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Home My WebLink AboutAccounts Payable Batch - Accounting (003)Payable batches audited and certified by the auditing officer as required by RCW 42.24.080 and those expense reimbursement claims certified as required by RCW 42.24.090, have been recorded on a listing which has been made available to the Board: As of this date, 07120/2023 the Board, by a majority vote, does approve for payment those payable batches . Payable Total: 4,789.00 Review eA and certified UmmissloneK 4f: Z Commissioner ChairmalT**ITSoard of Commissioners Date: 7/20/2023 Invoices/Batches not approved: Double Chocked by: Date: AP BATCH ID: GCEMG 712012023 Grant County Claims Clearing Account - 9201 Name FUND AMOUNT CURRENT EXPENSE 001.000. COUNTY ROADS 101 CARES ACT - ELECTIONS 102 VETS ASSISTANCE 104 HAVA 3 ELECTIONS 106 FEDERAL DRUG lut CHECKS: MENTAL HEALTH 108 4,789.00 VOIDED: ST DRUG SEIZURE- 109 LAW LIBRARY 110 ---------- BATCH PMCHK CREDITS PMTRX TREASURER O/M 1.11 $ - $ » $ JAIL CONCESSION 112 $ - $ $ ECON ENHANCMNT 113 $ - $ $ TOURIST ADVERT 114 $ - $ $ COUNTY FAIR 116 $ - $ $ $ INET INVESTIGATION 118 PROS CRIME VICT 120 $ 4,789.00 $ 9,578.00 $ - $ 9,578M SH072023RGEXP LAW & JUSTICE 121 $ - $ - $ - $ TURNKEY LIGHT 122 $ $ - $ $ AUDITOR 01M 124 --------------------------- $ $ - $ $ DD RESIDENT PROD 125 $ r $ r $ $ R.E.E.T. 1 st 114% 126 $ $ $ $ TRIAL COURT IMPROV, 127 $ » $ $ $ DOM VIOL SRVCS 128 $ $ $ $ AFF HOUSING 129 $ » $ » $ - $ HILLS HSLOC 130 $ $ w $ - $ REET 2nd 1/4% 132 $ $ » $ Econ Enh. Rural Co 133 $ » $ $ $ Dispute Resolution 136 $ $ $ Building 138 $ $ »$ REET Admin 139 $ $ w $ SHERIFF SURPLUS 140 $ - $ » $ » $ SHB 1406 141 - $ $ $ GC ABATEMENT 150 $ - $ $ $ HILLGREST GRID 161 $ $ » $ GRANTS ADMIN. 190, $ $ - $ ARIA 191, $ $ - $ AOC BLAKE DECISION 192 $ $ $ - $ MUSEUM CONTRUCTION 304 $ $ $ - $ MACC Bond 307 $ $ $ $ MCKINSTRY ESSENTION 308 $ w $ $ COUNTY FAIR SEWER 309 $ $ $ $ PROP 1 SALES TAX 311 $ $ $ $ ERP RESERVE 312 $ $ $ $ SOLID WASTE 401 $ $ DATA PROCESSING 501 $ w $ $ INSURANCE 503 $ $ $ $ INTFUND BENEFITS 505 $ $ $ - $ UNEMPLOY COMP. 506 $ n $ $ - $ DENTAL INS. 607 $ $ $ OTHER PR BEEN. 508 $ $ $ VISION BENEFITS 509 $ 4,789.00 $ 9,578.00 $ $ 9,578.00 EQUIP RENTAL 510 $ 4,789.00 $ 91578.00 $ $ 9,578.00 COMMUNICATIONS 511 l $ $ PITS & QUARRIES 560-1--- 1w $ 4,789,00 $ 9,578.00 $ 9,578 , .00 TOTAL TRANSFER: $ 41789.00 System: 7/20/203 1:46:04 PM County orGrant page` z User Date: 7/20/2023 CASH REQUIREMENTS REPORT User zo' oayanez Payables Management Ranges: Vendor zo' l - oxzzzxzzzuzzzz Vendor Name: First -Last 'Vendor Class: First -Last User -Defined z, First - Last Sorted By: Vendor zo Payment Priority: First -Lao Due Date: First -Laa Discount Date: First -Lamt Payment Date: 7/31/2023 Vendor ID Vendor Name Document Document GL Account Amount On Hold Total Number Date __--___________-_______-_—_-_______-____-__-____-____-____-__-______________-____-_ Moism zaMAEL MORENO 08.2023 A.R RENT 7/20/2023 188.150.00.8078.564444502 $1,200.00 $0.00 $1,200.00 mCONL J&V INVESTORS LLC 08.2023 RENT 7/20/2023 08.150.00.8078.564440502 $800.00 $0.00 000.00 LLPoA LAKELxmD POINTE APARTMENTS 08.2023 J.e RENT 7/20/2023 108.15100.e078.564444502 $1,044.00 $0.00 $1,044.00 WPMGC WINDERMERE PROPERTY mAmArGE 08.2023 RENT 7/20/2023 188.150.00.8078.564444502 $995.00 $0.00 $395.00 wPINIso WINDERMERE PROPERTY MANAGE 08.2023 T.r RENT 7/20/2023 108.150.00.8078.5644*0502 $750.00 $0.00 $750.00 TOTAL -------------- FOR FUND 0 108 ------------- V4,789.00 _-_—_____ $0.00 $4,789.00 oRAm TOTAL ------------- --------------- $4,789.00 __-__-__ $0.00 $4,789.00 System: 7120/2023 1:09:32 PM County of Grant User Data: 7/2012023 PAYABLES TRANSACTION EDIT LIST Payables Management Batch ID: BH072023RGEXP Batch Comment: Trx Total Actual: 5 Trx Total Control: 5 Batch Total Actual: $4,789.00 Batch Total Control: $4,789.00 Batch Error Messages: Page: 1 User ID., nayanez Batch Frequency: Single Use Audit Trail Code: Posting Date: 7/2012023 VendorlD Document Number Document Date Voucher Number Purchases Document Total Vendor Name Terms Disc Avail - ------------------------------------------------- ECONL 08.2023 RENT 7/20/2023 0392969 $800,00 $800.00 J INVESTORS LLC Description 12532115 CBRA EMERG. HOUSING Payment Information Checkbook/Card Payment Number Document Date Amount Check 0/0/0000 Distribution Messages: Work Messages: 0 General Ledger Distributions Account Account Description Account Type Debit Amount Credit Amount 108.1 50.00,8078,564444502 MH ... BEACON - CBRA.-EMERC, PURCH 800.00 0.00 692.001,00.0000.211000000 WARRANTS PAYABLE PAY 0.00 800.00 ----------------- 800.00 ----------------- 800.00 Vendor ID Document Nu'rnber- Document Date,- Vouch6r- Nu''mber, Purchases Document Total der or Name Aatl LLPOA 08.2023 J.P RENT .7/20/2023 0392973 $1 t044.00 $1,044.00 LAKELAND POINTE APARTMENTS Description. 12542161 OBRA EMERG. HOUSING Payment Information Checkbook/Card Payment Number Document Date Amount Check 0/010000 $0.00 Distribution Messages: Work Messages. - General Ledger Distributions Account Account Description Account Type Debit Amount Credit Amount 10,8,150.00.8078.564444502 MH ... BEACON - CBRA.-EMERC. PURCH 11044.00 0.00 692.001.00.0000.211000000 WARRANTS PAYABLE PAY 0.00 ----------------- 11044.00 1 ,044.00 --------------..