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Fsse 3Fom W-9 {Rev. 3-?024)
<br />Certain payees and payments are exempt hom backup wilhhalriing'
<br />See Exernlr irayee code,-laier, and the separate lnstructions for the
<br />Requeoter of Form W-9 for more information.
<br />See als,o Fsfab/lsfting U.S. sfafus forputposet of chapter 3 and
<br />clwtet 4 r,vithhatding, euliet.
<br />What ls FATCA RePorting?
<br />The Foreign Account Tex Compliance Act {FATCA) requires a
<br />participating foreign financial instiluiion to report all U.S. ac€ount
<br />hotUerL *aiare specffied U.S. persons. Certain payees are exempt from
<br />FATCA reporting.'See ErenrpU6n fom FATCA repofting code. later' and
<br />th6 lnstru;tion$-for the Requester of Form W-9 for more in{ormation.
<br />Updating Your Information
<br />You must provide updated information to any peBon to whom you
<br />claimed to be an exempt payee if you are no lcnger an exempt payee
<br />anrl anti^ipela rmciuing rolnrtahto leymmtc in thc fi rh rm from lhis
<br />person. for examp{e, ybu may need td provide updated information if
<br />vou are a C corporation that elects to b€ an S corporation, or if you are
<br />io longer tax exempl ln addition, you must fumish a new Form W-9 if
<br />the nale or TIN changes for the aicount, for example. if the grantor ol a
<br />grantor trust dies.
<br />Penalties
<br />Failure to funrish TlN. lf you fail to fumish your conect TIN to a
<br />requester, you are subject to a penalty of $50 for each such..fuilure
<br />unless youi fail.tre is dle to reasonable cause and not to willful neglect'
<br />Civil nenaltv for false information with respect to withholding' lf you
<br />nrake a fal# statement lvith no reasonable bbsis that results in no
<br />backup vrilhholding, you are subject to a 5500 penalty.
<br />Crinrinal penahy for falsifying itrformalicn. Willfully lalsi{ying
<br />certifications or affirmationi may subiect you to criminal penafties
<br />including fi nes and/or imprisonment.
<br />Misuse of TlNs. lf the requester discloses or uses TlNs in violation of
<br />federal law, lhe requester may be subiecl to civil and criminal penalties'
<br />Specific lnstructions
<br />Line 1
<br />You must enter one of the following on this line; do not leave this line
<br />blank. The name should match the name on your lax retum.
<br />lf this Form Ui*9 is for a ioint account (other than an account
<br />maintained by a foreign financial instiMion {FFI}), list first. and then
<br />circle, the name of the p€Eon or entity whose number you entered in
<br />Parl I of Form W-9. H you are providing Form W-9 to an FFI to document
<br />a joint accounl each holder ol the accbunt that is a U.S. person musl
<br />provide a Form W-9.
<br />. hrdividual. Generally, enter the name shcwn on your tax return. lf you
<br />have changed your lait name withor:t informing lhe SocialSecurity
<br />AdministrJtion 1SSA) of the name change, enler your first name, the last
<br />name as shorvn on your social security card, and your new last name.
<br />Note for tTlN applicant: Enter your indlvidual name as it was entered
<br />on your Form W-7 application, line 1a This should also be ihe rame as
<br />the name you entered on the Form 10"to you filed wilh your application'
<br />. Sole proprietor. Enter your individual name as shown on your Form
<br />1 040 o; lin-e 1 - Enter youi busine€s, lrade, r:r "doing business as" (DBA)
<br />name on line 2-
<br />. Parlnershirr, C corporation, S corPolation, or LLG, other than a
<br />disregardetl entity, Enterthe enlity'd name as shown on the entity's lax
<br />refum on line 1 and any business, trade, or DBA name on line 2'
<br />. Other entities. Enter your name as shown on required U"S' federal tax
<br />documents on line 1. This name should match the name shown on the
<br />charter or other legal document creating the entity. Enter any business,
<br />trade. or DBA name on line 2.
<br />. Disregarrled entity. ln general, a businets entity.thaf has a eingle
<br />owner, including an LLC, anO is not a corporation, is disregarded as an
<br />entitv separate irom its owner (a disregarded entity). See Regulations
<br />sectibn iot .zzot -2(c)(2). A disregarded entity should check the
<br />aoorooriate box for thb tax classification of its owner. Enter the owneds
<br />nlin" bn line 1 , The name of the orvner entered on line I should never
<br />be a disreoarded entiW. The natne on line 1 should bs the name shown
<br />on ttr* in"6** tax retuh on which the income should be reported' For
<br />lF rhe en{tYilntllvldual oft llh€ 1
<br />isa(n| ...
<br />THEN ch+ck the b,}r lor
<br />r Corporation Corucration"
<br />. lndivkluai or
<br />r Ssle propristorsltip
<br />lndl4duaLrssie p{Oprietor.
