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Fom W-9 {Rev.3-2024)Paoe 3
<br />C,ertain payees and payments ar€ exempt from backup withholding.
<br />See Exempt pyee code,laler, and the separate lnstructions for the
<br />Requester of Form W-9 for more information.
<br />See also Fstabrishing U"S. status for purposes of chapter 3 and
<br />chapter 4 withhdding. eadier.
<br />What ls FATCA Reporting?
<br />The Foreign Account Tax Compliance Act (FATCA) requires a
<br />parlieipating foreign financial institution to report all U.S. account
<br />holders that are specified U.S. persons. Ceriain payees are exempt ftom
<br />FATCA reporting. See Exemption from FATCA repofting code, later, and
<br />the Instructions for the Requester of Form W-9 for more informalion.
<br />Updating Your lnformation
<br />You must provide updated information to any person to whom you
<br />cloimod to bo nn oxompt poyoo if you aro no longor on oxompt payoo
<br />and anlicipale receiving reportabl€ paymenls in the futurc from lhis
<br />pereon. Fir example, ybu may need to provide updated information if
<br />you are a C corpcration that elects to be an S corporation, or if you are
<br />no longer tax exempt. ln addition, you must tumish a new Form W-g if
<br />the name or TIN changes for the account, for example, if the grantor of a
<br />gaantor trust dies.
<br />Penalties
<br />Failure to tumish TlN. ll you fail to fumish your conect TIN to a
<br />r€quesler, you are subject to a penalty of $50 for each such failure
<br />unless your failure is due to reasonable cauae and not to willlul neglect'
<br />Civil penalty for false information with respect to withholding. lf you
<br />make a false statement rvith no reasonable basig that resufts in no
<br />backup withholding, you are subject to a 5500 penalty.
<br />Criminal penafty for falsifying informalion. Willfully falsi{ying
<br />certificatjons or affirmations may subject you to criminal penalties
<br />including fi nes and/or imprisonment.
<br />Misuse of TlNs. ll the requester discloses or usas TlNs in violation of
<br />federal law, the requester may be subiect to civil and criminal penalties.
<br />Specific lnstructions
<br />Line'l
<br />You musl enler one of the following on this line; do not leave this line
<br />blank. The name should match the nams on ycur tax retum,
<br />lf this Form W-9 is for a joint account (other than an account
<br />maintained by a foreign financial institution {FFI}), list first. and then
<br />circle, the name cf the person or entity whose number you entered in
<br />Part I of Form W-9. if you are providing Form W-9 lo an FFI to document
<br />a ioint account, each holder of the qccounl that is a U.S. person must
<br />provide a Form W-9.
<br />. lndividual. Generally. enter the name shown on your tax retum. lf you
<br />have changed your last name wilhor.rt informing lhe Social Security
<br />Adminislration (SSAJ of tfre name change, enter your first name, the lasl
<br />name ae shown on your social security card, and your new last name.
<br />Note for MN applicant Enter your individual name as it was enlered
<br />on your Form W-7 application, line 'la. This should also be the same as
<br />the name you entered on the Form 1040 you filed with your application'
<br />. Sole proprietor, Enter your individual name as shown on your Form
<br />1040 on line 1, Enter your business, lrade, or "doing business as" (DBA)
<br />name on line 2.
<br />' Partnership, C corpcration, S corporation, or LLC, otherthan a
<br />disregardedentity. Enter the entity's name as shown on the enlity's tax
<br />retum on line 1 and any business, trade, or DBA name on line 2.
<br />r Other enlities. Enler your name as shown on required U.S. lederal tax
<br />documenls on line 1, This name should match the name shown on the
<br />charter or olher legal document creating the entity. Enler any business.
<br />trade, or DBA name on line 2.
<br />' Disregarded entity, ln general, a businese entity lhat has a single
<br />owner, including an LLC, and is not a corparation, is disregarded as an
<br />entity separate from its owner (a disregarded entity). See Regulations
<br />section 3o1 .7701 -2(c)(2). A disregarded entity should check the
<br />appropriate box for the tax classification of itg owner. Enter ihe owneds
<br />name on line l - 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 retum on which the income should be reported. For
<br />Kittitas County Agreement for Services (rev. 5/7a/251
<br />Page 16 of 20
<br />example, if a foreign LLG that is lreated as a dieregarded entity for U'S.