-- 11044-00 System: 7/20/2023 1:09:32 PM County of Grant Page: 2 User Date: 7/20/2023 PAYABLES TRANSACTION EDIT LIST User ID: nayanez Batch ID BH072023RGEXP Payables Management Vendor ID Document Number Document Date Voucher Number Purchases Document Total Vendor Name Terms Disc Avail L— - — ------------ -- --- MOISM 08.2023 A.R RENT 7/20/2023 0392974 ISMAEL MORENO Description 12542257 CBRA EMERG. HOUSING Payment Information Checkbook/Card Payment Number Document Check Distribution Messages: Work Messages: General Ledger Distributions ---------------------------- $1,200.00 $1,200.00 Date Amount 0/0/0000 $0.00 Account Account, Description Account Type Debit Amount Credit Amount 108,150,00.8078-564444502 MH.. .BEACON - CBRA.-EMERC PURCH 11200-00 0.00 692.001.00.0000.211000000 WARRANTS PAYABLE PAY 0.00 13200.00 ----------------- ------------------ 11200.00 11200.00 Vendor ID: Document Number Document Date Voucher Number Purchases Document Total Vendor Name Terms DisGAvail WPMGC 08.2023 RENT 7/20/2023 -- -- --------------- 0392970 $995.00 - ------------------------- $995.00 WINDERMERE PROPERTY MANAGEMENT GRANT COUNTY, INC Description 12543280 COBRA EMER. HOUSING Payment Information Checkbook/Card Payment Number Document Date Amount Check 0/010000 $0.00 Distribution Messages: Work Messages: General Ledger Distributions Account Account Description Account Type Debit Amount Credit Amount 108.150.00.8078,564444502 MH. .BEACON - CBRA.-EMERC- PURL H 995.00 0,00 692.001.00.0000.211000000 WARRANTS PAYABLE PAY 0.00 995.00 ----------------- 995.00 ----------------- 995.00 System: 7/20/2023 1:09:32 PM County of GrantPage: 3 User Date: 7120/2023 PAYABLES TRANSACTION EDIT LIST User ID: neyanez Batch ID BH072023RBEXp Payables Management | ( Vendor ID Document Number Document Date Voucher Number Purchases ------------- Document Total 'Vendor Name Terms Disc, Avail VVpMBC O8.2O23l[PRENT 7/2012023 0392972 $750l0 $750I0 WINDERMERE PROPERTY MANAGEMENT GRANT COUNTY, INC Description 1253O255CBRAEMERG.HOUSING Payment Information Checkbook/Card Payment Number Document Date Amount Check 0/0/0000 $0.00 Distribution Messages: Work Messages., General Ledger Distributions Account Account Description A000un Typo Debit Amount Credit Amount 108.150.00MH. -.BEACON-CBRA.-EMBRC. PURCH 750.00 . 0.00 092.001.00.0000.211000000 WARRANTS PAYABLE PAY 0I0 750I0 ---------- --------- 750l0 Purchases Amount Terms Disc Avail Document Total ________ -----------__-_ ------------------ $4,789.00 ______-__$4.7B9.00 $0.00 $4.709.00 ================ ================== ================== ------------------ State of Washington -County of Grant 11 the undersigned, do hereby certify under penalty of perjury that the materials have been furnished, the services rendered or the labor performed as described herein, that any advance payment is due and payable pursuant to a contract or is available as an option for full or partial fulfillment of a contractural obligation, and that the claim is a just, due and unpaid obligation against the county, and that I am authorized to authenticate and certify to said claim. Subscribed this day of (Signed) For Department Approved and Authorized By Date Allowed Commissioner Commissioner Commissioner ieor Date., 7/2012023 tch ID BH072023RGEXP PAYABLES TRANSACTION EDIT LIST User ID: rgonzales Payables Management lendorlD Document Nu*er b D60u e m M n't Date Voucher Number fender -Name 'PMGC 08.2023 T.P RENT 7/20/2023 0392972 `INDERMERE PROPERTY MANAGEMENT GRANT COUNTY, INC; lescription 12530255 CBRA EMERG, HOUSING yment Information Checkbook/Card Payment Number DOGLIment Check .-tribution Messages: )ri( Messages: neral Ledger Distributions - - ----------- - PurchasEis Document Total Terms Disc Ava'il $750.00 $750.00 Date Amount 010/0000 $0.00 count Account Description Account Type Debit Amount Credit Amount 3,150,00.8078.564444502 MH. 13EACON --CBRA.-EMER( PURCH 750.00 01M 2,00 1 .00,0000.21 000000 WARRANTS PAYABLE PAY 0.00 750.00 75100 750.00 Purchases Amount Terms Disc Avail Document Total $4,789,,00 $0.00 $4t789.00 ---------- ttate of Washington -County of Grant the undersigned, do hereby 6ertify under penalty of perjury that 6e iate-rials have been furnished, the services rendered or the labor performed s described herein, that any advance payment is due and payable pursuant a contract or is available as an ti tion -for full or partial fulfillment of a P ontractural obligation, and that the claim is a just, due and unpaid bligation against the county, and that I am authorized to authenticate and ertlify to said claim, -dell" S' 0 ubscribed this _-.day of For (Signed) 0 0 r Department Approved and Authorized E3v Commissioner Commissioner Commissioner Date Allowed Ooft ........ 00�a, � ( C a x rwI lz�uj Grant, Bohavlum[meralblj r, wellne!Ia REcEm';U JuL I s IqU 31a�1 s-� Name: 15;',2\\S Date: Item(s) Requested (include a photo if you need a specific item): A- L Ak, it __.., ..',. ,." Reason for Requesb "Oman"r Date Needed Supervisor's Signature � � �,1 Date 2:,� x A Please have your supervisor sign the form and then return 'lot to the Finance Department, W 417A Request for TaxpCIyer GIVO FOrm to the Pew. Qqloboy 20113) IdentificatIm NuMber alid Certifloation reqtILwator. 