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Form W-9 (Rev. 3-2024)
<br />Part 11. Certification
<br />To establish to the withholding agent that you are a U.S. person, or
<br />resident alien, sign Form W-9, You may be requested to sign by the
<br />withholding agent even if item 1, 4, or 5 below indicates otherwise.
<br />For a joint account, only the person whose TIN is shown In Part I
<br />should sign (when required), In the case of a disregarded entity, the
<br />person identified on Sine 1 must sign. Exempt payees, see Exempt payee
<br />code, earlier.
<br />Signature requirements. Complete the certification as indicated in
<br />items 1 through 5 below.
<br />1. Interest, dividend, and barter exchange accounts opened
<br />before 1984 and broker accounts considered active during 1983.
<br />You must give your correct TIN, but you do not have to sign the
<br />certification.
<br />2. Interest, dividend, broker, and barter exchange accounts
<br />opened after 1993 and broker accounts considered inactive during
<br />19W. You must sign the certification or backup withholding will apply. If
<br />you are subject to backup withholding and you are merely providing
<br />your correct TIN to the requester, you must cross out item 2 in the
<br />certification before signing the form.
<br />3. Real estate transactions. You must sign the certification. You may
<br />cross out item 2 of the certification.
<br />4. Other payments. You must give your correct TIN, but you do not
<br />have to sign the cart ficatlon unless you have been notified that you
<br />have previously given an incorrect TIN. "Other payments" include
<br />payments made in the oourse of the requester's trade or business for
<br />rents, royalties, goods (other than bills for merchandise). medical and
<br />heatth care services (including payments to corporations), payments to
<br />a nonemployee for services, payments made in settlement of payment
<br />card and third -pally network transactions. payments to certain fishing
<br />boat crew members and fisherman, and gross proceeds paid to
<br />attorneys (including payments to corporations).
<br />S. Mortgage interest paid by you, acquisition or abandonment of
<br />secured property, cancellation of debt, quatified tuition program
<br />payments (under seclion 5291, ABLE accounts (under section 529A),
<br />IRA, Covercleil ESA, Archer MSA or HSA contributions or
<br />distributions, and pension distributions. You must give your correct
<br />TIN, but you do not have to sign the certification.
<br />What Name and Number To Give the Requester
<br />For this type of account:
<br />Give name and SSN of:
<br />1. Indodaid
<br />The individual
<br />2, Two of more indivlduafa (joint account)
<br />The actual owner of the account or,
<br />other than an account maintained by
<br />if combined funds, the first individual
<br />an FFI
<br />on the account
<br />$:7wo or more U.S. persons
<br />Each holder of the account
<br />(joint account maintained by an FR
<br />4. custodial accatmt of a manor
<br />The minor'
<br />(Uniform Gift to Mbom Ac:)
<br />5. a. The usual revocable stivmugs bust
<br />The grantor -trustee'
<br />(grantor is Ao trustee)
<br />h. SUt"Jled Rust account that ra not
<br />The actual owner'
<br />a Legal or valid bwt under state law
<br />b. Sole proprietorship or disregarded
<br />The owner3
<br />entity owned by an individual
<br />7, Grantor trust fling under Optional
<br />The grantor
<br />Filing Method 1 (see ftogu6lliorr
<br />section 1 Z71-4(bX2)(7tk] -
<br />Kittitas County Agreement for Services (rev. 5/14/25)
<br />Page 22 of 23
<br />Page 5
<br />For this type of account:
<br />Give name and EIN of:
<br />e. Disregarded entity not a%-Ld by sir
<br />The ovvner
<br />Individual
<br />9. A valid trust. estate. or pension trust
<br />Legal entity'
<br />lo. Corporation or LLC electing corporwe
<br />The corporation
<br />vntus on Form W2 or Form 2553
<br />11. Association, dub. religious. charitable-
<br />The organization
<br />educational. or other tax-exempt
<br />prganizatioft
<br />12, Parubrahip or muhi-member LLC
<br />The partnership
<br />13. A broker or regvrtered nom nee
<br />The broker or nominee
<br />14. Account with the Department of
<br />The public entity
<br />Agriculture it the name of a putAic
<br />entity (such as a state or local
<br />government, school district, or prison
<br />that receives a0cuiturai pragam
<br />payments
<br />1S. Grantor trust filing Form 1041 or
<br />The trust
<br />under the Optional Fling Method 2,
<br />requiring Farm 1099 (see Regubtald
<br />section 1,671-t1b)(2i ii B))"
<br />r List first and circle the name of the person whose number you furrirsh.
<br />If only one person on a joint account has an SSN. that persons number
<br />must be furnished.
<br />'Circle the minor's name and famish the minor's SSN.
<br />' You must show your individual name on line 1, and enter your business
<br />or DBA name, if any, an line 2. You may use either your SSIN or EIN (if
<br />you have one), brit the IRS. encourages you to use your SSN.
<br />'List first and circle the name of the truist. estate, or pension trust. Po
<br />not tumish the TIN of the personal representative or trustee unless the
<br />legal entityitself is not designated in the account title.]
<br />'Nate: The grantor must also provide a Form W-9 to the trustee of the
<br />trust.
<br />For mare information on opborW (Ring methods for grantor trusts. see
<br />the Instructions for Form 1041.
<br />Note: If no name is circled when more than one name is listed, the
<br />number will be considered to be that of the first name listed.
<br />Secure Your Tax Records From Identity Theft
<br />Identity theft occurs when someone uses your personal information.
<br />such as your name. SSN, or other identifying infomtation, without your
<br />permission to commit fraud or other trines. An identity thief may use
<br />your SSN to get a job or may hie a tax return using your SSN to receive
<br />a refund.
<br />To reduce your risk:
<br />• Protect your SSN,
<br />• Ensure your employer is protecting your SSN, and
<br />■ Do careful when choosing a tax return preparer.
<br />If your lax records are affected by identity theft and you receive a
<br />notice from the IRS, respond right away to the name and phone number
<br />primed on the IRS notice or letter.
<br />If your tax records are not currently affected by identity theft but you
<br />think you are at risk due to a Jost or stolen purse or wallet, questionable
<br />credit card activity, or a questionable credit report, contact the IRS
<br />Identity Theft Hotline at 800-908.449D or submit Form 14039.
<br />For more information, see Pub. 5027, Identity Theft Information for
<br />Taxpayers.
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