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Form W-9 (Rev. 12-2014) <br />General Instructions (continuation of page one) <br />Section references are to the Internal Revenue Code unless otherwise noted. <br />Future developments. Information about developments affecting Form W-9 <br />(such as legislation enacted after we release it) is at www.irs.gov/fw9. <br />Purpose of Form <br />An individual or entity (Form W-9 requester) who is required to file an information <br />return with the IRS must obtain your correct taxpayer identification number (TIN) <br />which may be your social security number (SSN), individual taxpayer identification <br />number (ITIN), adoption taxpayer identification number (ATIN), or employer <br />identification number (EIN), to report on an information return the amount paid to <br />you, or other amount reportable on an information return. Examples of information <br />returns include, but are not limited to, the following: <br />• Form 1099 -INT (interest earned or paid) <br />• Form 1099 -DIV (dividends, including those from stocks or mutual funds) <br />• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) <br />• Form 1099-B (stock or mutual fund sales and certain other transactions by <br />brokers) <br />• Form 1099-S (proceeds from real estate transactions) <br />• Form 1099-K (merchant card and third party network transactions) <br />REV: 01-17-18 RL <br />ATTY/AGR/2018.012/COUNTY OF SAN MATEO <br />6.1.C. - Page 51 <br />• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T <br />(tuition) <br />• Form 1099-C (canceled debt) <br />• Form 1099-A (acquisition or abandonment of secured property) <br />Use Form W-9 only if you are a U.S. person (including a resident alien), to <br />provide your correct TIN. <br />If you do not return Form W-9 to the requester with a TIN, you might be subject to <br />backup withholding. See What is backup withholding? on page 2. <br />By signing the filled -out form, you: <br />1. Certify that the TIN you are giving is correct (or you are waiting for a number <br />to be issued), <br />2. Certify that you are not subject to backup withholding, or <br />3. Claim exemption from backup withholding if you are a U.S. exempt payee. If <br />applicable, you are also certifying that as a U.S. person, your allocable share of <br />any partnership income from a U.S. trade or business is not subject to the <br />withholding tax on foreign partners' share of effectively connected income, and <br />4. Certify that FATCA code(s) entered on this form (if any) indicating that you <br />are exempt from the FATCA reporting, is correct. See What is FATCA reporting? <br />on page 2 for further information <br />Form W-9 (in-house rev. 07-2015) <br />