1)0 not 1 0 Ymmuly 12(m,"a"Intilr414121 War"L 1 )0- 09 tO WWW.1MVoV1FOanW for InstrUctlojM' 8d to the IRS't to '11"10 I -Mt 0 Mid the tatexE 0111 I Nama Pa gkow Opp Maur IWO 6 11no; do n& lap" Vitt 170 blan& U4 V namoMora 6wed are Vol" abovo tM 0 Pato box floe fod010 Pefson w17O34n*r11e IS Ontared on 1111a I 01100k My otle of fallowing Oever) boxe5, the 4 Eb(OMPU,*n$ (podV, 40 Only to 9 WIN1101�RVS019 POPHOW br El c atrPamilon El 8 ourporation El pxjngraijp Trqwattata 'Pjy verts1r) MOO, Aot IndfividualII *0 b6tudlarla on pogq 07 }.,LLLimited 4146"ember LLO riabilit/ corrpany, Epfar ilie t4ix (04 corporMon, S-4 corponLljan, 5*01pt payos Obde (dgily) Nutp: Oj)salc fto mPmpri-ate box in MO #00 Owe for fbo W LL!a DORGtdOck Ll LC fWi O depalff4d op =that Ig iii aided f"I0141 I 6 N vmqr9nIwm the owner of tllb LW is e. Excimpilonf roqj PA'rCA r r1i epo rjg Mother LLO tiNt to not disrWgrd�41 ft ool the ownerfor u.8, redergj �M pUM0863, Oftjyjj'q81 a alngle-mem�er LLL that 14 �OWl1rdkW frOM W OW W zftUld chu* 1bg RPRO NtO bei ft-r1he tax c1aBs(ffc;jt[O)j two (if any) 01 As OWbtt, gift ..... .. Z "t.Kv ZI.OJ ) QVOW4,eg nam and Adaydit (riptionwif --- ------------ . ....... l Mqaunt raimbur(s) hbr* (bpUonaq ---------------- t ------------------- - 1 axpayer IdOnMeation Humber MN) Eimer Your TIN in tW PpprQprfidA hox. 1 -he TIN pmvld,`-�d must amtoh tho nano VfvtFi aji, irne 1 tQAvc;ld bqqkup withho(dino, P& iftdIvIduala, the 1(3 _jon��Ily your SCOW 000voty nurn4er �98M)' KOMWOr7 Mr, 0 regfa6ntsheer, sofa p)zprlator, or dlsregwdadmttfty, nthe IMOUbUons fQr P'FA 1, fat6r., far other Pftflfle�, It Ls your &-nployar feahtffftaffon nurnb& (El N). If -you do 116t h6mg a number,,see How to gat a TIN, Iter, Note: If the. accoLmt Is In more 1hart Qnej namol 80Q the lrmtruoil6mg for It lVaMbOf To Give the Paqueater for guldellpoti on Whoso nUmbalT, tb Me 1. Alwgaa What NamaiI Pnt.vr,. ia��IM *fir i# on nqm* iT -- ------ — ---------------------- ----------------- V vilder POMNIC4 of Pe'dwy, I OAify Ifiatf, I. TbG T114mberofiown on thjs fom Is my �eot taXpAyor kle 'jpkdgion ME m4rabor (or I am waillng or a humbat jo bb W, ued tct 2. (am not &Ubjeat to bal*up vvKhhQId[n�%bqcausa: (a) I ft MmPt VOM bAOk4p WIthhotdIng, or 1b) I havo nOt h0h RuNed by t�o lfltomaj pavgrjue 86rvice on) th(Af I AM WWOOM b4okuo. livithhold?ng eq a * Po 1on9eraubjo*t to 4aCkUP Wlthh6ldlng,' and fftft Oft ia fallurOlc NPOrt 41t MPNO or cilvidands, im (0) fhO IRS has M001W me ttlat I am I am a U.S. 01fizen or other U.S. pmorl"(definod bofo)- and 4# DO FATOA00de(s) entorod on this form (if any) ledlaalitIg t am oxampt from FAT CA repatitj CaniOtt on InAttuotionsp you tylust cro:��t Out Itsm 2 Above a you have tH�eri, noted by tho IM tW YOU Art aurrenfly s0blact to bachup w1thholdling bouawe, you hW'O N19(f 10 tOpat ll Inter"t and OvIdan4a on your W returm Fcr real WstO tragiani atom 2 doo rot apply. Vor M*�ggge interest p4ld, ucquisftn O(Obandonment of WoOted propeq, canceflatlon of del y4 cantrIbutions to JAn fad'hAdual reUrement arrangamf4jt VRA), and geifiarajjy, paymgtTt�z *�or than hit-armt ood YOU M hot r�JrAfrod to aign 1116 c4IM009n, but you mu*t OtiWjda y0ti v-Pavot TIN, See 1h% 10tructong tbr Pad, 110 (ator SignaAure of V%porgen P- e) General instructions Fom IM -DI (djvJdond,4, roc. W4jrU thd# from stocks or Mtttu;W fu n de) 6�ton raUeenemn aro to thf� Internal Revenue Qadd urtla$g far Mot Form 1099,,M]SO (vat -bus j�po Of 11CCII Odk6a, tMards, or j;ras,* Future dovalopmeaU,. ror th 0 1AW 1WcIrmat'jon about dtivogpments pwr'eed�) ' FQrM 10 99'�s rolat�d tG Form W-9 aild Ita InaftwOorio, eivcb gj$ jug' lation on trao L dock or mutual fund wJes and d0fth Otbar 13 ftted toldylt After thWara pbliIshedogo to WWWfr8.gOV1PD'rMV.19-' ey PurPOSO of Form Form 100-81 fpr-qapqc1,% from yQW Outatia Form I 099-K (mirchant cArd and Wrd P;adY networX lmnsactfoms) An Itid'jidwf or enifty ftnin W,!D roqrsjesto. who Isa r4qUIMd tckfjle an Form 1 W13 (homy Maft(.Oa'q int4re4t), 100- 81-41E 'student lo, -m Wenqsj), information edimn with the IR 8 must- obtain yaur cqffevt taxpiayar (tuftlon) ldehtifiOlAt�on nUrnber MN) which may be. YOUY SOCW SeCtXify nMMbW Foma 1089-0 (canci*d tlebt) PSM, MOMdUft! taxpaya numbor (ITIN), ddopdon iaxp�",r Idontffidatiori frombor (.TIM, or mployot !d6nffm;,g-UQA nuftibiw AForm 1099-A (acquilsition or kibandon mmht of eeaured properM g-W)j trt Pn an Itifoint aUon return tfii�.gmount pzdd to you I (:Tr athi�r We Form W-0 only It yoij aed a Lt.& Pjarson �Incltldlng ia maidFint ftmavAt MpOrNble oil a6 106TmiAtIon"Wrim, Exwples of hformeffpn Allen), tia prcLvld& your cmr.qa 111,L rolumt lnoljAde, but are not )IMAW to, the fQWrig. PYQU do not mfurn Fat m W-9 to tho r04V-I Wit- a T yp(j M Farrel '1099 -INT Chtay6st earned or j3afd) b4.abjoat to hgalwp wMhj?jdjn'g. 311 What 14i backup wiftoldIngtbht i4ix A Form W-'9 otv,1 `73 renew RECEIVED JUL 19 20275 Grmnb Behavloral Health 13 Wellness 0), Names, 1 "41 L-9 Date: `� 1 �2�. Item(s) Requested (include a photo if you need a specific item): Date Needed By.. M, W Q ,, ON SUpeiVISOr'S Signature k Date -`' Please have your supervisor sign! the form and then return it to the Finance Department, November 20.17) partrmnl of Ilia Treasury Internal € ovenvo $ervlaa iVame fa. ett for Taxpayer Idealtification Number and Certification Go to. vvww.1n%VovJFarrrtl�t.� far Instructlons andthe lata*t Information. on your Incomo NAXreturn). Name b toquff lnO bl-Mh, fet 1 name, 3 Choick apprcpdato lax for ied�rat tax elasslf(catlon e1 ttrp ponon onforad on Ilns 1. 01ack artiy one Of the Vq 01tuyring eMn boxy indl�rlr iJa�Us lr~r prCtprl ter CJ' C Cotponitian s. t arporaliah 1.��,.i PArtnerihip TrusVestale 0 oingi leyMombor LLC j� Limited Ircrhiiity company, enter iiia ta, c { �}c .