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.',,' llU'9
<br />ATTACHMENT'E"
<br />Request for Taxpayer
<br />ldentification Number and Gertification
<br />Co lo www.lts.govlFormwg lot instrucllons and th€ lat68t lntormauon.
<br />Givo form to th€
<br />rsquestgr. Do not
<br />gend to the lRS.
<br />(Hav, March 20?4)
<br />Dopartmdrl ot lhs lromury
<br />lntomal Rovonuo Sorulco
<br />Bofora For rolalod to lh6 of Forrn W-9, see of Form, bolow.
<br />t Namo ot entity/lndividual. An enlry is required. {Fo( a solo proprietor or disrogarded eolity, onter tho ovner's nam on lire 1. and enlar tho busine$s/disreqardcd
<br />entity'e omo on 2.1
<br />n LC
<br />2 9usln6s nmo. il ditloront arom
<br />4 Exomptions (codos
<br />cortain enlities. not
<br />apply mly lo
<br />indivlduals:
<br />s* inslnrctons on pag€ 3):
<br />Cesr,rut palw codu {il trtr)
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<br />oodo
<br />o
<br />olEo.o>E
<br />oca6
<br />o. .Q
<br />0oo.tt,
<br />ooa
<br />Exsnpllon |tom
<br />Complinnc6 Act
<br />cod6 (if sy)
<br />Forcign Account T6x
<br />{FATCA) reporlirc
<br />(Applias lo accounas mainlainod
<br />Ntsido lhs united st8t8.)
<br />Requ€sler's name and ad.lro$s (optlonal
<br />? I sl accounl harg (oplronai)
<br />Enl€r your TIN in the appropriate box, The TIN provided must rnatch ihe narn€ given on lin6 1 to avoid
<br />backup withholding. For individuals, this is genorally your social security numb€r (SSN). Howevor, for a
<br />resident alien, sole propaietor, or disregarded entity. see th6 instructions for Parl l, laler. For other
<br />entilies, it ls your employer identification nurnber (ElN|. ll you do not have a nurnber, see How to get a
<br />IrN, later.
<br />Noto: lf the account is in more than one name. see tho instrucliolrs for line 1, Seo also What Name and
<br />Number To Aive lho Raquesler for guidelines on whoso ntrmber to enter'
<br />Certitication
<br />Under p€nalties of perjury, I certity that:
<br />l. Th€ number shown on thrs form is my correct taxpayer rdontification number (or I am lvaiting for a ntlmber to be issued to mo); and
<br />2. I am not subject to backup withholding becauso (a) | am oxempt from backup wilhholding, or (b) I havo not been nolified by the tnternal Revenue
<br />Service (lRS) that I am subiect to backup withholding as a result of a tailure to report all interest or dividends, or (c) the IRS has notilied me lhat I arn
<br />r1o longer subject to backup withholding; and
<br />3. I am a U.S. cilizen or other U.S. person (dofinod below); and
<br />4. Tho FATCA code(s) entorod on this fonn (if any) indicating thal I am oxernpt from FATCA reporting is correct.
<br />Cortlflcatlon instruc,tions. You rnust cross out itetn 2 abovo if you havo bocn nolilied by lho IRS that you arc ctrrently subiect to baekup withholding
<br />becauss you hav€ failed to reporl all intsrest and dividonds on your tax return. For real ostato transactions, itern 2 does not apply. For mortgage interest paid,
<br />cancellation ol debt. contributions to an individual retiroment anangsment (lRA), and, generally, paymsnts
<br />othor than intersst and aro not lhe but musi correct TlN. Seo tho instructions fot Part ll. latsr.
<br />Sign
<br />Here
<br />or
<br />acquisition or abandonment of secured property,
<br />General lnstructions
<br />Seclion references are lo lhe htle;nal Roverlue Code unless olhenvise
<br />noted.
<br />Future dovolopmonts. For the latost inlonnation about devolopmonts
<br />ralated to Forrn W-9 and its inslructions, such as legislation enscted
<br />atter thsy were published, go to r.vww.irs.govlFormw9,
<br />What's New
<br />Lino 3a has been modilied to clarity how a disregarded entity completes
<br />this line. An LLC that is a disregarded entity should check tho
<br />appropriato box for tho tax classification of rls owner. Othenvise, it
<br />should check the "LLC" box and enter its appropnate tax classitication.
<br />Dato
<br />Now lins 3b has been addod to this form. A flow-through snlity is
<br />required to cornpleta this lhle to indicat€ that it has direct or indiract
<br />loreign partners, owners, or betleficiaries when it provides the Fonn W-9
<br />to anolher flow-thtough ontity in which it has an ownetship intotest' This
<br />chango is intended to provido a flow-through entity with information
<br />rogarding th€ stdtus ot ils indiroct {oroign partnors, owners, or
<br />ben€ticiarios, so lhat it can satisfy any applicabl€ reporling
<br />requirements. For example, a partnership lhat has any indirect foreigrr
<br />partners may bo required to complote Schedulos K-2 and K-3' Soe thc
<br />Partnership lnstructions for Schedulos K-2 and K-3 (Form 1065).
<br />Purpose of Form
<br />An lndlvidual or entity (Fotm W-9 rsquester) who is rcquired to file an
<br />informalion retum wilh ths tRS is givhrg you this lottn b€cause thoy
<br />"16
<br />2u
<br />30 Chek th€ spt ropriato oox aor lgderal lax clagsrlicaioi ot lhe entilyrnd,vrdlal lvhos narno is sllersd on ln€ l. Chock
<br />oniy ono of ths followirlg sovoil boxo$.
<br />fl rndividuaysto proorietor I C corpomrion I S corporation n Pa'1ne6hlp f] Trosvestaio
<br />ilrar. antnr tno,ax clil$srllcatlor(u. ucorporatldn. S. scotpotalldn, P = Pflrthershlp) P
<br />Noto: Ch*k Itre 'LLC" t ox abov€ snd, in lhe enlry space, enl€r lh€ approprlalo cod€ (C. S, or P) tor tho lu
<br />cltrsification of tho LLC, unloss il is a {rissgardod srtity. A di$.og8rdod ofltity should ir8load cbek iho aDptoptiato
<br />box tor ?hs td clssilicntion ot its orvrot.
<br />n othw{winslructioos)
<br />3b It on lino 3s you chockod "Partro6hip" or "frusvoslato,' ot c|:&kod "LLC" md ontsed "P" as ils tu classification.
<br />and you il€ p.oviding tiis torf, lo a pMn€rship, lrust, or eslalo !n which you have an ov/narsnip rnlaresl, ch*k
<br />thb box ll you have eny lorolgn parlrleB, ov,n€6, or b€netrcltr€s. Soe;nstnicllons n
<br />w S u[t{1
<br />ild s\ritgol SeeAdd.6ss5 stl@t,spt.no.).(numb€.
<br />n E a
<br />aL0 0@
<br />I Crty.stalo- and ZIP codo
<br />ldentilication
<br />numb6r
<br />Part I
<br />2 t I
<br />Part ll
<br />Signatu.o ot
<br />U,S, por8on
<br />Cal. No. 10231X
<br />Kittitas County Agreement for Services (rev.5lL /25ll
<br />Page 14 of 20
<br />Fom W-9 (Rov.3"2024)
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