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<br />Certain payees and payments are exemp! frorn baclap lvitlithdiding,
<br />See Eremptpayee code, laler, ard the separate lnstuctions for the
<br />Requesler of Form W-9 for more infannalicn.
<br />See also Fstat/islrling U"S. status forpurpoces afcftapterg and
<br />cfiqpler 4 witfrhddi4g, earlier.
<br />What ls FATGA Reporting?
<br />The Foreign Accornl Tax Compliance Acl {FATCA} teqdres a
<br />participating foreign fnancial institution lo report dil U.S. affount
<br />trolders that are speolfied U.S" persons. Cerlain payee* ae eramFt frmr
<br />FATGA. reporting. See F,ternpfion frorn FAICA repordfig code, later. and
<br />the lnsructiafls fior the Requesler of Form W-9 for more informalionr
<br />Updating Your lnformation
<br />You n:usl provide updated infiormation to any pe*i{rn t{}whom you
<br />clairned to be an exempt payee if you sre no lonq€r an erempt pa|lee
<br />and anticipale receiving ruportable payments in tie futxe foorn ttds
<br />person. For example, ybu may need lo provide updated information ifi
<br />you are a C corporation thal elecls to be an S corporalion" or ff you are
<br />no :onger lax €xempl ln addition, you musl fumish a nevi Form W-9 if
<br />lhs name orTlN changes for the accornt, for exanph. if lJhe gmntor of a
<br />gnntor lrust dies.
<br />Penalties
<br />Failure to fumish TlN. lf you iailtc fumish yourcor€ctTlN to a
<br />r€quesler, you are subject lo a penalty ol $5{} lor each ssrch fui}ure
<br />unless ycur lailure is due to reasonable cause and nol to willft-d neglect"
<br />Givil penalty for fulse information with respect to withholding. Ilf yottr
<br />make a fulse statemenl rvith nc reasonable basis *rat resllts in no
<br />backup withholding, 1lou are subject to a $500 pendty,
<br />Criminal penafty for lalsifying inlormalion. Wiltfully laHlying
<br />certifications or affinnations may subjecl you to criminal penaities
<br />including fi nes and/or imprisonment
<br />Misuse of TlNs. lf the requester discloses or uses TtNs itr lriolation of
<br />lederal law. the requ€ste. may be subiecl to ciuil and crimirnd penal{ies.
<br />Specilic lnstructions
<br />Line 1
<br />You musl enler one of the following on this line; do not leave ltris line
<br />blank" The name sftould match the name on your tax reftjnr"
<br />lf lhis Farm W-9 is for a joint account {olhe: than an account
<br />maintained by a foreign financial inslihrtion {FFt}}, list frrsl. and &en
<br />circle, the name af the person or entity whose rnumfueryour enlwed in
<br />Part I of Form W-9. lf you are providing Forrn W-9 to an FFI tD document
<br />a loint accounl each holder of the acc-ount lhat is a U-S. person mud
<br />pruvide a Farm W-9.
<br />. lndividual. Generally, enter the name shown on yaw tax rsftJl'n- [f ytHrl
<br />have changed lour last name witftout infonning ttte Sochl Securitty
<br />Adminislration {SSA) ol the name change, enter your first name" lfrte lmt
<br />name as shown on lour social security card, ard your ne*l last natne-
<br />Note lar lTlN applicant Enter ycur indiuidual name as it wa€ eritered
<br />on your Form W-7 applbation, line 1a. This sho.uld also be lhe same a:
<br />lhe name 1ou entered on tft* Form 1040 you filed witfrt yuur ap$icatiorn"
<br />' Sole proprietor, Enler your individuaf name as atlstln on yaur furrn
<br />184-S on line 1, Enter your business, trade, cr "dbing business as" [lEAi
<br />name on line 2.
<br />r Partrrership, c corporfrtion, S corporalion. or LLG. ollpr than a
<br />disregarded entity, Enter the enlity's name as shot'*n on lhe €ntit!'s tax
<br />retum on line 1 and any business, trade ar DBA name orn line 2.
<br />. Olher entities. Enler your narne as shown on required U"$" ledhral tax
<br />docurnenls on line 1. This name shauld match the narne shown sn tha
<br />charter cr olher legal documenl creating the entity- Enter any busiress..
<br />trade, or DBA name on line 2.
<br />. Disregarded entity. ln general, a bssiness entity lhat has a singfe
<br />owner, including an LLC, and is not a corporation. is dsregprded m an
<br />entity separate from its ownar [a disregarded entity]. See Reguhiors
<br />s€ction 3O1 .7701 -2{c}{2f. A disregarded entity should chec* lhe
<br />appropriate box for lhe lax classification ol its ownet,. Enter the owner's
<br />name on line 1, The name of the owner entered on llne 1 should newr
<br />be a disregarded entity. The name on line 1 should be tie narne slmwn
<br />on lhe income tax retum on rrhich lhe lncorne should be reported. Fo*
<br />Kittitas County Agreement for Services (rev. 5/74/251
<br />Page tG of 22
<br />erande, if a foreim LLC that is trealed as a disreEarded eniitl for U.S.