+� jy� [��+�rYto S f+� M1 $X 'VJ Q �f►>./N�t� 3! YJ ii4!y �Mt(�e ��D'•7i tee br'�# RI�GtI WI(.l4 li , Px; Pat ills rship) . Note: Chack IhO apprc041e bOx 11111113 line shove for the tax 03301eaticrr of ft single -member owner, Do not ctlacic tLO If the LLCIs clasaifW 0s ra 81rt91enmerrrber LLC that Is alere�arded Irerrr ttra �v��rKr° i s the �� of the L.�� Is ironer LLC that I$ not disra �rtfed from tfle Nvner for It1 " fedt�rei tai ter h r � nl" � he O e . , p £nth r � amber LLIh- t Is disregarded from tho owner should cl�ecli tho appraprfate box for IIle tax clessIflaatlen of its ovrn�r. ,thr Iaea I'istr rctl nsl [iARFMT l'number,, alreet, and aptt or suite no §3 g IJ stha ticrr Requeste 'e name 1916 611h AVe West 6Qftyt a .atol and Zip cue ` 41CMa 111A 'a"' 7 !lit acc ount nr#mbeosl h Ir pticti TeX . Oyer (dentification Ht,llra be"Iili11';11'� Enter Vour TIN in the appropriate box, 7hs, TIN pr vfded Must Match the name given on ling 1 to avoid backup withholdir . lar Iraoll'vidual , tats I generally your social security rtun�ber { i�}� ��r��v�r� i~�r � ra ldent alfenE Ole proprlator, or disra.9ar entity, 00 the Instructions for Part 1, Pater. For other entittes, It IS ycr;Fr employer identification number (EIN)i If you do not havo a n�lrnber, s Now to �'ut' 7` 1% later, Ngte: It the account lo In more than one name, see thQ Instruotiorts fer Kne 1. Also see What Ivame ,end 07ber To Diva the Reg(JO$ter for gUidolinoa on whose nvrTtber to enter, t t t n t t k Give Form to tile requester. DO r6ot serail to the 4 axernptlocts (codes npp(y cnCy t c. �.. nartaln ontltias, not Individuals, sae Instructlons r�n R890 3)- 5xC-1irpt payea code (I'anyl x, emptlan from FATOA reporting code lir ony) rct aoo % (Ppti nal) 5e01at Ou rRY nu r --- .._ or ��rplcy�a� lr+t�rr!ti�icaE�n Ce icto Under pi�nalfles of ,perjury,, I certify that; 1. The number shown an this form is my corfect taxipaAr i entlfication numbertcr,e or I aM Waiting 2. � l� rtuber to be Issued to Me)t and l am not subject to backup withholding bacaus�t W) Am exampt from backup Withholding, or (b) I have not been notif ecl b the In OMce (IRS) that I am subject, to backup withholding a a result of a failure to report all Inter st or dividet�,da, or (b) the tF1 has notif' ;d l I eve t I no longer subject to backup withholding; and ��.. r11c that l �n 3, l am s U.S, Citizen or other M. person (defined below): and 4, The FATCA coda(s) enterad on this fora (if any) indicating that I QM exempt from FTA reporting r art 00 tra t ction � You gust cross cut'tarn above If you have men t'icllfled b � � l� cc fc��t# you have filed to repp� all Intare�t art�i dlwiden�s on your �. rent. For Jreei �:s�te Ira � �cnsf a � dais not hat you are rr�rttl,� scrbjt to bAclti#�p wItt�hcicflr� catts acquisition or abandontnant of secured property, Maellation of debt, f orrtdbutiorns to an indivrdwni ret"' arrant elm ��r mortgage � � ihleeest pat�lr other than interest and dividends, YOU are not required to sign the certification, but you must tOvIda cur correct � � g n �e�ct`J��iy� payments - p Tl 1, lea the lnstrurrttcrta for Part H, later. �t 00113tur o or t' U.S, parson *x - General Instruc*ns er,tlon tof rence$ arra to tho Inte Al RMnua Code unIes uharwise noted, Future davalupmeqts, For the latest Intormatfon about developments relzted to form '-9 end its lnstructions, such as 1091slaticn enacted attar they were published, 90 to www.1rs.9ov1Forfn /9, Purpose of Form At Individual or entity ([:otm W4 requester, who is required to file art Itttormation return With the IRS must obtain your carrect taNpayer Identificallon number (TIN Nhlcli may be your social security number (M), individual taxpayer Idontifloation number (M", .adaption taxpayer Identlficattcn number (ATit�), or emptoyer IdenfEflcation. number (SIN), to report on an Information return the cmouttt paid to you, or caller amount reportable on an information return, E-xarrtples of Information returns include, but are riot limited tot the follow[r g. d Forint 1099 -INT Clinterest earned or paid) Date * w/9/1% 9/1 & Form 1 Ow.DI's (dividends, Including those from shacks or mutuaf funds) Forum 1099- 099-MISO (varlous types Of Incurs, prizes, awards, or grass proceeds) a Form 1099-8 (stock or mutual tend Saps and cartaln other Vic nsactions by brokers) 0 Form 109-$ (proceeds from real estate transactions) 0 Form 1099•K (merchant Lard and thin party network transactions Forint 1099 (home mortgage Interest), 10 6-E (student Chan Interest), 1098-T (tulilon) 0 Form 100-- (=Wed debt) * Form 1099-A (acquisition or abandonment of secured pmparty) Use Form W-9 only if you are a 11, 5, person (including a ri�sldent alien), to provide your correct TIN. If you do not mfurn form 9 tO the requester with a 77pil ,you mfght be subject to backup withholding, See What Is backup withholding, toter, Cat. No. 10231 X FarC VV-9-li 131,11-201 rene'.... 0- ronb Behavioral Health a Wellnes-q �USS�"� 0�,21��I RECEIVED JUL 19 2023 r Name. Date,, Item(s) Requested ('include a photo if you need a specific item), Fu�nding Source, it known, .......... Reason for Request: ('I (P/� .� _F%I,(�i%�/9 ��-�,+� eli z) A r Arm 1 1, 1 I- IM Art Request for TaxPayer Form W U Pow,, Octcher 2018) Identification NuMber and Certification I'lll"11" "I otthe Treasunj InteIr"nal1'eVIenvo 801VIOG �Gotowww.