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ATTACHMENT'E"
<br />o.,,,,llU'9 Request fol TaxPaYer
<br />ldentification Number and Certification
<br />Go lo ww.its.govlFormYlg lor instructions and the lalest information'
<br />Give form to the
<br />requester. Do not
<br />sond to the lRS.ill€v. March 2924)
<br />fleparllnont o{ tlrs TPasury
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<br />Belore bsqln. For relaied to tho oi Form sBa of bsio}J.
<br />I Nsme ol entity'/ltdlvldual. r'ln entry i5 Gquired'
<br />F!l/'9 rama on 'ine 2 l
<br />iFor a sle proprielor or disregarded sitit'/. enter the o\,/ne/s .ame on li*e 1, and enter ih€ business/dlsreqsCed
<br />2 8u$i!i9$ namc/disroqa.dod olltity naFc, it diflsrentirem sbovc
<br />4 ExomFtions {codos aPPiY mlY to
<br />sertain entiti6, not individuals;
<br />9e ingttrlcli€as on Psge 3):
<br />Erulul pdyw rug, (ll .ltiy)
<br />Fxffiptlorr from itrolgr\ Acc@nt tax
<br />Comp'iancs Act iliATCAi r€porlifig
<br />cod6 (d uy)
<br />(Appli6s lo accetnL, tHifitainsd
<br />dtside ihr uniled stslos,)
<br />Feqr€sler's nsme itFd addFss (oplionai]
<br />7 L,st eo@nl nornber(si here {aphqral}
<br />Tax
<br />Ent€r yoor TIN in the approp.iate box. The TiFl Provided .nust match the naFe given on line 1 to avoid
<br />backup withholding.For individual8. ihrs is qenorally yotlr social security nilrnber (SSN)' llows'/er, for a
<br />re$id6nt ali€n, $ole Proprialor or dl$rugarded entity, $oe the inslrirction$ for Part l, lafor. For othot
<br />entitiBs, it is your amPloyer identitication nulnber (ElNi lf you do not have a ndrnbet, tea Haw to gel a ot
<br />lJ^,r. laier.
<br />Noto: lf the account is it.l morg than one :lame, 9ee the in8tnlctions for lilre '1. see also what Naft|e and
<br />Numbor To Qive the Requeslsr for glidollnes on whosa ntfitlor to m{tr-
<br />Under penatties of perjury, I csrtif'/ that:
<br />1 ,
<br />-rh€ number shown on this fom is my corract iilpaye. identification numbo' {ot I em waiting ior a number to D€ issued to me}; and
<br />2. I am noi subjeci to backuF withholding bocause {ar) I am exempa froa t}ackup leithhofding, or {b} I havo.ot b€en notified b'y ihe internfll Ret/anro
<br />seru'ce (lFlS) tha! I am subject ,. ou"riup *i*'noroing as a result ol a lailure to report ail inle.eet or divid€nds, of ic) the iRs ils$ rlotiJied rne that I ar)
<br />no ionger subiect to backup wiihholding; and
<br />3, I am a U.S. cilizen or other U S. person idefined bolow). ancl
<br />.1. Tho FATCA code(s)ontered on th;s forn 0f any) indicaling thal I am exempt from FATCA rQporting
<br />'5
<br />corrst'
<br />certmcafion imtr:rctbn3. You must closs out item ? above if you have been nolifled by the IRS lhat you are currently subject to backuP withholdhg
<br />b€cause you have tatlgd to teport all intorest and divid€nds on Your tax rsturil. For raal estale i.ratlsaclions' item 2 doss no{ apply. Fot mort?age ifllerast paid'
<br />acquisition or abandonm€nt of gecured property,canc€llation of dobt,contributions to an individuai
<br />othor inttr*t and dividonds.ara r€t io lhs carlifitaiion, but .nu6t
<br />$ign
<br />Here
<br />Signablrc ot
<br />U,S, pdson Date
<br />General lnstructions
<br />Section references ale to the lntemal llevellue Code unless otheruise
<br />noted.
<br />Future doveiopmants. For lhg :alesl infotrnal:on aboul dev€lopmenls
<br />rciated to Forrn W-g anrl its instructions' st,ch as legislatlon enacted
<br />atter they were published, ga lo vvww-irggovlFamw),
<br />What's New
<br />Lrne 3a has beeE mod|lied to clarity hovr' a dis'regarded eatity completes
<br />thrs lino. An LLC that is a disregarded entit, should chosk tho
<br />appropriate box for ihe lax claisification of lts ownel Othsr#ise' it
<br />sirorlit check the "LLc" bor and enter its approprate tax classification'
<br />Now line 3b has bson added to this fom. A flow-through enlily is
<br />required to eo{nplete this line lo indicale that,t has direet or indirect
<br />totLign pa.iners, ovtners, or beneticiaries whetr il provides the Fonn W-9
<br />io an"otner ttow-inrough enllty in which it has an own€rship intorest This
<br />ciranqe is intanOeU to'provide a flow-through enlity with lnfotrnation
<br />reoardrno lhd staius of 'ts lndirocl fo/oign padners, dwttors or
<br />oe-neficrides. so lhat it can sattsfv any applicablo reporting
<br />requiremants. For example, a partnorship that has any ndrrec-t ro'elgn
<br />onin"t" -oy ba required to complcte Schodules K-2 atrd K-3 Sse the
<br />Farrnonhip instruction* for Schcdules K-2 and K-3 {Forrn 1C65)'
<br />Purpose of Form
<br />An individual sr entity (Form W-9 requaeter) who i3 requited :o lile an
<br />ir'rforrnation return w;ih the IBS is giving you tllis lorm because they
<br />only ono of lho followrng 6ovar boxg
<br />n individuatsle propristor ! C c*poration ! S corporation fl Partrorshlo ! TnrsVostatc
<br />E LLc- Entct tha tor cldssili$llon 1C -' c {;orPomllon, 3 = S rorposlion' P = Pattntrship}
<br />Notc: chsk lh€ "LLc" frox abov€ ird, [r lhs entry space, enter the appropilale code (C' $' or P) lor ihe tax
<br />ctmstficalon ot th6 Lic, untasa ttiJa;ir8iugur,il'oiirtv. A dismgartoi emiry shoitd i6$t66.J chd:k li4 aopropfiJ{'
<br />bd lorthe tax classificalioa of ilg ownei-
<br />n Oth* {sq inAtructioil$}
<br />vhqse naile i$ srl€rsl on liris 1 - Chwk3a Ch&k lhe sopopriala box {or tfrleE{ l6x ciasslicalron o{ lhe flrlttyrnd;vidr4l
<br />classiication.ontqtdilid iu:ischeckadd''TruBv€teto,olit3blino0n3a"Pann€6h;P"checkedy0u chtrkints€i,an own6r5lpha!eostategwhichformlbiElatrust,Youparinsghip,ileed providingyou
<br />SeelFnellclarlos.:nEltitllonsofboxlhigparhgF,yot,arly lorelgn
<br />Add.ess (numbet, str4t, and Fpl. or suite no ).5 See inctruclions.
<br />6 City. stato, aod z,P code
<br />numbeaPart I
<br />Cfr iltoystaer.trncmionnumber
<br />Part ll
<br />Cal- No. 1tl231X
<br />Kittitas County Agreement for Services (rev.5/Ia/25')
<br />Page L4 of 22
<br />Fcrn lAf-9 lFcv. 3-202'll
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