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Form W-9 (Rev. 3-2024)Pss* 5
<br />Part ll. Certification
<br />TD establish to the wilhholding agent lhat you are a U.S. person. or
<br />resident alien, sign Form W-9. You may be requesled to sign by the
<br />withholding agent even ff item 1, 4, or 5 below indicales othen'{ise-
<br />For a joint account, only the person whose TIN is shown in Pari I
<br />shculd iign {when required). ln the case of a disregarded enlity, the
<br />person idbntified on line 1 must sign. Exempt payees, see Fxempl payee
<br />code, eadier.
<br />Signature requirements. Complete the cefiilication as indicaled in
<br />itemsl through5below.
<br />1. hrterest, dividend, and barter exchange accounls opened
<br />before 1984 and broker accounls considered aclive during l98il'
<br />You must give your correct TlN, but you do not have lo sign the
<br />certification.
<br />2, lnterest, dividend, broker, and barter exchange accounts
<br />orured afler l98il and broker accounts considered inactive during
<br />1b83. Yuu rrrust sign the cenlfication or backup wi$rholding rvill apply. If
<br />you are subiect to backup withholding and you are merely providing
<br />your conect TIN to the requester, you must cross out item 2 in the
<br />certification before signing the fomr.
<br />3. Real estate transactions. You must sign lhe ceiliflcalion. You rnay
<br />cross out item 2 of the cerlification.
<br />4. Other paynrerrts. You must give your conect TlN, but you dc nol
<br />have to sign the certification unless you have been nolifed lhal you
<br />have previously given an inconect TlN. "Otherpayments" include
<br />paym'ents mad-er-n the course of the requester's trade or busines for
<br />ients, royalties, goods (other than bills for merchandise), medical and
<br />health care services (including payments to corporalions), payrnents to
<br />a nonemployee for selices. payments made in setdement of paym€nt
<br />card andthiid-party network trdnsactions. paynrenls to certarn frshing
<br />boat crew members and fishermen, and gross proceeds paid to
<br />attomeys (including payments to corporatioflsl.
<br />5. Mortgage interest 1:aid lry you, acquisition or abandotlment of
<br />secured Dror)ertv. cancellation of debt, qualified trtition program
<br />pavmentb (uirdei section 529), ABLE accounts (under section 529A),
<br />lRA, Coverdell ESA, Archer MSA or HSA contributions or
<br />distribulions, atrtl pension distributions. You must give your corect
<br />TlN, but you do not have to sign the certification.
<br />What Name and Number To Give the Requester
<br />For this of account:
<br />B. Disregilded ffitity not ovrned by m
<br />individml
<br />g. A valid trust, esiate, or peNi6 t.ust
<br />1o- Corpoation or LLC electing csrpsate
<br />status on Fom 883? or Form 25,53
<br />l1 . Assmialim, club. religirus, ch*itable,
<br />educational, or other til-exffiPt
<br />0rqaniataon
<br />.12. Parln€Ehip or muhimmber LLC
<br />13- A kokBr or registered nomin*
<br />1+. Acount with the Departmmt of
<br />Agriculture in lhe name ol a Public*lity (such m a state or laal
<br />govemmtrl, school dbkict, or pdson)
<br />ihat reeives agricultuml program
<br />pnymenls
<br />15. Gmtor trust filing Fm l04l or
<br />uoder lhe Optional Filing Method 2,
<br />requirinq Fom 10€9 (sR Fl€gulations
<br />sstion 1.671 -4ib)(2XiXB))"
<br />Give name and €lN of:
<br />The owrer
<br />Legil entiqd
<br />The csp€ralisn
<br />The +rganiatim
<br />The partrrership
<br />The brolts or nominee
<br />The public mlity
<br />The minor:
<br />The grstor-trusleer
<br />The actuai omerl
<br />The ovrneF
<br />The gmtor'
<br />Kittitas County Agreement for Services (rev.5/14/251l
<br />Page20 of 2I
<br />The trust
<br />'List lirst and circle the name of the person whfs€ number you fumish'
<br />lf only one penion on a ioint account has an SSN, that person's numb€r
<br />musl be fumished.
<br />zCircle the minor's name and fumish the minor's SSN"
<br />3You must show vour individual name on line 1. and enter your business
<br />or DBA name, if ahy, on line 2. You may use eilher your SSN or EIN df
<br />you have one), but the IRS encourages you to use your SSN-
<br />l List {ilBt and circle the name of lhe arust, estate, or pension lrust. {Do
<br />not fumish the TIN of the personat representalive or trustee unless tfie
<br />legal entity itself is rrot designated in the account litle.)
<br />'Note: The grantor musi also provide a Fo(m W-9 1o the truslee of lhe
<br />trust.
<br />'. For more infonnation on oplional ftling methods lor Eranlor Susts' see
<br />the lnstructions for Form 1941.
<br />Note: lf no name is circled when more than one name is lisled' the
<br />number lvill be considered to be that of the tirsi name listed'
<br />Secure Your Tax Hecords From ldentity Theft
<br />ldentitv theft occurs when someone uses ytur persona! informatiolr'
<br />such as your name, SSN, or other identifi;ing information, '.'rithoul your
<br />permission lo commit fraud or other crimes. An idenliiy thie{.may use
<br />your SSN to get a job or may file a tax retum using your SSN lo receive
<br />a refund"
<br />To reduce your risk:
<br />. Protecl your gSN,
<br />. Ensure your employer is ptotecfing your SSN, and
<br />. Be careful when choosing a lax retum paeparer-
<br />lf your lax records are afiected by identity lheft and yotl recei're a
<br />nolice from the lRS, respond right away to the narne and phone nurnber
<br />printed on the IRS notice or letter.
<br />lf vour tax records are not cunenlly affected by rdenldy theft but you
<br />thin( you are at risk due to a losl or itolen purse or wallet' questionable
<br />credifcard activity, or a queslionable credit report, conlact the lBS
<br />ldentity Theft Hotline al 800-908-4490 or subrnil Foffn .l 4,039-
<br />For more information, see Pub. 5o2?, ldentily Theft lnlormstion for
<br />Taxpayers-
<br />For tlris of account:
<br />2. Two or more individuals fioint account)
<br />other than an accsunt maintained by
<br />an FFI
<br />3 Two or more U.S. peruons
<br />floant account maintained by m FFI)
<br />4, Custodiql account oI I minq
<br />{Unifom Gift to Minors Act)
<br />5. a. The usual revomble uvings trust
<br />(grmtor is al* frustee)
<br />b. So-called trust accmni lhat is not
<br />a legal or vali<J lrct under state law
<br />6. Sole proprietorrhip o disregrded
<br />atity owned by an individual
<br />7- Grantor lrust filing under Optional
<br />Filing Method 1 (see Flegulations
<br />strtion 1.671 -aibXzXiXA)"
<br />Give narne and SSN of:
<br />The
<br />The actual orer of the rccwnt or.
<br />il mmbined funds. the fist individual
<br />on ihe accounll
<br />Each holder ofthe rccounl
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