* L(Py1F6rrhW9 for Instructions and the latest Inf-iormatlon. I Name (as shown on your Incorna tax riXurn.). Name Is required on this 11 no; do not leave this 11110 blan't I t. 0 1e, 9- Business name/dWe .gaided entity nonle, it ditte I rent froln above Give Form to the, te4uestar. Do not Bend to t1i o IR$% A.1 Ir 3 Check appropriate box for federal tax class.1firatlan of the person whose name Is entared on line I E Chook only one of the 4 Exampfforis (codas ap'-p- ly ont to folfw4ing seven boxes. y rartaln e6thles, not Iq0iV1duo)s-'see lnstmctllanra 00 page a),' Individuat/sole proprietor or El C Corp ration El 8 Corporition El Par- 11 I a hiership Trust/astgita single-meniber LLO a Exampt 'Payee code Pf.any) 0 El Limited fl - ,ability ciornpany. Enter tho ta.!< plassifloatlon (0=0 �otparatlon, S --S coeporatlon, P W-Partne'rshlp) Nore: 0hook the appropriate box In the 11110 abova for the 'tax, alas 11 affloatlor� of tits single -member owner, Do not shook Exemption frorn FATOA a LLG if the LL O la otassifiqd as 4 aftle-rilember LLQ that Is do I I . . r.p Iting lsragartfod from the ottoner unless the owner of the LLO Is - another LLG that is not disra9drded from the mimer fiae US. federal tax ptirpo�,, es."OtharwIss, a sIngle-member LLG that oode Qf arty) Is- disragarded from the owner should check the appropriate box for -the tax cla ssitication of Its oftee. Other (see Instructiopp) ....... . ... (APIP103 IOAMDUH13 t0mlakxd oubr* The V.,bj ---------- Address (number, atreet, dad apt, or sulto no. SeeilAstructiotis, ReqUester's name. and address 6 Oily, stats, and ZIP cods 7 List acooutit nurnber(a) here (qptlonai} to- TaXpOyer Identification Number (T[N) Enter your T)N M the ppro date box. The `Ti provided Mst th-Atdil the sacurinufin tyber P e naine given on line I to avoid backup Y�ithholdflng, For,111diViduals, this Is gen4ally yoursoclal SecUrity number However, .for a resident allen, sole proprletor, or disregarded entity, see the InStrLIC-tions for Part I, later. For other entle-sy it is your employer Identification number (EWj. If you do not have a n0mbar, see Pow fo get a d- Flo] 2 TIN, Irater, 0 Nota'l If the Roodunt Is In oro than one netme, see the instructfans for line 1. Also aiee Whit NamGi ani Employer Identif Ication humbee Number To Glive the Raquest0lr for guldeflne:3 on whose nutyiber,to enter, F IT I f 0 o f Certification --- - ------ Under perialties of perjury, I certify that., - --- --- - ----- 1. Tho nuMber shown on this form 1p my correct taxpayer IdentIf toation number -ber (0] QM waltIng for a numbbr to be Issued to rne); end 2,., 1 gin alit subject to bdokup Withholding because: (a) t am examot from badkUPWIthhotding, or (b) I have not b6en notlifled by the Intemal Revenue Ser/loe (IRS) that I am subject to, bavkup withholding a result failure to report all interest or dIvIdonda, or (d) the IRS has n6tifled ,no longer subject to backup w1thholding; and me that I am .3. 1 am a U,3, citizen or other U.S. person (dofined below).; and 4, The rx= cod�(S) enterbd 6n this form (If ani) IndicatIng that I am exemptfrofti FATCA Moorting Is correct. Certification histruiations. You mist, cross out item 2 above If you have been n6tlfled by fie IRS that you are currently subject to backup w4hhol 'ding because you have tiled to report ell Interest and dividerids on your tax rot -urn. For real estate tran , saotlons,. Rem 2 does not 'apply. For mortgage Interest paid,' acquNltlon,or abandonment oitseoured property, Danc�llatlo'n of debi, contributions to an IndivIdual retirarpent arrangern4nt (IRA), and generallyj paynionts alter than Intarm it and d1vidends, you are not required to. s(gn the certification, but YOU Must provide your correct -171N. -See the instructions f6r Part 11, later.' fis Lz. Gate 0-�- Here C 07z General Instructlohs Form 1099 -DIV (dividends, Inotuding those from stocks or mutual funds) Sectforr references to thel Internal Revenue Code unless otherwise noted. # Form `1 099-M 1,90 (Varloms �ypes of Income, prizes, -awards, or gross proceeds) Future developments, For the latest Information about 8evelopments o rorm 1099-B (stock or olutual fund sales and c4dain other related to Form �V-9 and its Instructions, such as legislation enacted by broken�) after they Were published- go to mvmk,�. fX1FdrmltV9. Fon 1099-S -(proceeds from real estate franSaOt[0118) Purposo Of ForM Form 1039-K (merchant card and third party network -trainsactions) -An individual or dntity (Fbtm W-9 requester`) who Is requIred to file an. Form 104(home mortgagainterost), 1098-E (student [c)aij Intergot), Information returp with the IRS Must obtain your correct taxpayer'I g�8�`f` (Ulltl0n) Idendfloation number (M) which may be your social security nornbeir Form 1099-0 (canceled debt) (M), individual: taxpayer Identification humber (]TIN), adoption taxpayer Ident1ficaflon number (ATIN), or employer identification number Form I 099-A (acqulsltloa or abandonment pf secured property) (EIN), to report on an Information return the amount pall to you, or other Use Form W-9 only if you are, a U.S. person (Includfng a resident amount reportable on an Information return. Examples of Information ailen), to provide your correct TIN.. returns Include, but are not 11mIted to, the following. If you cto riot return. Form W -D to the mquester with a TINt you mfght Form 1099- 1 NT (interest earned or paid) be subject to backup withholclIng. $ee What is backup WIthholding, hater, Cato leo.1023'1 Form W-9 (Rev. 10-2016) HMIs Clie r7t Info rM ed Consent Client Release of Information and Informed Consent IMPORTANT: Do not enter personalty identifying Information into HMIS for clients who are-. 