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,",,n llll'9
<br />ATTACHMENT'E"
<br />Request for Taxpayer
<br />ldentlfication Number and Gertificatlon
<br />Go to r,vww.td.govlFormlll9lor ln8tructlons and tha latcst lnformallon'
<br />Glve form to the
<br />requester, Do not
<br />send to lho lRS.
<br />(,16v. M6rch 20?4)
<br />Dopflrlmont ot lho Tr€&ury
<br />lntomol Rovonuo Soruico
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<br />Enter your TIN ln th€ approprlate box. The TIN provlded must match tho name givon on lino 1 to avold
<br />backup wilhholding. For indlvlduals, thie is genernlly your socinl socurity numbor (SSN). l{owever, lor a
<br />rssldont allon, solo proprlotor, or dlsrogarded ontity, soo tho lnstructlon$ for Prrt I, laler. For olhot
<br />onlitlss, it lB your employer idenlilicatlon number (ElN). ll you do nol have a numb€r, s€e How lo 961a
<br />nN, later.
<br />Notc: ll the sccornrt is in moro than one namo, seo lho lnstruclions lor llno 1. Seo also What Namo and
<br />Numbor To Glva th6 Roquoslar for guldolinos on whoso number lo onlor,
<br />Slenalure ot
<br />U.g. pcrson Drto
<br />For rolalod to lh6 ol Form soo ol bolow.
<br />I Namo ol sntity/indlvlduol. An entry 18 requircd. {For a sole proprietor or disregarded ctrlity, ontor lhe owner's name on llno 1, and cntor lho businoss/dlsrogffdod
<br />entity's nams on lina 2.)
<br />2 Buslnos8 nmoldbrogardod onliiy namo, il difloront trom 8bov6.
<br />4 Exomptions (codos apply orly to
<br />cortnh enlltl€. nol indivlduals;
<br />sea lnslniclions on page 3):
<br />ExomDt paym codo (it Bny)
<br />€x€mptlon frorn Fo'oign Accounl Tax
<br />Complianco Act {rATCA) roportl4g
<br />codo (il try)
<br />(Appllss to accMnls mainlain$
<br />Nlsido tha UniIod Statos.)
<br />Requ€ster'a nflme end add.oss {opllonaD
<br />7 | ,sl nccq,nl nurnbe(El h€re (opliorat
<br />or
<br />Under ponaltles ot perjury, I certity that:
<br />'L The numbor shown on this form ls my correct taxpayor idonlifioation numbor (or I am waiting tor a nttmbor to bs issued to mo): and
<br />2. I Bm not subJect to backup wilhholding bocouso (o) I am oxompt from backup withholding, or (b) I havo nol b6on nolltiod by tho Intornnl Rovonuo
<br />Service (lRS) lhat I am subiect to backup withholding 6s a result ol a falluro to report all int€rest or dividends, or (c) tho IRS has nolilied tne that I am
<br />rro longer subi€cl to backup withholding; and
<br />3. I am a U.S. ciliz€n or oth€r U,S. pe€on {dofinod balow); and
<br />4. Th6 FATCA codo($) onto.6d on ihls form (if 6ny) lndicaling lhat I am oxampt from FATCA roporllng is correct.
<br />Corimcailon lnstruc-llons, You must cross out itom 2 abovo ll you havo boen nollliod by tho IRS that you aro curronlly 6ubje.l to backup withholdhg
<br />because you have tailed to roport all intorest and dividonds on your tax r6tum. For roal estate Itansaclions, itom 2 does nol apply. For mortgage interest paid,
<br />acquisition or abandonment of secured property, canc6llation of debt, contributions to an individual r6tir€menl anengsment (lRA), and, generally, psn€nts
<br />othsr than intorost and 8r€ not to lhe but mugt conoct TlN. Se€ lho instrucllons for Parl ll, later
<br />Sign
<br />Here
<br />General lnstructions
<br />Seclion relerences ar€ to lh€ lntenlal Rovenue Code unless othsrwlse
<br />notod.
<br />Futurg dov6lopmgnts. For lh6 lat€gt informalion about dovolopmonts
<br />16latgd lo Form W-g and lls instructlons, such ae l€glslatlon enacted
<br />atter they woro published, go to www.irs.govlFomw9,
<br />What's New
<br />Lino 3a has boon rnodilied to clarity how a disrogarded ontlty completss
<br />this lino. An LLC lhat ls a disregarded ontlty should chock lhe
<br />spproprlato box lor tho tax classlflcation of its ownor. Olhorwlso, lt
<br />should chsck lhe "LLC" box and en16r its appropri6t€ lax classlficatlon.
<br />Now line 3b has boon addod to this form. A tlow-lhrough €ntily i3
<br />requlred to compl€to this line lo indicale lhat il has direct or indiroct
<br />lorelgn partners, owners, or b€neliciarios when il provides lhe Fonn W-9
<br />to anothor {low-through ontity in which il hfls an ownershlp intorest' This
<br />chonga ls lntondod lo provldo a llow-through onlity with informatlon
<br />rogarding tho status ol it$ lndlroct forslgn partner$, owners, or
<br />bsnoliciarios, so that it can salisly any appllcablo rsporting
<br />roqulrsmsrrts, For example, a partne6hlp that has any indirect {orelgn
<br />partners may be roqulrod to comploto Schodtllos K-2 and K'3. Sao lho
<br />Pdrtnorshlp lnsttuctions for Schedulos K-2 and K'3 (Form 1065).
<br />Purpose of Form
<br />An lndlvldual or onllty (Fonn W-9
<br />inlormation r€tum wilh lho IRS ls
<br />roquostor) who is roqulrod to lllo Bn
<br />glving you this torm b€cause lhey
<br />3a Chack lh6 approprlalo box ttr tedoml lex classrflcation of lh6 entilylndivrduel vhose name is cnlered on Ine L Chack
<br />only on. ol the lollowing fovgn boxo0.
<br />f] lndlviduavsoloproDrlotor I Ccorporatlon f] Scorporallon I Pdrtncrchig f] Ttusvostalo
<br />n LLC. Eutnr th" tax classlllcollon (C = C mrFnnlion, S = S corporatlon, P.. Parlnorshlp)
<br />Nol.: Chek tho "LLC" box abovo aad, ln lhe snlry spac6, enl€r ths appropriate code (C, S, ot P) lor lhe tu-
<br />classlflcellon ot lho LLC, unl6ss ll ls I disrogerdad dltlly. A disr60ardod onlily should lnsl€ad chsk lhe atproftlslg
<br />box fot tho ld clas8ilication ot iB ownor.
<br />n Oth$(s6o inrlruclions)
<br />3b ll on lino 3n you choched "Pdrtnorehip" or "Trusv8stat6," ot ctlockod "LLC" and sqteted "P'ss ils tu clossification,
<br />&nd you tr6 providlng this lom to R pa.tn€rship,1ru9t, or 6slnt€ in which you havo an ovJnership intersst, chtrk
<br />lhls box ll you have sny lorrlgn psrlnaF, own€'s, ot bonsticlarl€s, Ses inslruollons .
<br />5 Addmss (numb€., $tresl, dnd apt. or sult6 no.l. S€e lnstnrcllons.
<br />0 City, slat6, and ZIP coda
<br />ldenlificatlon NuPart I
<br />Part 1l
<br />Cal. No. 10231X
<br />Kittitas County Agreement for Services (rev.5/Ia/25)
<br />Page 14 of 19
<br />rorm W-9 {nov. e-eotc}
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