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HomeMy WebLinkAboutCARES Act ResolutionOva SEBAST!AN HOME Or PELICAN ISLAND CITY COUNCIL AGENDA TRANSMITTAL FORM COUNCIL MEETING DATE: July 22, 2020 AGENDA ITEM TITLE: Resolution R-20-10 Approving the COVID-19 Recovery & Stimulus Plan Grant Application Process and Submittal to Indian River County for Pre -Approval. RECOMMENDATION: Move to Approve Resolution R-20-10, Submit the Plan to Indian River County for Pre -Approval and Proceed with Implementation. BACKGROUND: City Staff developed the attached grant application process to administer the Plan addressed in the Resolution. With the amounts expected to be made available through Indian River County from the Coronavirus Aid, Relief and Economic Security (CARES) Act federal stimulus package, we see a great opportunity to assist qualified local businesses to endure the detrimental financial effects of the COVID- 19 Pandemic, as well as help their workers that reside within the City limits. Note that this is directed only to small independently owned and operated businesses that have been affected by the shut -down and that currently maintain a storefront location within the City limits. The business may have no more than 20 workers. Also note that larger businesses and home -based businesses will not be eligible, at this time. The Grant amount available for each business will be $5,000. We feel it also important to take this opportunity to also assist the workers of the qualified businesses that are awarded the grants who have involuntarily suffered from a loss of income during the COVID-19 Pandemic. Note that only workers that live within the City limits are eligible, at this time. The Grant amount available for each worker will be $500. Assuming pre -approval by Indian River County, we will attempt to quickly advertise the grant availability and promptly accept applications and issue checks on a first -come, first -served basis. Staff believes this will be helpful in sustaining these small businesses and their workers and serve to promote a speedier recovery from the COVID Pandemic. IF AGENDA ITEM REQUIRES EXPENDITPRE OF FUNDS: Total Cost: Not to exceed Coronavirus Aid Relief and Economic Security Act funding. Funds to Be Utilized: Up to $924,320 Reimbursement f m Indian River County. Administrative Services Department Review: f - '' Y ATTACHMENTS: COVID-19 Recovery & Stimulus Plan Grant Application Documents City Manager Authorization: Date: o",I E: r,vll e Digitally signed by Paul E.Carlisle Date: 2020.07.16 07:56:20-04'00' RESOLUTION NO. R-20-10 A RESOLUTION OF THE CITY OF SEBASTIAN, INDLAN RIVER COUNTY, FLORIDA, ADOPTING A COVID-19 RECOVERY & STIMULUS PLAN, PROVIDING FOR A GRANT APPLICATION PROCESS; PROVIDING THAT THE CITY SHALL BE REIMBURSED FOR SUCH GRANTS WITH FUNDS FROM THE CORONAVIRUS AID, RELIEF AND ECONOMIC SECURITY (CARES) ACT FEDERAL STIMULUS PACKAGE SHARED BY INDIAN RIVER COUNTY; AUTHORIZING THE CITY MANAGER TO CAUSE SAID PLAN TO BE PUT INTO EFFECT; PROVIDING FOR REPEAL OF RESOLUTIONS OR PARTS OF RESOLUTIONS IN CONFLICT HEREWITH; PROVIDING FOR SEVERABILITY AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, Indian River County plans to share funding allocated by the Coronavirus Aid, Relief and Economic Security (CARES) Act with the City of Sebastian; and WHEREAS, Indian River County must pre -approve the spending plans; and WHEREAS, the City of Sebastian has developed a plan to process formal applications from small businesses and their workers for grants intended to help qualified small businesses and their workers by offsetting some of the loss of revenue during the COVID-19 Pandemic; and; WHEREAS, the City Council concurs that the Plan will help sustain such small business and their workers and thereby serve to promote a speedier recovery from the COVID-19 Pandemic; NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SEBASTIAN, INDIAN RIVER COUNTY, FLORIDA, that: Section 1. The COVID-19 Recovery & Stimulus Plan is hereby approved. Section 2. The City Manager is authorized to submit the Plan to Indian River County for pre -approval and after any required minor adjustments, advertise the Plan and put it into effect. Section 3. Sections of this resolution may be renumbered or re -lettered and corrections of typographical errors which do not affect the intent may be authorized by the City Manager, or the City Manager's designee, without need of further action of City Council by filing a corrected copy of same with the City Clerk. Section 4. CONFLICT. All resolutions or parts of resolutions in conflict herewith are hereby repealed. Section 5. EFFECTIVE DATE. This resolution shall take effect July 22, 2020. The foregoing Resolution was moved for adoption by Councilmember . The motion was seconded by Councilmember and, upon being put into a vote, the vote was as follows: Mayor Ed Dodd Vice -Mayor Charles Mauti Councilmember Jim Hill Councilmember Damian Gilliams Councilmember Pamela Parris The Mayor thereupon declared this Resolution duly passed and adopted on this 22"d day of July 2016. ATTEST: Jeanette Williams, City Clerk CITY OF SEBASTIAN, FLORIDA 0 Ed Dodd, Mayor Approved as to form and legality for the reliance by the City of Sebastian only: Manny Anon, City Attorney LIP OF SEg'°`sTI tN HOME OF PELICAN ISLAND CITY OF SEBASTIAN, FLORIDA COVID-19 RECOVERY & STIMULUS PLAN GRANT APPLICATION Eligible Small Businesses: The City of Sebastian has decided to award grants of $5,000.00 to eligible small businesses located within the City limits to assist in addressing their immediate cash flow needs as a result of demonstrated economic injury due to the COVID-19 Virus. Each business can only receive one grant. Applications will be reviewed to confirm eligibility using the parameters listed below: 1. Must be a for -profit, privately -held small independently owned and operated business currently maintaining a commercial physical storefront location within the City limits of Sebastian. 