0 1) in DV agencies or; 2) currently fleeing or in danger from a domestic violence, dating violence, sexual assault or stalking situation; 3) are being served in a program that requires disclosure of HIVIAIDS status (1.e.; HOPWA); or 4) under 13 with no parent or guardian available to consent to enter the minor's information in HITS,If th 1*5 upp lies to you, S ro P_ Do n o t s la n this fo rrn. This agency participates In the Washlinaton State Homeless Management Information System (HMI -S) by collecting information, overtime, about the 0 a b characteristics a n d service needs eds of people fa cing homelessness, RCC 4-3.18 5 C. 180 an d RCW 43, 185 C,03 0 to To provide the most effective services in moving people from homelessness to permanent housing, we need an accurate count of all people experiencing homelessness In Washington State, In orderto insure that clients are not counted -twice, we need to collect four pieces of personally identifying information. SpecificallY, we collect: name, birth date, and race feth ni city, You may also choose to provide your social security number. However, signing this form does not equire you to do so. Your information will be stored in our database for 7 years after the last date of service, 0 r i e, If you have questio'ns about collection of data or your rights regarding your identifying information, contact the HMIS System Administrator at: (360) 725-3029 OF personally We use strict security policies designed to protect your privacy, Our computer sy5tem. Is highly secure and Uses up-to-date Protection features such a� data encryption, passwords, and tw . 0 - . o -factor authentication required for each -system user.. There Is a small risk of a securitybreach, br h, grid someone might obtain and use your Information inappropriately. If you ever suspect the data in HIVIIS has b misused, immediately contact the HMIS System Administrator at: (360) 725-3028 een U The data you provide may be combined with data from the Washington State Department of Social and Health Service (DSHS) and Education Research and Data Centerfor the purpose of further analysis. Your name and other IdentifAngy information will not halseed in an v reports orpublicatlons, Only a limited number of staff members, who have signed confidentiality agreements, will be able to see this Information, Your information will not, be used to determine eligibility for DSHS programs, Washington State HMIS system administrators haste full access to all information In HMIS. This includes the Department of Commerce staffdesignated HMIS system administrators, and the software venclor, , By signing this form You acknowledge and allow Department of Commerce staff to obtain additional records of information from other 0 state agencies with which there *15 a data sharing agreemen"t", (DSA) on dile between Commerce and the other agency. Our DSA uidesa da transfer and storage security protocols. If DSAS are in place) Commerce is authorized by you to obtain, add to HMISagnd use for g evaluation purposes any other datzyou have provided to other Washington state aencles. , Your decision in the NM IS wilt It notaffectth TTe I the guafliyorguanfitvof services you are digibleto receivefrom this agency, and III not be used to deny outreach, assistance, shelter or housing. How if you do' choose to participate, services'! wt ever, . n the region may improve If we have -accurate information about homeless individualsand the services they need Furthermore, some funders MAY require that you consentto provide your personally identifying Information in HMS in order for you to receive services -from that funding source. IV I understand the above statements and consent to the inclusion of personally identifying Information in HNIIS about me and any dependents dents listed below, and authorize information collected to be shared with partner agencies. I understand that my personally identifying information will not be made public and will only be used with strict confidentiality. I also understand that I may withdraw,my consent at any time by filing a ,'Client Revocation of Consent' fortis with this agency. I understand that I may obtain a copy of my signed consent form from this Agency (including forms signed electronically). Dependent children under 18 in household, if any (Please print first and last names): Client ioana are -Guardian) Client Name (PrieAcleartv) Date Agency Staff Name (Print clearly) Initials Client refused consent (Agency Staff Initials), HMIS Unique Identifier (optional) Client Release of InformaLian and Informed Consent Revised 612ois This form may trot be amended except by approval of the WashinatOn State Department of Commerce Approved as to form by Sandra Adix, Assistant Attorney General, 6/51201a JUL 19 . RECEIVE 7023 el le W. Gront; Behoviaral Fler-Iftv-h S Wellnes5 Name: 402 Isern(s) Re uested (include a photo iF you need a specific item: Iff I Approximate Cost, ft= Funding Source, if nn: A n 41 - ------------------- M11101111 -1011.1111111 . Date Needed Bye., Supervisor"s Signature .,�y�� Date � + i .. Mease have your supervisor sign the form an then return it to the Finance Department, Form WWW9 (Roo. Oolobur 20 f 8) pep� 11 torSON 0 I Nqtno (ao shown oil your Windermere Pr opert 2 Bualws nalno/dIsronar( Request for Taxpayer Identiff0ation Ntimber and Certificat" Ion 0- GO tO WW1NdM.g0VJF0rJ11W,9 for 111o1rklotiolig Ung * - 11 4 1 _kft the llatou.t inforonatfoll. oomo tax Muni), me �rbqulrod on tills line; do 1101 1ORY0 this Iftle blank, Management Na'', isrant CDuiity, ina, I onlity nao)% If dIffeviont from abovo 0 IVO FQrM to the requestor. Do not send to the IRS. 3 Check