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Form W-g {Rev,3-2024)Page 5
<br />Part ll. Certification
<br />To establish to the withholding agent ihat you are a U.S. per6on, or
<br />resident alien, sign Form W-9. You may be requested to sign by the
<br />withholding agent ev€n if item 1, 4, or 5 below indicates othsr'lvise.
<br />For a joint account, only ihe person whose TIN is shown in Part I
<br />should sign (when required). ln the caoe of a disregarded entily, the
<br />peroon identified on line 1 musl sign. Exempt payees, see Exempt payee
<br />code, earlier.
<br />Signature requirements. Complete the certitication ae indicated in
<br />itemsl through5below.
<br />l. lnterest, dividend, and barter exchange accounte opened
<br />belore 19&l and broker accounls considered active during l98il.
<br />You must give your correct TlN, but you do not have to sign the
<br />certification.
<br />2. lnteresl, dividend, broker, and bader exchange accounts
<br />opened after 198i1 and broker accounls considered inactive during
<br />l98l|. You must stgn the certficatlon or backup wthholding will apply. lf
<br />you are subject to backup withholding and you are merely providing
<br />your conect TIN to the rsquester, you must cross ont item 2 in the
<br />certification before signing lhe form.
<br />3, Real estate transactions. You must sign lhe cerlification. You may
<br />cross out item 2 ol the certiftcation.
<br />4. Ofher payments. You must give your conect TlN, but you do not
<br />have to sign the certification unless you have been notified that you
<br />have previously given an incorrect TlN. "Other payrnenlsn include
<br />payments made in the course ol lhe requester's tnde or business for
<br />renls, royallies, goods (other than bills for merchandiae), medical and
<br />heahh care services (including payrnents to corporations), paFnenls to
<br />a nonemployee for services, payments made in satdemeni of paymsnt
<br />card and third-party network transactions, paynenls to cartain fishing
<br />boat cr6w members and fishermen, and gross proceeds paid to
<br />attomayo {including paym€nte to corporalions).
<br />5, Mortgage interest paid by you, acquieition or abandonment of
<br />secured property, cancsllation of debt, qualified tuition program
<br />paymentC {under section 529), ABLE accounla (under eection 529A},
<br />lRA, Coverdell ESA, Archer MSA or FISA conlritrutions or
<br />dietributions, and peneion dislributione. You must give your conect
<br />TlN, but you do not have to sign the certification.
<br />What Name and Number To Give the Requester
<br />For thie of account:Give name and SSN of:
<br />1. lndividual
<br />2.Two or more individuals (ioint account)
<br />other lian an account maintained by
<br />an FFI
<br />3. Two or morc U.S. persons
<br />toint accoml maintained by an Ffi)
<br />4- Cuslodial accoml of a mins
<br />(Uniform G;ft to Minors Ac{)
<br />5- a. The usual revocable mvings kust
<br />{grantor is abo tustee}
<br />b. So-called tnBt acc&nt thst is not
<br />a legal s valid trust mder state lav,
<br />6. Solo proprietorship or disregarded
<br />eitity omed by il individual
<br />7. Granior bust filing rmder Optlrul
<br />Filing Method 1 {se Regulatiorrs
<br />section 1.671 -a{bX2XiXAD"
<br />The
<br />Kittitas County Agreement for Services (rev. 5/L4/25)
<br />Page 18 of 19
<br />For thig of accountl
<br />8, Digregarded enlity not owned by an
<br />individual
<br />9- A valid trugt, estai6, or ponsion lrwt
<br />10. Corporation or LLC ebcting corporate
<br />siatus on Form 8832 or Fo?m 2553
<br />t 1. Associalim. club, religior:e, chsitable,
<br />educalional, or other lax-exf,npl
<br />organizalion
<br />.t2. partnerghip or multi-member LLC
<br />13. A broker or registered nominee
<br />14. Account with the Department of
<br />Agriculture frr the name ol a public
<br />mlity {such as a state or local
<br />gowmrnent, school district. or prison)
<br />lhat receives agricultuml progrm
<br />DaYmenls
<br />15. Granlor irusl fling Form 1041 or
<br />wder lhe Optional Filing Melhod 2,
<br />requiring Form 1089 {s* Regulations
<br />section 1.67.1 -4{bXaHil{B}}"
<br />Give name and EIN of:
<br />The owner
<br />Legal entity{
<br />Tha corporation
<br />The organization
<br />The parhersfiip
<br />The broks or nominee
<br />Tle public entity
<br />The aetual owner of the sccount or.
<br />il combined funds, the firet individual
<br />on ttle accouoll
<br />Each holder ofthe account
<br />The minor2
<br />The grantor-lrust*r
<br />The actiral ownerl
<br />The owners
<br />The grantor'
<br />Th€ trus!
<br />1 Ust first and circle the name of lhe person whose number you fumish.
<br />lf only one person on a ioint account has an SSN, that person's number
<br />must be fumished.
<br />?Circle the minols name and fumish lhe minor's SSN,
<br />3You must show vour individual name on line 1. and enter vour business
<br />or DBA name. if a'ny. on line 2. You may use either your SSN or EIN (if
<br />you have one), but the IRS encourages you to use your SSN.
<br />{List first and circle the name of lhe 1ru6t, estale, or pension lrust. (Do
<br />not fumish the TIN of the personal r€presentative or trusles unl€se the
<br />legal entity itself is not designated in lhe account title.)
<br />'Nole: The grantor must also provide a Form W-9 to the trustee of lhe
<br />trust.
<br />" For more information on optional filing methods for granlor trusts, seg
<br />the lnstructions for Form 1041.
<br />Note: lf no name ie circled when more than ong name is listed, the
<br />number will be considered to be that of lhe first name listed.
<br />Secure Your Tax Records From ldentity Theft
<br />ldentity rheft occurs when som€on€ uses your pectonal informalion,
<br />such as your name, SSN, or other identifying information, without your
<br />permission to commit {raud or other crimes. An identity thief may use
<br />your SSN to get a iob or may file a tax r€turn using your SSN to receive
<br />a refund.
<br />To redwe your risk:
<br />r Protect your SSN,
<br />' Ensure your employer is protecting your SSN, and
<br />. Be careful when choosing a tax relum preparer.
<br />lf your tsx records are alfected by identity theft and you receive a
<br />notice lrom the lRS, respond right away to the name and phone number
<br />printed on the IRS notice or letter.
<br />lf your tax records are not cunenlly affected by identity theft but you
<br />think you are at risk due to a losl or stolen purse or wallet, questionable
<br />credit card activity, or a queslionable credit report, contact the IRS
<br />ldentity Theft Hotline al 800-90&449O or submit Form '14O39.
<br />For more information. see Pub. 5027, ldentity Theft lnlormalion for
<br />Taxpayers.
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