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Form W-9 (nev. 3-2024)Page 3
<br />Certain payees and payments are exempt from backup wilhholdirq.
<br />See Exernptpayee code, later, and the separate lnstructions forlhe
<br />Requester of Form W-9 for more information.
<br />See also Esfab/ishrng U.S. status for purpses of chapter 3 and
<br />chaptet 4 withhdding, eadier.
<br />What ls FATGA Reporting?
<br />The Foreign Account Tax Compliance Act (FATCA) requires a
<br />participating foreign financial inslitution to report all U.S. account
<br />holders that are specified U.S. persons. Certain payees are ex€mpt from
<br />FATCA reporting . See Exempt-an from FATCA repiling cde.later, and
<br />lhe lnstructione for ihe Requesler of Form W-9 for more information.
<br />Updating Your lnformation
<br />You must provide updated informalion to any pereon lo whom you
<br />claimed to be an exempt payee if you are no longer an exempi payee
<br />and anticipate receivinq reportable paymenb in the tuturs from this
<br />person. For example, you may need to provide updated information if
<br />you are a C corporaiion that elecls lo be an S corporalion, or if you are
<br />no long€r tax exempt. ln adclition, you must fumish a new Form W-9 if
<br />the name or TIN changes for lhe account, for example, if lhe gmntor ol a
<br />grantor trust dies.
<br />Penalties
<br />Failure to fumigh TlN. lf you bil to fumish yorr correct TIN to a
<br />requester, you ar€ subiect to a penalty ol $5O for each such fuilure
<br />unless your failure is due to reasonable cause ard not to wi[ful neglect.
<br />Civil penalty for lalse informalion with respect to withholding. lf you
<br />make a false statemenl with no reasonabls basis that resuhs in no
<br />backup withholding, you are su$ect to a $5ffi pana$.
<br />Criminal penahy for fahifying information. Wiltfully lalsifying
<br />certificalions or afftrmations may subiect you to criminal pernlties
<br />including fi nes and/or imprisonmenl
<br />Misuee of TlNs. lf the requester discloses or uses TlNs in violation of
<br />lederal law, the requester may be subjecl to civil and criminal penelties.
<br />Specific lnstructions
<br />Line I
<br />You must enl€r one of iha following on this line; do not leave this line
<br />blank. The name should match the name on your tax relum.
<br />lf this Form W-9 ia for a ioint account (othor than an account
<br />maintained by a foreign financial institution (FFt[. liet firut, and then
<br />circle, the name of the person or entity whose number you entered in
<br />Part I of Form W-9. lf you are providing Fom W-g to an FFI to document
<br />a ioint account, each holder of ths account that is a U.S. person muet
<br />provide a Form W-9.
<br />. lndividual, Generally, ent€r tho name shown on your tax retum, lf you
<br />have changed your last name without informing lhe Social Security
<br />Administration (SSA) ol $e name change, €nter your firsl name, lhe last
<br />name as shown on your social security card, and your new last name.
<br />Nole for lTlN applicant: Enter your individual narne as it was entered
<br />on your Form W-7 application, line 1a. This should also be lhe same as
<br />the name you entered on the Form 10lt() you filed with your applicalion.
<br />. Sole proprietor. Enter your individual name as shown on your Form
<br />1040 on line 1. Enter your business" trade, or "doing brniness as" (DBA)
<br />name on line 2.
<br />. Partnership, C corporation, S corporation, or LLG, other than a
<br />disregarded entity. Enterihe entity's name as shown on ihe entity's tax
<br />rstum on line 1 and any business, trads. or DBA narne on line 2.
<br />o Other entities. Enter your name as slrown on reguired U.S. federal tax
<br />documenls on line 1. This name should malch the name shown on the
<br />charler or other legal document creating the entity. Enter any business.
<br />trade, or DBA name on line 2.
<br />. Disregarded entity. ln general, a txrsiness enthy lhat has a single
<br />owner, including an LLC, and is not a corporation, is disregarded as an
<br />entity s€parale from iis owner (a disregarded entity). See Fegulations
<br />sectfon 301.7701-2(cl(21. A disregarded entity should check the
<br />appropriate box for the tax classification of its owner. Enter the owner's
<br />nam€ on line 1. The name of lhe owner enlered on line 1 should never
<br />be a disregarded entily. The name on line 1 should bc lha name shown
<br />on the income tax retum on which the income should be reported. For
<br />Kittitas County Agreement for Services (rev.5lM/25)
<br />Page 15 of 19
<br />example, if a foreign LLC that is lreated as a divegarded entity lor U.S.
