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Form W-9 (Rev. $20241 Pase 4
<br />2-Ths United States or any of its agencies or inetrumentalities.
<br />3-A slate, lhe Distdct of Columtia, a U.S. comnrtnweallh or tenitory,
<br />or any of thdr political subdivisbns or instrum€ntalitie€.
<br />4-A forsign govemmenl or any of ils political subdivieions, agencias,
<br />or ingtrumentalities.
<br />5-A corporation.
<br />6-A dealer in gecuriliee or commodilies required to reg;ster in the
<br />United Slates, the District of Columtia, or a U.S. common$realth or
<br />lenitory.
<br />7-A fulures commission merchant registered wilh lhe Commodity
<br />Futures Trading Commission.
<br />8-A real estate investment bust.
<br />9-An entity registered at all times during the tax year under the
<br />lnvestment Company Act of 194O.
<br />'lo-A comrnon trust fund oporat€d by a bank under section S84(a),
<br />11-A firrarrcial hrctilutiur as tlelirred utnlu scutiorr 501.
<br />12-A middleman known in the invegtment community as a nominee or
<br />cusiodian.
<br />13-A trust exempt from tax und€r section 6€4 or deecribed in section
<br />4947.
<br />The following chart shows types of payrn€nts that may be €xempt
<br />lrom backup withholding. The chart apdi€s to the exempt payees listed
<br />above, I 13.
<br />lF the paynent is lor . .THEN the pryment is exempt
<br />lor -. .
<br />. lnt€rest and dMdend payments All exempt palE€s except
<br />for 7.
<br />r Brokerlransactions Exempt paye€s 1 through 4 and 6
<br />through 1 1 and all C corporations.
<br />S corporations must ftol enter an
<br />exempt paye€ code because they
<br />are exempt only for salas of
<br />noncovered securities acquired
<br />lo 2012.
<br />r Bartgr transactions Exempi payees 1 through 4.
<br />snd
<br />. Payment8 ov€r required to
<br />be reported and dir€ct sales over
<br />$5,ooo'
<br />. Payrnanis made in settlem€nt of
<br />payment card or third-party
<br />netYvork trarEactions
<br />l See Form 1099-M|SC. Miscellaneous lnformation, and its instructions.
<br />2However, the following payments made to a corporation and
<br />reportable on Form 1O99-MISC are not exempl from backup
<br />withholding: medical and health care payments, atlomeys'fees, gross
<br />proceeds paid to an attotney rcportable under section 6045(0, and
<br />payments for services paid by a federal executive agency.
<br />Exemption lrom FATCA reporting code. The following codes klentily
<br />payees that are exempt from reporting under FATCA. These codes
<br />apdy lo persons subrnifting this form for accounts maintained outside
<br />of lhe United Slates by certain foreign financial instihrtions. Therefore, if
<br />you are only eubmitting this form for an aocount you hold in the United
<br />State6, you may laave this lield blank. Corsuh with the person
<br />requesting this form if ;ou are uncenain if the financial instiMion ie
<br />subiect to these requirements. A roquester may indicate that a code is
<br />not required by providing you wilh a Form W-9 with "Not Applicable" (or
<br />any similar indication! entered on the line for a FATCA exemption code.
<br />A-An organization exempt ftom tax under section 501(al or any
<br />individual retirement plan as defined in secdon 77O1(aX37).
<br />B-The United Srates or any of its agencie or instrumentalities.
<br />C-A state, the District of Columbia, a U.S. commonwealth or
<br />tenilory, or any of their political subdiv'reiong or instrum€ntalities.
<br />D-A corporation the etock of which is regdarly lraded on one or
<br />more established securitiee markets, as d€scribed in Fegulations
<br />section 1.1472-1 (c)(1[i).
<br />E-A corporation that is a member of the sama expanded affiliated
<br />group as a corporation deecribed in Regulations sec'tion 1.1a72-1(o[1[i).
<br />Kittitas County Agreement for Services (rev.5/1,4/25)
<br />Page 19 of 21
<br />F-A dealer in securities, commodities, or derivative linancial
<br />inslruments fncluding notional principal conlracts, futures, fonvards,
<br />and optione) that is registered as such under lhe laws ofthe United
<br />States or any state.
