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Fom W-9 lRev.3-2024)Page 3
<br />Cerlain payees and payments are exempt from backup withholding.
<br />See Fxem!l layee code,'later, and the separate lnsttuctions for the
<br />Requester of Form W-9 for more infomtation,
<br />See also Fstab/lshing U.S. status for purposes of ehapter 3 and
<br />chepter 4 withhdding, eaflier.
<br />What ls FATCA Reporting?
<br />The Foreign Account Tax Compliance Ac1{FATCA} requires a
<br />parlicipating foreign financial institution to r€port all U.S. account
<br />holders thai are specified U.S. persons. Certain payees are exempt from
<br />FATCA reporting.'See Evemptiirn from FATCA repofting code,later, and
<br />the lnstruclions for the Requesler of Form W-9 for more information.
<br />Updating Your lnformation
<br />You musl provide updated information to any person to whom you
<br />claimed to be an exempt payee if you are no longer an exempt payee
<br />and anticipate receiving reportable pavments in the future from thin
<br />peeon. F6r example, ybu may need to provide updated information if
<br />you are a C corporalion that elects to be an S corporation, or if you are
<br />ho longer tax exempt. ln addition, you musl fumish a new Form W-g if
<br />the naire or TIN chinges for lhe account, for example, if lhe grantor ol a
<br />grantor lrust dies.
<br />Penalties
<br />Failure to firmish TlN. lf you fail to fumish your correct TIN to a
<br />requester, you are subiect to a penalty of $50 for each such failure
<br />unl-ess youi failure is due to reasonable cause and nol to will{ul neglect.
<br />Civil penalty lor false information wilh respect to withholding' lf you
<br />make a false statement with no reasonable basis that results ln no
<br />backup withholding, you are subject to a $500 p€nalty-
<br />Criminal penalty for falsifying inforrnation. Willfully falsifying
<br />certifications or affirmatians may subject you to criminal penalties
<br />including fi nes and/or imprisonment.
<br />Misuse of TlNs. ll the requester discloses or uses TlNs in violation of
<br />{ederal law, lhe requester may be subiect to civil arrd criminal penalties-
<br />Specific lnstructions
<br />Line I
<br />You must enter one of the following on this line; do not leave this line
<br />blank. The name sftotlld match the name on your tax letum.
<br />lf this Form W-9 is for a ioint account (other than an account
<br />maintained by a foreign financial institution (FFl)), list firsl, and then
<br />circle, the name of the person or entity whose nutnber you entered in
<br />Part I cf Form W-9. lf you are providing Form W-9 1o an FFI lo document
<br />a ioint account, each holder of the account that is a U.S. person must
<br />provide a Form W-9,
<br />. hrdividual. Generally, enter the name shown on your tax retum. lf you
<br />have changed your last name without informing lhe Social Security
<br />Administrition (SSA) ol the name change, enter your first name, the lasl
<br />name as showd on your social security card. and your new last name.
<br />Note for lTlN applicant Enter your individual name as it was entered
<br />on your Form W-7 application, tine 1a. This should also be the same as
<br />lhe name you entered on the Form .1040 you filed with your application.
<br />. Sole proprietor, Enter your individual name as shown otr your Form
<br />'l 04o on line 1. Enter your business, trade, or "doing business as" (DBA)
<br />name on line 2,
<br />. Partnership. C corporation, S corporatiolr, or LLC, otherthan a
<br />disregarded'entity. Enter ths entily's name as shown on the entity's tax
<br />retunion line 1 and any business, trade, or DBA name on line 2.
<br />o Other entities, Enler 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 olher legal document creating the entity. Enter any business,
<br />trade, or DBA nam6 on line 2.
<br />. Disregarded entity. ln general, a business entity that has a single
<br />owner, including an LLC, and is not a corporation, is disregarded as an
<br />entity separate ftom its owner {a disregarded entity)' See Regulations
<br />section io1.zzo1-2{cJ(2). A disregarded entity should check the
<br />appropriate box Jor the lax class;fication of its owner. Enter the owner's
<br />nime on line .l
<br />- The name of lhe owner entered on lir.re 1 should never
<br />be a disregarded entity. The narne on line 1 should be the name shown
<br />on the incime tax retrim on rvhich the income should be reported. For
<br />THEN check the box lcrlF the entity/individual on line I
<br />isa{n)...