<br />tederat tar purposes has a sirqle owna tlnt is a t-i.S. persorq Oe U.S.
<br />o'.'r:er's nane is required ro be provided on lirp 1. ]f tlre direr-t ounet of
<br />ttre, enlity b abo a drsregarded entty. enterlhe first o'wris tlat b nct
<br />dwegaded lor fuderal tax ptlrpos€s. Enter lhe dsregaded enti!/s
<br />nsne onr llne ?. lf the owner olthe dsregaded entity is a furdgrn pmoq
<br />th* o.rnat nrust completq an 3pp!'opdiate Form lS-8 irnted of a Form
<br />It-9, This is the cae euen if the loreign person has a U.S- Tlil"
<br />Une 2
<br />lf gou have a businss name. lrade natne. EBrl narTe. ct' discgnrded
<br />el:tit!'nam€, enter it on line 2"
<br />Line 3a
<br />Ctmlt $e apprcpriate box on line 3a for the U.5" lederal ta:t
<br />d*afibatkn of the person rvhoe natn€ b e{rtersd on line' 1" Cfiree*t ady
<br />one box on $ine 3a
<br />Une 3b
<br />Chec* this box if you are a partnershir [iincfutfng an LLC chssified as a
<br />parBrerslrip for U.S, fuderal tax pu.pm€s!" trust* or estate lhat has ilty
<br />lorcign padn€rs. owners. orbeneficiqies, and you are ptoui&lg $tis
<br />{own t6 a partnership, trusE 6r eslala in which yolt have an ownerstrip
<br />iffierEst- You rnust ctreck lhe hox on h.re 3b r you receive a Fotm tfd-g
<br />{or dscumentary evidencel fronr any partner, owner" or benefiikry
<br />eetablistring loreigF stalus or if you reeeiue a Fonn W-9 frarn any
<br />parber, swner, or benefciary that has chscked the b,ox on iine 3b.
<br />Note: A partnership ltrat p,rouides a Fonn 1S-9 and chechs box sh may
<br />be e4nred ro conplete $cheddw K-2 and K€ lForm 10651.. FDr mo{e
<br />ilnforrmatipn, see lhe Paflnership lnstructirns fon Schedies K-Z and K-i
<br />{Form 1065i.
<br />lf you are required tc comSele lin* 3b but {ait to do so, ysil rTEy tlot
<br />neceirre the info*rrration reeessaty lo frle a cqnect infonnation rehtrn wifi
<br />the lFtS or furnish a c(Nreci payee statefi€rit to lqur p.arblers or
<br />herneficiaris, $ee. fr exarn$g s€ctions 669s" 6122' and 6?24 for
<br />penafties fhd rnay apply.
<br />Une 4 Exemplions
<br />ff you a.e exempt frorn backup wilhhrrldng and.for FATCA rryrling,
<br />eri|er in tlre appiopriate spuc+ un lire .t arry cctiu{s} llrat rluy a1tFly tu
<br />$€u..
<br />Exenpt peyee code.
<br />. Gensally. indir,ridtrais {incfuding sole proprietors} are not ex€mpt frtrifln
<br />hockrry '.'ritlfiddng.. b(c€pt as prqvidhd betow, corporalioris are exernpt ftom baclaup
<br />u*irthhoHing for cerrtain payrnents, includt€ intetest and dntitdends-
<br />r Corporations are not exempt lrum backup *itt'thotdrq fur Faltn€nts
<br />nnade ira setdement ol payment card or ttfrd-party netuedk trmsaclirns.
<br />. Corporations ale nst exempt lrorn backup wittthotdng rrith respect to
<br />attomeys'fees or gross proceeds paid to attoffre}ts, and corpqratims
<br />tlrat provide rrnedcal or heallh care ser*bes are not exempt with tsPect
<br />lo, payments reporiahte on Forrn !fit9{lIl5C.
<br />Tlne followling codes idenli$ payees tlut ane exernpl from, backup
<br />wiillirholding. Enterthe appropriate code in tlr+ space on linrc 4.
<br />tr -An organization exempt from tax arnder seetion 5oltal, arry lRA. ot'
<br />a cqstodial $count under secticn 403{Wxl i{ t}F actounl satisfies tfre
<br />nequirennenls of section a.01 fil{zi.
<br />lF l}re entityAnditddual on line I
<br />isa(n|...
<br />TIIEN check the box lor
<br />o Corporatton Corporation-
<br />* lndlvilusl o.
<br />. Sole proprietorship
<br />tndviruelf*ofe Foprietor"
<br />. LLC clmsilied as apartnerdfp
<br />fo. t r.S, iederai tax purposes or
<br />. LLC lhathas filed Form8832 or
<br />2553 d€cting ro be taxed as a
<br />conporation
<br />Limked fiabitily conpany and
<br />eriter rte +propdate rEX
<br />dassifrcation:
<br />P = Parbership,
<br />C=GcorFomliofl.otr
<br />S = S corpcration.
<br />. Partnemltp Partrteship,
<br />Trlrsl'estate Trusbrestate,
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