<br />r LLC classified as a pathershiP
<br />for U.S, federal lax PUrPose€ or
<br />. LLC that has filed Form 8832 or
<br />?553 et€cting to be tsxed as a
<br />corporalion
<br />Limited fiabtity cornpanY and
<br />enter lh* appropriate tax
<br />elassificatiDn:
<br />P = Partrrership.
<br />C=0corporatio{r.or
<br />S = S corporation.
<br />. Parhership Partriasltip-
<br />. Trustlestate Trustiestate.
<br />examole. if a foreion LLC that is lr:ated a a dis'egard*d entity for U'S'
<br />fedet tar putpoG* has a srnEb owner the.t is a U'5- person. the U'S'
<br />or$nefs na;re is required to be prodd+d on lin'ra 1- l{ tie dirEct owner of
<br />the entity is also a disregrarded entilu' enter fie frr5t owner that is nol
<br />Aisregarled for federal tax trspcsei. Enier tfle distegarded entity's
<br />namJon line 2. lf tfie ownsof ttre disregar# e*t-ly is a foreignperson,
<br />tie onner must complete an approFrhte FDlTn U{-6 instead-ol a Form
<br />W-9. fhis is lhe cas,] e'ren 'f the forelgn person has a U.S- TIN'
<br />Line 2
<br />lf you have a business nafils. lnrJe nanre' DBA nsre, or disregarded
<br />entity name, enter it on lfue 2.
<br />Line 3a
<br />Check the appropriate box sn line 3a fc,r the [J-S" federal tax
<br />classificalion of tir. per*on whose flame is efi1er€d an line 1 ' Check only
<br />one box on line 3a.
<br />Line 3b
<br />Check this box if you are a partnership lincluding an LLC classjfied as a
<br />parfrership for U.'S" feaeral tax purposeGl" ttust" or estate that has any
<br />ioreign partners, owners, or beneficiaries. and 1"ou are providing this
<br />iom"to a oartnersftio, trilst. ,]t estate- k whiclr loU tiaue an ownership
<br />inteet. You must iheck the box on Une 3b if 3"sir receir€ a Form W€
<br />{or documentary evidenceJ frotr, any Partftef. owner' or beneficiary
<br />eslablishing foreign status or il you receive a Form W-g frotn any
<br />partner, ovjner, oi benefr:iary that has chetked the box on line 3b'
<br />Nate: A partne.ship that pror,'ides a Form Yd-B anrd checks box 3b may
<br />be requiied to cornplete Schedules K-? and K-3 {Form 1065}' For more
<br />information, s€e the Pattnerchip lnstn cticns for Schedulee K-2 and K-3
<br />(Form 1065i.
<br />H vou are teouired to complete line 3b but faittD do so. you may not
<br />receiJJtne intormation neceisarytc file a r*nec.l in{ormatieft retum wilh
<br />fhe IRS or fumish a csnect payee stalBff€nt to ]€ur Fiarbr*rs or
<br />benei:ciaries. See. for erample, se{{iofls 6699. 6.7?2, uld 6724 lor
<br />penafties that nray a$PlY.
<br />Line 4 Exemptions
<br />lf you are exempt &cfi] baakup wi*thlldng an:lror FATCA r€Forling,
<br />eril.s irr the appiotrxiate spacri on firw { arly eo"J*isl tiral illay appiy ts
<br />y0u.
<br />Exempt payee code'
<br />. Generally, indivirftrals {inctuding s'r{e prrupnetorsl are not exempt {rorn
<br />backup rvithholding.
<br />. Except as pmvided belol'r' corp'c'ratiofls are Firsrnpl ftom backuP
<br />withhaliing fix certain payrnents' inoludirq interes! and dt'idends-
<br />. Corrorations are not exe{nFt frgrn backup u*iihhddiftg for paym€ntg
<br />maae in setttement of paymeit card or third-party net'vcrk transaciions'
<br />. C{rporations are not exemPt {rtm bskup rvi{htrolc{ing with resPect ts
<br />attomeys' fees or groes proc6'eds paid to attornel'q and rorporutions
<br />rhat orovide med&i or treahh cari ser'rbe6 are nctt sxempt !'rith respect
<br />to piyments reportable ofl Fonn'[89&fu11ffi.
<br />The follor',,ing codes idenliflr p*ayeee {hat are *tempt lrom backup
<br />withhr:lding. Enter the appropriate cc'de in tlre space on flne 4'
<br />1-An organization exempt fronr tax under se-ction Soliaf , any IRA' or
<br />a custodiaiaccount ufld€r aection 403tb)tr1 lf the accc'unl satisfies the
<br />requirements of ssctior ao1 if1{2}-
<br />Kittitas County Agreement for Services (rev' 5/L4/251
<br />Page L6 of 22
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