r1l)ProprIato box for fadern! tax 0IA1JtW0aV0r' Of 010 Petoon Whaw name Is entered on lino 1, 0hook only Ghe'of t'ho - 4 rExampttons (codos. follo%no Wan boxes, apply only to cortain ohiltles, not lhdlvldkials; Sao IMtructions on p4qea): cc D 1ndIvIdi1aDUJ(3 proprietor DO Oorporatlon FJV 6 Corporation Partriership L] TrusVestqta alfl&-mamlaor LLQ �Xalppt payee 00de {Ir any) LI'mited Ilability oompany, Fnter 11ho taX C1a$Slf1QatI0h (0=0 oorporiation, $::�S 00rPorAtIont P=PartnorohIp))1-,,,,. Note; Oliack tlia appropriate box (ii rho Ma Wove for the 1EM 0061010040011 Of the sIngle-inembet "ner, DO '10t cheOR EX9rrtlDJJ IrOM FATOA re-portho LLO It lie LW Is olasalfleclaa otaingle-Met-1-0 that ladlaregarded fMM Vie Dwnartinlesathoamor oR f the LLQ Is another LLL thAt Is not d1sregardod from the owner for U4, federal t ode (if any) 1v d1oragarded from lira omior thould ohoql tai NtPOnfl- OffiBrINISe, a *Vlu-tnembor LLG that c the app(Qpd(ale box for thia toy, olqaql1loation of Ito 0W11Q1*' Other (sea lAttructlona).0- FS Addlrp�s bero stroet.,and apt. Roque name and addroas (optloijaD 324 S, Ash Sts SUIte A 6 01tY, state, and ZIP coda MOS05 Lake, WA 98837 7 Lint account numbur(s) lure (o�ilonnl) - - -------- . an - -- 'Taxpayer Ido ift Ifloation Number (TIM Ehter your TIN In thoapproprkqtG boXiTtie'ri�i provided must g�lven oil lino Ito avoid 00101 004urity Jltlliiboe backup withholding. For* IndivIduWa, this I� Yonerally your 8oaltill so. ourlty number (S$N), However, for a resident alien, a0lo proprietor, or dioregarded entity, we the Im5tructions for Part (, later, For Other entities, It la your employer ldentlfloatlon nomber (EIN). if you do no! have a MlMbor, a0e How 0 Vet 0 T14 later. [I] Note* Ilf Ilia a0count Is In more than one m"T10, sae H16 in-9tM01:10no for line 1. Also see 'IrVhat Narfle a or nd Employor Wontiflo0on M) - ni - Humber To Glue thO Roquestor for guldolltreg ori whose nqrnbar to enter, 3 7 2 0 1W Certification Under Penrall:105 of perjury, I certify that: i, The number shown on this form Is my oorroot twipayar Identifloation nurribor (or I am w4l.lj� fn�r a nUmber to be Issued to 1,nq); V�rld R� I arn not J3L1bJeQt to backup w1thholdl ng �Qoause: (a) I oral exempt from b-aolmp withholding, Pr M I have riot been notilled by the Inlernal R-ovanua $ervfoe (IRS)thnt I arn, sub eat to backvp with holdtriq ala a restlit of u fall'ure to report all Injorest or dividends, or (a) I no longer subloct to beLokup withlialding; and he IRS h4vIR notified Me that I am 8, 1 am a U.S, citizen, or othor U,$. parson (deflned, bplow); Qrld 4, The FATCA code(s) entered on this form (if arty) Ind larAting that I atyl (J;v,.0MPt from FATOA reparting Is aos,reot. 00 Mflonflon Instmatlon s. You amat orotr,- r% t Item 2 above If you havor been notitled Who IRS that you aro ourrently oubloot to be-okup vvItilholding �00,1:uso you have failed to report all Ilitaeou'tittl(I dividends -MYOW tax rotor. For real ostato lranaaollon% Item 2 does not pply, acquIsItIon or abfiAdonmant of iaeourbd property, oancell4tion of debt, oorilributlona to an lndtiv[dual rotiromentra t a o For mortgage Interest paid, .ngernent 09A), and gonorally, PXyments other than Interost and dividends, you aro not requIrod to Aign flie cerlifictitlon, but yoU must provIdo your ooiywt TIN, 800 the Instruoti -§A .... ons for Pad 11, later, tign slonattirs Hore --------- Date 0- 2e90 General Instructions, o Form 1009 -Di (dIvidell -V d,*., Including those from stools or Muttial funds) SWUM rate-ronoeo are to the Internal Revenue 00du unloa othervilso noted, Form 1 Ogg -I' ISO (varloua type: of Income, prizes, Qwards, or oros.3 procoods) Fkftiro For tho letteat Information about developmont,.cl related to Form W-� and Its Inatruatlons, auch as legislation onciatod v rorrfl 11099-13 (6tOOk Or MUtUE-11 fund sales and oorlaln other, after they woro publlohod, go to www.,1*8,g0V1p0111-1t,.V9, Lransaotions by brokers) Form 1090-s (proceeds from real estate tjtA11oaot1oh$) Purpose of Form Form1099,-K (morahant oard and third party notwork tranuactions) An Individual or en tity (Farm W-9 requester} Who is requIrod to file an Form 1090 (home i-nortgago Interest), I 0198-E (student loan Interest), linfotratlon return witll the IRS must obtain YOUr Qarroct taxpayer M -T (tultlon) Identiff oation nurnbor 01N) WIllob may ba your soclal aaouKty numberrr 009-0 (caticeled debt) (-S8N),, Individual taxpayer Ident1floation nUmbor OTIN), Adoptlon taxpayer Idenfiff(jotlo n number (ATIN), or eniplQyer Idetitiftatlon number Form 1099-A (acquisl0an or eabandonment Df oecured property) (�[N), to report on art Information return tho omount paid to you, or other Use Form W-9 Only If you are a U.