2. Must not have any current unpaid code enforcement liens and must not be operating in violation of any state, federal or local laws. 3. Must have been mandated by the government to reduce or eliminate services or have a demonstrated reduction in sales revenues of 25% or more due to the loss of business income related to COVID-19. Documentation may consist of (1.) certified Point of Sale or QuickBooks reports, (2.) certified income statements or (3.) sales tax returns, which demonstrate a comparison of the current month sales revenues versus the same month the previous year. 4. Must be a small business that as of March 1, 2020 had at least 2 employees or independent contractual workers but no more than 20 full time and/or part time employees or independent contractual workers in addition to the owner. Documentation may consist of (1.) the 2019 IRS Form W-3, (2.) the IRS Form 941 or (3.) the summary filed with IRS of 1099s issued to individual independent contractual workers for that time period. 5. Must submit a copy of the primary applicant(s) current driver's license(s), a copy of the applicant(s) current passport or other photographic identification. 6. Must submit a copy of a completed and signed IRS Form W-9. 7. Must submit completed COVID-19 Small Business Grant Application no later than September 30, 2020. 8. Must submit COVID-19 Employee Grant Application(s) at the same time as submitting the COVID-19 Small Business Grant Application. Employers are encouraged to inform eligible employees of their intention to apply and the possibility that employees may also be eligible. Mail or hand deliver the Application and all supporting documentation to 1225 Main Street to the attention of the Administrative Services Director or email them to COVID19GrantPcitvofsebastian.ore. Do not forget to include any Applications for the COVID-19 Employee Grants, as described on the next page. Eligible and fully completed applications will be promptly processed and awarded on a first -come, first -served basis. Payments for those approved will be made via checks mailed to the Applicant's business mailing address or the employee's mailing address. Page 1 of 2 Elieible Emolovees or Independent Contractual Workers: The City has also decided that certain employees or independent contractual workers, excluding the owner(s) of the small businesses determined eligible for the above COVID-19 Small Business Grant may be awarded grants of $500.00: 1. Must reside within the City limits. 2. Must have worked an average of 20 hours or more per week prior to March 1, 2020 3. Must have been involuntarily terminated, furloughed or had their salary, commissions, tips or contractual payments from the eligible Small Business Grant Applicant reduced by at least 25% since March 1, 2019. Must provide a statement signed by the Worker and the Employer certifying the Employee had at least a 25% loss of income. 4. Must show evidence of being past due on rent, utilities or other essential expenses, as preference will be given to those demonstrating the severest economic need. (Past -due notices or letters from landlord or utility company for no less than $500.00). 5. Must submit a copy of the individual's current driver's license, current passport or other photographic identification. 6. Must submit a copy of a completed and signed IRS Form W-9. Submit the attached COVID-19 Employee Grant Application to the Employer in advance of the Employer's submittal of the COVID-19 Small Business Grant Application. All applications must be submitted by the Employer at the same time. Conditions: Grant awards are discretionary in nature and should not be considered an entitlement by the applicant. All grant criteria contained herein are guidelines for awards. Even should an application meet all grant criteria, a grant may or may not be awarded at the City's discretion due to funding limitations, competing applications and/or competing priorities. The number of grants that can be awarded is subject to the expectation that the City will be reimbursed from funding provided by the Coronavirus Aid, Relief and Economic Security (CARES) Act federal stimulus package the County is sharing with the City. The grant proceeds are intended to help qualified small businesses and their workers by offsetting some of the loss of revenue during the COVID-19 Pandemic. Grant proceeds are unrestricted and have no specific requirement as to how it is used, leaving how the money is best spent entirely at the discretion of Grantee. Page 2 of 2 MOF SE�TIAN HOME OF PELICAN ISLAND COVID-19 RECOVERY & STIMULUS PLAN FOR SMALL BUSINESSES GRANT APPLICATION Legal Name of Small Business: Fictitious Business Name (Doing Business As): I Business Phone Number: IBusiness Property Address: Business Email Address: Business Mailing Address: IDescribe Your Business and the Services/Products Offered: Describe the Economic Loss Suffered: (Either Forced Reduction of Services or Documented 25% Loss of Income). Number of Workers (Only Include Part Time Employees That Worked Over 20 Hours per