<br />federal tax purposes has a single owner that is a U.S. persofl, the U.S.
<br />ownels narne is required to be provided on line 1. ll the direct owner of
<br />the entity is also a disregarded entity, enter lhe lirst owner that is not
<br />disregarded for federal tax purposes. Enler lhe disregarded entity's
<br />name on fine 2. lt the owner of the disregarded entity is a foreign person.
<br />the owner must complete an appropriate Form W-8 irstead of a Form
<br />W-9. This is the case even if the foreign person has a U.S. TlN.
<br />Line 2
<br />lf you have a businees narne, lrade name, DBA name, or dbregarded
<br />entity nam€, enter it on line 2.
<br />Line 3a
<br />Check the appropriate box on line 3a for lhe U.S. federal tax
<br />classification of the pereon lvhos€ name is entered on line 1. Check only
<br />one box on line 3a.
<br />Line 3b
<br />Check thb box il you are a partnership (including an LLG classified as a
<br />partnership for U.S. lederal tax purposes), trust, or estate that has any
<br />foreign partners, owners, or beneficiaries, and you are providing this
<br />form lo a partnership. trust, or estate, in which you have an ownership
<br />interest, You must check the box on line 3b if you receive a Form W-8
<br />(or documentary evidence) from any partner, owner, or beneliciary
<br />establishing foreign stalus or if you receive a Form W-g lrom any
<br />partner, own€r, or beneficiary thal has checked the box on line 3b.
<br />Note: A parlnership that provides a Form W-9 and checks box 3b may
<br />be reguired lo complele Schedulee K-2 and K-3 (Form 1065). For more
<br />information, see the Parlnerghip lnstructions for Scheduleg K-2 and K-3
<br />(Form 1065).
<br />ll you are required lo complete line 3b but fail to do go, you may nol
<br />receive the information necessary to file a correcl informalion retum with
<br />the IRS or fumish a conect payee statement lo your partn€rs or
<br />beneficiaries. See, for example, BectionB 6898, 6722, and6724 fo(
<br />penalties that may apply.
<br />Line 4 Exemptions
<br />lf you are exempt from backup withholding and/or FATCA reporting,
<br />enter in the appropriate space on line 4 any code(s) that may apply to
<br />you.
<br />Exempt payee code.
<br />. Generally, individuals {including sole proprietors) are not exempt from
<br />backup whhholding.
<br />. Except as provided below, corporations are exempt from backup
<br />wilhholding for certain paymenG, including interest and dividends.
<br />. Corporations are not exempl trom backup withholding for payments
<br />made in settlenrent of payment card or third-party network transaclions.
<br />. Corporations are not exempt trom backup withholding with retpect lo
<br />attomeys'lees or gross proceeds paid to attomeys, and corporations
<br />thal provide medical or health care s€ruices are not exempl with respect
<br />to payments reportable on Form 1099-M|SC.
<br />The following codes identify payoes that are exempt from backup
<br />withholding. Enter the appropriate code in the space on line 4.
<br />'l -An organization exempt from tax under section 501(a), any lRA, or
<br />a custodial account under seciion 403(bX7) if tbe account satisfies the
<br />requirements of sec'tion ao1(0{2).
<br />lF lhu untily/irrtlivirlual urr lhrc I
<br />is a(n) ...
<br />THEN chcch lhe bue lur , . ,
<br />r Corporation Corporation.
<br />o lndividual or
<br />. Sole proprietorship
<br />lndividual/sole proprielor.
<br />. LLG classified as a partnership
<br />for U.S. lederal tax purposes or
<br />o LLC that has filed Form 8€$2 or
<br />2553 electing to be taxed as a
<br />corporation
<br />Limfted fi ability company
<br />enter the appropriate tax
<br />classification:
<br />P = Partnership,
<br />C-Ccorporation,or
<br />S = S corpontion.
<br />and
<br />. Parhership Partnership.
<br />o TrusVestate TrusUestate.
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