<br />. Corparation Corporation.
<br />. lndividuat or
<br />. Sole proprietorship
<br />lndividual/sole proprietor
<br />. LLC classilied as a pannership
<br />for U.S. federal tax purpo3es o{
<br />. LLC that has iled Fo,m 4832 or
<br />2553 electing to be taxed as a
<br />corporalion
<br />Limiled liability company and
<br />enler the eppropriate tax
<br />classification:
<br />P = Partnership,
<br />C=Ccorpcralion,or
<br />S = S corporation.
<br />. Par-brership Partnership.
<br />Trusuestate TrusUestale,
<br />examole. if a foreiqn LLC that is lreated as a divegarded entity lor U'S.
<br />federal tax purpos-es has a singt€ owner that is a U.S person, the U.S.
<br />owner's narne is raquired to be provided on line 1' ll the direct owner oi
<br />the entiiy is a,so a disregarded enthy, enter lhe first ownet that is not
<br />disregaried for federal tax pul'poses. Enler the disregarded entity's
<br />name on fine 2. lf the owner cJ the disregarded entily is a foreign person,
<br />lhe owner must complete an appropriate Form W-a instead 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 business narne, lJade nane. DBA name, or disregaded
<br />entity name, enter it on line 2"
<br />Line 3a
<br />Check the appropriate bcx on line 3a for lhe U.S. federal tax
<br />classification bf lhe pe{Eon who$e flame is enlered on line 1. Check only
<br />one box on line 3a.
<br />Line 3b
<br />Check this box if you are a partnersh:p {including an LLC classified as a
<br />partnership for U.S- federal tax pu.poses). Itust, or eslate that has any
<br />ioreign partners, ownem, or beneficiaries, and you are providing this
<br />formlo b partnership, trust, or eslale, in which you have an ownership
<br />interest. You musl iheck th€ box on line 3b if you receive a Form W-8
<br />(or documentary evidence) lrom any partner, owner, or beneliciary
<br />istablishing foreign slalus or if you rcceiue a Farm W'9 from any
<br />parher, owner, or beneficiary tfiat has chesked the box on line 3b.
<br />Note: A parln€rship that Prolides a Form W-9 and checks box 3b may
<br />be required to complete Schedul* K-2 and K-3 {Form 1065}. For more
<br />information, see lhe Parlnersftip lnstructions for Schedules K-2 and K-3
<br />(Form 1065).
<br />l{ you are required to complele lineSb but {ail to d-o so, you may nol",.
<br />receive lhe information nece'ssary to file a ccrrect information refum wilh
<br />the IRS or fumish a corect payee statement to your parhers or
<br />beneficiaries. See. for example, seclions 6699, 6722' and 6724 lor
<br />penalties that may apply.
<br />Line 4 Exemptions
<br />lf you are exempt lrom backup whhholding and/or FATCA reporting,
<br />eril.er irr tlre appiupriate spaue $rt l;t!e 4 arry co<Jds] lllai tllay apply lo
<br />you-
<br />Exempt payee code.
<br />o Generally, individuals {including sole proptietors) are not exempt lrom
<br />backup withholding.
<br />. Except as provided belcq'" co{pclations are exempl f(om backup
<br />withholiiing for ceriain payments, including interest and dividends-
<br />. Corporations are not €xempt frsm backup whhholding for payments
<br />made in settlement of paymeilt card or third-pa$y nelwotk transaclions.
<br />r Corporalions are not exernpt {rom backup withholding wilh respecl io
<br />attomeys' fees or gross proceeds paid to attorneys, and corporations
<br />that provide rned;cal or health care services are noi exempt with respect
<br />to payment6 reportatlle on Form .1S99-MISG'
<br />The following codes idenli{y payees that are exempi from backup
<br />withholding" Enter tha appropriate code in the space on line 4.
<br />1 -An organization exempl from tar unde{ section 501[a], any IRA' or
<br />a custodiai account unde{ seclion 403tb){4 il the actount satisfies the
<br />requirements of section 4S1 {t){2}.
<br />Kittitas County Agreement for Services (rev. 5/7a/25)
<br />Page 18 of 21
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