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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 of the Treasury send to the IRS.
<br />internal Revenue Service Go to wwwJmgov/FormW9 for instructions and the latest information.
<br />Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
<br />1 Name of entityAndlvldual. An entry Is required. (For a sole proprietor or disregarded entity, enter the owners name online 1, and enter the business/dlsregarded
<br />enirty's nure on line 2.)
<br />t �6,cs etuN Iv C'aLt
<br />2 Business namold'sregarded entity namo,'rf d a nt from above.
<br />m
<br />3a Check the appropriate box for federal tax classification of the entitylindiwdual whose name Is entered on line 1. Check
<br />4 Exemptions (codas apply only to
<br />only one of the following seven boxes.
<br />certain entities, not individuals;
<br />a
<br />C
<br />❑ Incilvidual/solo proprietor ❑ C corporation ❑ S corporation ❑ Partnershle, ❑ Trust/estato
<br />see Instructions on page 3):
<br />0
<br />❑ LLC. Enter the tax classification (C = C corporation, S = S corporatlon, P = Partnership) . . . .
<br />Exempt payee code (If any)
<br />p
<br />Note: Check the "LLC" box above and, In the enlryspace, enlsr the appronrlate code (C, S, or P) for the tax
<br />classification of the LLC, unless It Is a disregarded entity. A dirregerdorl entity should Instead chock the onpropdale
<br />Exemption from Foreign Account Tax
<br />`o
<br />box for the tax classification of its owner.
<br />Compliance Act (FATCA) reporiing
<br />In
<br />Other (see Instructions) SVI C
<br />Icode (If any)
<br />a,
<br />(Applies to accounts maintained
<br />3b I1 on line 3e you checked "Partnership' or'TrusVeslete," or checked "LLC" and entered "P' as its tax classification,
<br />and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check ❑
<br />outside the United States.)
<br />this box If you have any foreign partners, owners, or beneficiaries. See instructions . . . . . . .
<br />u)
<br />5 Address (number, street, and apt, or sulte no_). Jae instrut;`+ntm
<br />Requester's name end address (optlonaQ
<br />fY� Tr'
<br />a r
<br />s City, slaty.- Zip sad
<br />7 List account number(s) here top 4 sq
<br />Taxpayer Identification Number (TIN)
<br />Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
<br />Social secorlty number
<br />backup withholding. For individuals, this is generally your social security number (SSN). However, for a
<br />resident alien, sole proprietor, or disregarded entity, see the Instructions for Part I, later. For other
<br />entities, it is your employer Identlflcatlon number (EIN). If you do not have a number, see How to get a or
<br />TIN, later.
<br />C
<br />Note: If the account is in more than one name, see the instructions for line 1. See also What Name and r
<br />Number To Give the Requester for guidelines on whose number to enter. I �
<br />Certification
<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 me); and
<br />2. 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have d by the internal Revenue
<br />Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or a 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 ect.
<br />Certification Instructions. You must cross out Item 2 above If you have boon notified by the IRS that currently subject to backup withholding
<br />because you have failed to report all Interest and dividends on your lax return. For real estate Iran . Item 2 does not apply. For mortgage Interest paid.
<br />acquisition or abandonment of secured property, cancellation of debt, contributions to an indlvld 6mBnt arrangement PRA4. and, generally, payments
<br />other than Interest and dividends, yc iu are not roqulrod to sign the cortiflention, but you must pro ur correct TIN. Soo lho rnstnrclIons for Part II, later.
<br />Sign I signature or f / _ A� —]1 ((J
<br />Here U.S. person pr.!j•�L� Data f �i
<br />General Instructions
<br />Section references are to the Internal 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/ForinW9.
<br />What's New
<br />Line 3a has been modified to clarify 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. Otherwise, it
<br />should check the "LLC" box and enter its appropriate tax classification.
<br />Cal. No. 10231X
<br />Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 14 of 19
<br />New line 3b has been added to this form. A flow -through entity is
<br />required to complete this line to itldreate that it has direct or indirect
<br />foreign partners, owners, or beneflctarles when it provides the Form W-9
<br />to another flow -through nntity in wnich it has an ownership interest. This
<br />change is intended to provide a flow -through entity with information
<br />regarding the status of its Indirect foreign partners, owners, or
<br />beneficiaries, so that it can satisfy any applicable reporting
<br />requirements. For example. a partnership that has any Indirect foreign
<br />partners may be required to complete Schedules K•2 and K-3. See the
<br />Partnership Instructions for Schedules K-2 and K-3 fFomn 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 />Form W-9 (Rev. 3-2024)
<br />
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