Week): Full Time Employees: PartTime Employees: Independent Contract Workers: As Of Current ---4sW Current Of Current March 1, 2020: Number: March 1,, 2020: Number: March s1,, 2020: Number: By signature of this application, the applicant(s) agree that this application and other relevant documents are subject to verification by the City and may be shared with internal and external stakeholders and hereby certify that my Business has been negatively impacted by the COVID-19 Pandemic: Primary Owner's Name: (If Primary Owner has less than 51% of Equity, Attach List with Names, Primary Owner's Title Signatures and Titles of Collective Owners Equaling at least 51%). Primary Owner's Signature: Date: Documentation Required With This Application: 1. Unless Business was mandated to reduce or eliminate serves, provide: (1.) Certified Point of Sale or QuickBooks Report(s), (2.) Certified Income Statements or (3.) Sales Tax Returns, which demonstrate a comparison of the current month sales revenues versus the same month the previous year. 2. Documentation of Workers with either: (1.) the 2019 IRS Form W-3, (2.) the IRS Form 941 or (3.) the Summary filed with IRS of 1099s issued to individual independent contractual workers for that time period. 3. A Copy of the Primary Applicants Current Driver's License, Current Passport or Other Photographic Identification. 4. A Completed and Signed IRS Form W-9. 5. All COVID-19 Small Business Worker Grant Application(s). Ma SE !L qN HOME OF PELICAN ISLAND COVID-19 RECOVERY & STIMULUS PLAN FOR SMALL BUSINESSES WORKER GRANT APPLICATION w. Legal Name of Small Business: IWorker's Email Address: Worker's Mailing Address: Legal Name of Worker: Worker's Home Address: (Must Reside in Sebastian). Worker's Phone Number: Describe Your Job (Including the Average Hours per Week You Worked Prior to March 1, 2020): Describe the Economic Loss You Have Suffered: (Must Have Experienced a 25% Loss of Income to Qualify). By signature of this application, the Above Worker agrees that this application and other relevant documents are subject to verification by the City and may be shared with internal and external stakeholders. Also by signing below, the Small Business Owner and Worker hereby certify that the Worker worked for the small business an average of 20 hours per week or more prior to March 1, 2020 and has lost at least 25% of their income due to the negative impacts of the COVID-19 Pandemic: Small Business Owner's Name: Primary Owner's Signature: Worker's Signature: Date: Documentation Required With This Application: 1. A Copy of Worker's Current Driver's License, Current Passport or Other Photographic Identification. Evidence of being past due on rent, utilities or other essential expenses. A Completed and Signed IRS Form W-9. CARES Breakdown per OST Allocation (Same allocation for half cent sales tax) Indian River County - All Municipalities Municipality Fellsmere Indian River Shores Orchid Sebastian Vero Beach Unincorporated County TOTAL % of 25% Allocation Total Allocation Population 3.00% 2.26% 0.23% 13.25% 8.75% 72.51% 100.00% per Municipality $ 209,070 $ 157,919 $ 15,874 $ 924,320 $ 610,734 $ 5,058,416 $ 6,976,333 per Municipality $ 836,279 $ 631,675 $ 63,498 $ 3,697,280 $ 2,442,937 $ 20,233,664 $ 27,905,332 C\Users�asonb\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\JU2T1KG2\Funding Allocation (002) W-9 Request for Taxpayer Give Form to the Form (Rev. October 2018) 1 Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service ► Go to www.irs.gov/FormM for instructions and the latest information. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above yP 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the Y 4 Exemptions codes apply only to P ( Pdu Y � fallowing seven boxes. certain entities, not individuals; see a Cp ❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate Instructions on page 3): ti single -member LLC Exempt payee code (if any) 0 ❑Limited liability company. Enter the tax classification (C=C corporation, S=5 corporation, P=Partnership) P. `o Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting c w LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is LLC is disregarded code d any) ( a U another that not from the owner for U.S. federal tar purposes. Otherwise, a single -member LLC that 'E is disregarded from the owner should check the appropdate box for the tax classification of its owner. d ❑ Other isee instructions)► (Apll efo •=coums m•mmm•d o•cur m• us.) to 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional) d V 6 City, state, and ZIP code 7 List account number(s) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid social security number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other = - entities, it is your employer Identification number (EIN). If you do not have a number, see How to get a TIN, later. or Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number Number To Give the Requester for guidelines on whose number to enter. m JiM Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11. later. Sign Signature of Here U.S. person ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments, For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.1rs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (FIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) Date ► • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Fonn W-9 (Rev. 10-2018) Form W-9 (Rev. 10-2018) Page 2 By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting, later, for further information. Note: If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S, person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien; • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States; • An estate (other than a foreign estate); or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States. • In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity; • In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and • In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items. 