$, persol) (Inclarilng a rosldent 41MOLInt reportable on all Inrormatlon return, Examples of Information clltati),'to provIdo ymir corroot TINo reftIM0 Include, but are not limited to, the fallowingk If You do not return FormW-9 to the requester V&J) a 71P�1 you t171glIt 5orm 1009 -INT (Ulteresl earned or paid) be stiblect fO bpciftip Villhhoidlng, See What I$ Mokup withholding, later, Cat, NO. 10231X Forin W-9 (Ray, I o,-2ol 0) RHEIVED JUL 1 9 2023 n;v w GronL 13ahavioral Heolth 0 Wellness Name,, Date: Item(s) Requested (include a photo if you need a specific item): 11 Reason for qtyestm A -2 I M I Date Needed ByJ, Supervisor's Signature Date Please have your supervisor sign � ici��-- i form and then returnit to the Finance Department, Formwk99 (Rev, Oolober 2018) D_ 11 )OM of the Treasuv/ ROVOMM 8�rvj'Qe 1 N a m o (ao' s h 6 W'_ -1-1 'on y'0'Ur' Windiarmero Prepeat 9 Bkfolnoae name/d[Gragar( Request for Ta xpayer Idetitification Number and Certification cid tca ww1P'J'-8.9ovXara7W9 for Instructiatip and the latost Infortnat(on, Gome Nx roturn), dame is roquiroq an this' 11ria; -do -nbl Management Grant CoUnty, 111c, I entity nL jilie, It dIfferant from above Givo Form tib •Iho r9quelst0f. 00 not send to the Irtsix Q 3 Mack opproptiale box for federal tax qlauuIflantion of %0 p-araan fdlMlno SOVEM b0%8% W,11000 naMo Is entered on llncii, Chook only one oF tho 4 ExemplIons (podes apply tartly to 0135 lRdIvIdual/sOle proprIetor or 0 Gorpamt[Qn Oorp'oratlon CJ Partnnruh)p El 1ruot/oetuta portain antitles, Wt Individuals; z;ee In8truatlons an page 3): 0 Ej Urnited 11abIlIty coinpany, Enter tho tux cIZIMM0411on (C=gorporation, 6_-S'00rP0Mtl01', P=:Pftrt11aeshlp), Exi; mpt p ayea COO (fIf any) q 0 - Note., Chook tilf) appropriate box In ffie One abova tor' tM tay, c1cissikatlon cal the 91119le-mornlanr owner, Do not chock d , LL O It the 1.14 [a olassigecl as a $in lo-Inembor LLO that 1.9 diaragardfld frons Die owner unlea.4 the ownor of tile LL O is another 1.1.01 that Is not dlarogar 59 rroM tho EKeMptlOn ftlt FATCA mparting 0 owpor for U,3, federal tax purposes, Othorwl-4% a �ulagls-mambgar LLC that Is d1aragorded from the, ownorollould 01160k rho appropriate box for the tOx of h ovyner,- code Of any� J11her (see Insirvotlons)0, 6 Addresu (riumberr, atre 04, Quo opt, or collo no) See Watructlons, 324 S, Ash Stt Salto A OUNW4 U10 Us,) Iquester's namoand addreas (opflonal) tate, and ZIP code ltd La�e, VIA 98837 7 List account nvmbur[a, Mora (aptlarml) laxpayer Identification Mum'ber M Enter your 7 IN In the appmprlato box, Tile Ti JN provided must match tho neirne Ulven on llnoj to avoid. baclivp withholding, For lodIvIduq(n, W3 N; generally your scald soourlb/ number (8W, Howavev, for a rosident ellen, We Proprlutornr disregarded aritlb/, see the Irl'structlons for Part It 161tar, For other GlItIns-1 It Is your employer Wentifloation number (EIN). If you do not have a nt. mber, Bee now to pet a VA), lator, Note; if the account In mar than one nfMr seoAha lilstructlongfor lin:uqe 1. Also u What N;Rmo and Number To G[ve tho F?oq('1ester for guld'ollne-son who3q ntimber to enter. $00141 seoupity numb, 01 ___— or jImployer wentl(104tkn numbor 2 0 1 6 Und6r Penalties of perjuryt I aerttfy that7, 1, Tho number shown On this fore IS My 00rrect taxpayer Identifloatlor) number (or I am walt]TIV for a number to be Issued to me), tAnd 2T 1 am natsubloot to bacj�up withholding bocause: (6� I am exempt from W101(UP WIthholding,or M 1 have riot beeri noiltiod by the Internal Revenue ervlae (IRS) that I am s0jeot to lir; w IthholdIng as a 1`0801t Of a fallurs to repoil all Intermit or divi4ends, or (6) the IRS has notified me that I am W larl9el'-sLiblool to backLiP withholding; and 3. 1 am C1 V-8, 01tizarl or Qther U,8. person (deflned below); and 4, The FATOA cod (s) entered on th I. form (it any) Indicating that I am exempt from FAT reporting isool-rectl Cortifloollon InstrLmflong. YOU MUM Gross OUt 1.tGM 2 Fibova If you hava been.. notified hY tho IRS that you taro 0. urrently tiub*t to ba0kilp Whhholding heQAVS9 You have failed to report all Interest and dividenda otT your tax return. For real estate t In 2 C1063 nQtMPPIY, 17-01' rflortgaoe Inter -eat or abandonment of secured prop orty rf�"Rct]ORal ItO eat pald, 0anoollalloti of debt, oantributions to gn InclIvIdual retlrety'0111 arra anent 0M), and genemlly, p other thrill fnlorM and dlytdonds, you oro not regUll'od to sign the cortificatlon, but YOU most provId o yoUr 00rreuL TIN. SO the lm;truotlonayments Part s for II,, later, ihIrlcrtcrrn HoVe Lk Z/ 7 l Instructjoins Form 1099-011 (dIvIdendo, ino. juding those from stooksi or mLitual Seotlan references aro to the Intalenal Revenue Gods wilesa otj�orwjqe funds) noted. * Form 1099-MISO �varlolo-stypQs of Ijjoojn% prizea, awards, or arass Future dovelopth6nts, For tho latest lnfcrmgMQn about dovelopmonts pr0000ds) related to r -00n IN -9 and Its Instructlons, such as 1091'slatlon orictoted * Form 1099-15 (stock or mutva�j fUnd e1*0 and oertaln oftr after they were published, go to KfWWJrs.,,7ov1FormVV,9. transactions by brokers) Purpose of Form * Form 1090-6 (Procoade from foal eaticte tvansaotions) # ForM 1 099-K (marchant =0 and third party nojworjt transRotlons) An Individual or entity (Form W-9 raqvostar) who 1,i required to file an * Foun 1098 (horns mortgage Interest) , 11098-E (ptudont loan Intemst), Informat Ion retum with the IRS must obtain your Qorreot taxpayer (tuition) I den 11flovation number' (TIN) which may be your �oclal 8-Murity number (S M, Individual toxpayor IderitIfloatJoh numbor (ITIN)t adoptlon F01'M *1099-0 (canooled dobt) taxpayer Identiflocition number (ATIN), Or employer WentIfIc-ation nuts bar rorm I Gq.�A (acquisition orrbandonment of -secured property) (1-'flN), to report on an Infoemation return the amount Vaid to you, oy other U80 r-Orlyl W-9 OWY If YOU are a UA person (Including a roddej)t amount reportable on an Information return. �xatnplos of Inforillat[on ellen), to provide your corroot TIN, Mums hioluda, bLA are not limited to, the followilig. If you do not return Fbt7n Vl-,g, to the roquester w1th a TIN, you I mIght Form 1090-I T (Intereat earned or paid) ,be sublecl' 40 bao,140 WithholdIng, See What Is baokup w1thholding, War. W, No. 10231K roml W-9 (Plev,