<br />feder.il tax purposes has a singb owner tlnt is a U-S. person. lhe U.S.
<br />owner's name is required ia be providied on line I ' ll tfte direct owner of
<br />lhe entity is also a disregarded enti'ty" enter lhe first ownet that is not
<br />dbregarded for {ederal tax p*poses. Enter the disregarded entity's
<br />name on fine 2. lf tfie owner ol the disregaded entity is a foreign person,
<br />lhe o!,yner mu6t complele an appropriate Fonn W-8 instead of a Form
<br />W-9. This is lhe case even if the foreign person has a U'S. TlN.
<br />Lins 2
<br />lf you have a business narne, lrade nam,e. DEIA name, cr disregarded
<br />entity name, enter it sn line 2"
<br />Line 3a
<br />Check the appropfiate box on line 3a for lhe U.S, lederal tax
<br />classificalion of lhe person r,'ihooe name is anlered an line 1. Check only
<br />one bax on line 3a.
<br />Line 3b
<br />Check thb box if you ale a partnership fincluding an LLC classifed as a
<br />partrrership for U.S- federal tax p.lrposesl, lrtnt, or estate thal has any
<br />foreign parlners. ownem, or beneficlaries, and you are providing this
<br />form to a partnerstrip, trust, ot €slale, in which you have an ownership
<br />interesl" You musl che€k the box on line 3b if you receive a Form W-8
<br />(or documentary evidence) lron any pa*ner, owner, or beneficiary
<br />eslablishing loreign status Dr i{ you receirre a Form W-g trom any
<br />partsler, owner, or bene{iciary tftat has checked lhe box on line 3b.
<br />Note: A partnership that provides a Folm W-9 and checks box 3b may
<br />be required to complete $chedulet K-2 and K-3 tForm
<br />.1065i. For more
<br />information, see lhe Parlnercftip lnstructions for Schedules K-2 and K-3
<br />(Form 10651.
<br />If you are required to comdete iine 3b btlt fail to do so, you may not
<br />receive the information necessary lo file a correcl information retum whh
<br />the IRS or fumish a conect Fayee statement to your partners or
<br />beneficiaries. See. for example, sections 6698, 6722, and 6724 lor
<br />penalties that may appty.
<br />Line 4 Exemplions
<br />lf you are exempt iiom backup wilhholding and/or FATCA reporting,
<br />eliter itt lle erpprul.xiate s;rawr orl litre 4 arry cod*{sf lftal rrray apply tt:
<br />you.
<br />Exempt payee code,
<br />. Generally, individuals {incfuding sole propietors} ara not exempt from
<br />backup rvithholding.
<br />. Except as provided belot'r, corporations are exempt from backup
<br />withholding for certain paynients, including interesl and dividends.
<br />. Corpomlions are ilot exempt frofiI backup withholding for paymeflte
<br />made in settlement of payffefit tard or third-party network transaclions.
<br />r Corporalions are not erernpt frorn backup whhholding wilh respect to
<br />attomeys'fees or gross proceeds paid to attomeys, and corporations
<br />thal provide medicel at health care s€rvices are not exempt with respect
<br />to payments repartable qn Form 1099-Ml$C.
<br />The {ollorring codes identrly paye€s that are exempt from backup
<br />wilhholding. Enter the appropriate code in the space on line 4.
<br />1 -An organization exempt from tax under seclion 501{af, any lRA, or
<br />a custodial account undet section 403{bxil il the accounl satisfies the
<br />requirements of section a01(fl{21.
<br />lF the enlity/individual on line I
<br />isa(n|...
<br />THEN check the box for
<br />o Corporation Carporation,
<br />. lndividual or
<br />. Sole proprietorsfiip
<br />lndividual/sole prcprietor
<br />. ILC classified as a partnership
<br />for U.S, fedenl tax purposes or
<br />. LLCftar has filed Form 8832 or
<br />2553 electing lo be laxed as a
<br />corporalion
<br />Limiled liability company and
<br />enter lhe appropriate lax
<br />clsification:
<br />P = Partnership,
<br />C=Ccorporalion.or
<br />S = S corporation.
<br />r Partnership Parlnership.
<br />o Trusl/estate Tru€tiestate"
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