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) In the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233. Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 24% of such payments. This is called "backup withholding." Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding it: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Instructions for Part II for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or S. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See Exemptpayee code, later, and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships, earlier. What is FATCA Reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specked United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code, later, and the Instructions for the Requester of Form W-9 for more information. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee If you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account; for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Form W-9 (Rev. 10-2018) Page 3 Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return. If this Form W-9 is for a joint account (other than an account maintained by a foreign financial institution (FFI)), list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. If you are providing Form W-9 to an FFI to document a joint account, each holder of the account that is a U.S. person must provide a Form W-9. a. Individual. Generally, enter the name shown on yourtax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name. Note: ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application. b. Sole proprietor or single -member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or "doing business as" (DBA) name on line 2. c. Partnership, LLC that is not a single -member LLC, C corporation, or S corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from Its owner is treated as a "disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business name/disregarded entity name." If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This Is the case even if the foreign person has a U.S. TIN. Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2. Line 3 Check the appropriate box on line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box on line 3. IF the entity/person on line 1 is THEN check the box for... a(n)... • Corporation Corporation • Individual Individual/sole proprietor or single- • Sole proprietorship, or member LLC • Single -member limited liability company (LLC) owned by an individual and disregarded for U.S. federal tax purposes. • LLC treated as a partnership for Limited liability company and enter U.S. federal tax purposes, the appropriate tax classification. • LLC that has filed Form 8832 or (P= Partnership; C= C corporation; 2553 to be taxed as a corporation, or S= S corporation) or • LLC that is disregarded as an entity separate from its owner but the owner is another LLC that is not disregarded for U.S. federal tax purposes. �• Partnership Partnership �• Trust/estate Trust/estate Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space on line 4 any code(s) that may apply to you. Exempt payee code. • Generally, individuals (including sole proprietors) are not exempt from backup withholding. • Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends. • Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. • Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC. The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space In line 4. 1—An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(t)(2) 2—The United States or any of its agencies or instrumentalities 3—A state, the District of Columbia, a U.S, commonwealth or possession, or any of their political subdivisions or instrumentalities 4—A foreign government or any of its political subdivisions, agencies, or instrumentalities 5—A corporation 6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession 7—A futures commission merchant registered with the Commodity Futures Trading Commission 8—A real estate investment tmst 9—An entity registered at all times during the tax year under the Investment Company Act of 1940 10—A common trust fund operated by a bank under section 584(a) 11—A financial institution 12—A middleman known in the investment community as a nominee or custodian 13—A trust exempt from tax under section 664 or described in section 4947 Form W-9 (Rev. 10-2018) Page 4 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for ... THEN the payment is exempt for... Interest and dividend payments All exempt payees except for 7 Broker transactions Barter exchange transactions and patronage dividends Payments over $600 required to be reported and direct sales over $5,000, Exempt payees 1 through 4 and 6 through 11 and all C corporations, S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012. Exempt payees 1 through 4 Generally, exempt payees 1 through 52 Payments made in settlement of Exempt payees 1 through 4 payment card or third party network transactions 1 See Form 1099-MISC, Miscellaneous Income, and its instructions. z