. You must check the box on line 3b 0 you receive a Form IN-8
<br />(or documentary evidence) from any partner, ovrner, or beneficiary
<br />establishing foreign status or if you receive a Form W-9 from any
<br />partner, owner, or beneficiary that has checked the box on line 3b.
<br />Note: A partnership that provides a Form W-9 and checks box 3b may
<br />be required to complete Schedules K-2 and K-3 (Farm Ic6q. For more
<br />infornation, see the Partnership Instructions for Schedules K-2 and K-3
<br />(Form 1065).
<br />if you are required to complete line 3b but fail to do so. you may not
<br />receive the information necessary to file a correct informafion return with
<br />the IRS or furnish a correct payee statement to yeur partners or
<br />beneficiaries. See. for example, sections 6698. W 22, and 6724 for
<br />penalties that may apply -
<br />Line 4 Exemptions
<br />If you are exempt from backup withholding and/or FATCA reporting,
<br />enter x1 the appropriate space on line 4 any codes) that may apply to
<br />you.
<br />Exempt payee code.
<br />• Generally, individuals (including sole proprietors) are not exempt from
<br />backup withholding.
<br />• Except as provided below, corporations are exempt from backup
<br />withholding for certain payments, including interest and dividends.
<br />• Corporations are not exempt from backup withholding for payments
<br />made in settlement of payment card or third -party network transactions.
<br />• Corporations are not exempt from backup withholding with respect to
<br />attomeys' fees or gross proceeds paid to attorneys, and corporations
<br />that provide medical or health care services are not exempt with respect
<br />to payments reportable on Form 10"-MISC,
<br />The Wowing codes identify payees that are exempt from backup
<br />withholding. Enter the appropriate node in the space on line 4.
<br />1—An organization exempt from tax under section Sol (a), any IRA, or
<br />a custodial account undersection 403(b)(7) ri the account satisfies the
<br />requirements of section 401(Q(2).
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