<br />G-A rsal estate investment trust.
<br />H-A regulated investmenl company as defin€d in s€ction 851 or an
<br />entity r€gistered at all times during the iax year under the lnvestment
<br />Company Act of 1940.
<br />l-A common trust lund as defined in section 584(a).
<br />J-A bank as defined in section 581.
<br />K-A broker.
<br />L-A trust exempt from tax under section 684 or described in section
<br />aeaT(aX1).
<br />M-A tax-exempt lrust under a section 4o3(b) plan or aeclion 457(9)
<br />plan.
<br />Note: You may wirh to comult wilh the financial instilution remtatting
<br />this form io det€rmine whether the FATCA code andor exempt payee
<br />code should be completed.
<br />Llne 5
<br />Enteryour address (number, sheat, and apartnrent or suite number).
<br />This is wlere tho requesler ol this Form W-9 will mail your information
<br />retums. tf this address differs lrom the one the requester already has on
<br />lib, enrer "NEW" at the top. lf a new address is pmvided, there is still a
<br />charrce the old address will be used until lhe payor changes your
<br />address in their records.
<br />Line 6
<br />Enter your city, slate, and ZIP code.
<br />Part l. Taxpayer ldentification Number fflN]
<br />Enter your TIN in the appropriate box. lf you are a resident alien and
<br />you do not have, and are not eligible to get, an SSN, your TIN is your
<br />IRS ITIN. Enter it in the entty space for the Social security number. lf you
<br />do not have an fflN, see How to get a II I below.
<br />lf you are a sole proprietor and you have an ElN, you may enter either
<br />your SSN or ElN.
<br />lf you ara a single-memb€r LLC that is disregarded as an enlity
<br />s€parate ftom its owner, ont€r lhe owner's SSN (or ElN, if the owner has
<br />one). lf the LLC is classified aa a corporation or partnership, ent€r the
<br />entity'e ElN.
<br />Nole: See What Name and NumberTo Give the Heguester,laler,for
<br />{urther clarification of name and TIN combinalions.
<br />How to get a TlN. ll you do not have a TlN, apply for one immediately.
<br />To apply lor an SSN, get Form SS-5, Application for a Social Security
<br />Card, from your local SSA offrce or get this form online at
<br />www.SSAgov. You may al6o get this form by calling 800-772-1213. Us€
<br />Form W-7, Application for IRS lndividual Taxpayer ldentification
<br />Number, to apply for an fflN, or Form SS-4, Application for Employer
<br />ldentificalion Number, to apply for an ElN. You can apply for an EIN
<br />online by accessing the IRS website at www.irs.grovlFlN. Go to
<br />www.irs.govlForns to view, download, or print Form W-7 and/or Form
<br />SS-4. Or. you can go to www.irs. govlOrderForms to place an order and
<br />have Form W-7 and/or Form S94 mailed to you within 15 business
<br />days.
<br />lf 1ou are asked to c€mpl€te Form W-9 but do not have a TlN, apply
<br />for a TIN and enrer "Applied Fof in the space for the TlN, sign and date
<br />the form, and give it to the tequester. For interest and dividend
<br />payments, and certain payments made with respect to readily tradable
<br />instruments, yor will generally have 6O days to get a TIN and give it to
<br />the requesier before you are subiect to backup withholding on
<br />payments. The 60-day rule does not apply to other types of payments.
<br />You will be subiect to backup withholding on all such payments until
<br />you provide your TIN to the requester.
<br />Note: Entering "Applied For' means thai you have already applied lor a
<br />TIN or that you intend to apply for one soon. See also Fstab/lshing U.S.
<br />status for putposes of chapter 3 and chapter 4 withholding, earlier, for
<br />when you may instead be subiect to wilhholding under chaptet 3 ot 4 ol
<br />the Code.
<br />Caution: A disregarded U.S. entity that has a foreign owner must use
<br />the appropriate Form W-8.
<br />Generally, exempt payees
<br />1 frrough 5.2
<br />Exempt payees 1 through 4.
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