However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 5045(f), and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with "Not Applicable" (or any similar indication) written or printed on the line for a FATCA exemption code. A —An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B—The United States or any of its agencies or instrumentalities C—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities D—A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section 1.1472-1(c)(1)0i E—A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1(0)(1)(i) F—A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state G—A real estate investment trust H—A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I —A common trust fund as defined in section 584(a) J—A bank as defined in section 581 K—A broker L—A trust exempt from tax under section 664 or described in section 4947(a)(1) M—A tax exempt trust under a section 403(b) plan or section 457(g) plan Note: You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns. If this address differs from the one the requester already has on file, write NEW at the top. If a new address is provided, there is still a chance the old address will be used until the payor changes your address in their records. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an MN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. If you are a single -member LLC that is disregarded as an entity separate from its owner, enter the owner's SSN (or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN. Note: See What Name and Number To Give the Requester, later, for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/Businesses and clicking on Employer Identification Number (EIN) under Starting a Business. Go to www.irs.gov/Forms to view, download, or print Form W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to place an order and have Form W-7 and/or SS-4 mailed to you within 10 business days. If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note: Entering "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8. Part IL Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, 4, or 5 below Indicates otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code, earlier. Signature requirements. Complete the certification as indicated in items 1 through 5 below. Form W-9 (Rev. 10-2018) Page 5 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), ABLE accounts (under section 529A), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual The Individual 2. Two or more individuals joint The actual owner of the account or, if account) other than an account combined funds, the first individual on maintained by an FFI the account' 3. Two or more U.S. persons Each holder of the account (joint account maintained by an FFI) 4. Custodial account of a minor The minor' (Uniform Gift to Minors Act) 5. a. The usual revocable savings trust The grantor -trustee' (grantor is also trustee) b. So-called trust account that is not The actual owner' a legal or valid trust under state law 6. Sole proprietorship or disregarded The owners entity owned by an individual 7. Grantor trust filing under Optional The grantor' Form 1099 Filing Method 1 (see Regulations section 1.671-4(b)(2)(i) (A)) For this type of account: Give name and EIN of: 8. Disregarded entity not owned by an The owner individual 9. A valid trust, estate, or pension trust Legal entity" 10. Corporation or LLC electing The corporation corporate status on Form 8832 or Form 2553 11. Association, club, religious, The organization charitable, educational, or other tax- exempt organization 12. Partnership or multi -member LLC The partnership 13. A broker or registered nominee The broker or nominee For this type of account: Give name and EIN of: 14. Account with the Department of The public entity Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 15. Grantor trust filing under the Form The trust 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section 1.6714(b)(2)(1)(13)) ' List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished. 2 Circle the minor's name and furnish the minor's SSN. ' You must show your individual name and you may also enter your business or DBA name on the "Business name/disregarded entity" name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. ' List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships, earlier. 'Note: The grantor also must provide a Form W-9 to trustee of trust. Note: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records From Identity Theft Identity theft occurs when someone uses your personal information such as your name, SSN, or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039. For more information, see Pub. 5027, Identity Theft Information for Taxpayers. Victims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll -free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious smalls or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business smalls and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. Form W-9 (Rev. 10-2018) Page 6 The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (fIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at Spam®uce.gov or report them at www.ftc.gov/complaint. You can contact the FTC at www.ftc.govlidtheft or 877-IDTHEFT (877-438-4338). If you have been the victim of identity theft, see www.identity7heft.gov and Pub. 5027. Visit wwwdrs.govlldentityTheft to learn more about identity theft and how to reduce your risk. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.