HomeMy Public PortalAboutTBP 2021-02-17Board of Trustees
Regular Meeting Agenda
153 Fraser Ave and Virtually
Wednesday February 17, 2021
7:00 PM - 9:00 PM
NOTE: Times are approximate and agenda subject to change
Virtual Meeting Information
https://us02web.zoom.us/j/83576180734
Meeting ID: 835 7618 0734
Phone 1 -669 -900 -9128
Roll Call
Approval Of Agenda
Consent Agenda
Minutes February 3, 2021
TBM 2021 -02 -03.Pdf
Executive Session
For a conference with the Town Attorney for the purpose of receiving legal
advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b),
and for the purpose of determining positions relative to matters that may
be subject to negotiations, developing strategy for negotiations, and/or
instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding
economic incentive program request
Executive Session
For a conference with the Town Attorney for the purpose of receiving legal
advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b),
and for the purpose of determining positions relative to matters that may
be subject to negotiations, developing strategy for negotiations, and/or
instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e),
regarding development matters.
Executive Session
For a conference with the Town Attorney for the purpose of receiving legal
advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b),
and for the purpose of determining positions relative to matters that may
be subject to negotiations, developing strategy for negotiations, and/or
instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding
Public Health
Discussion And Possible Action Regarding
Public Health Order Update
Temporary Amendment Order 2 -12 -21.Docx.pdf
Business Enhancement Grant Program
Business Enhancment Grant Reinstatment .Pdf
Business Enhancement Grant Program (PDF)_201905031002280022.Pdf
Business -Enhancement -Grant -Program -PDF COVID -19.Pdf
Economic Development Advisory Committee Applications
EDAC Applications.pdf
Open Forum
a) Business not on the agenda
(If you would like to request time on the agenda please contact the Town
Clerk, Antoinette McVeigh at 970 -726 -5491 ext. 201)
Updates
Staff Update On Technology - Michael
Staff Update On Events, Marketing And Economic Development -
Sarah
Staff Update On Meeting Notices - Antoinette
Adjourn
UPCOMING MEETING
WED. MARCH 3, 2021 BOARD OF TRUSTEES
1.7:00 P.M.
2.
3.
a.
Documents:
4.
5.
6.
7.
a.
Documents:
b.
Documents:
c.
Documents:
8.
9.
a.
b.
c.
10.
Board Staff
Direct : Define the service, product or value to
be delivered
Lead : Future focused planning
Protect : Establish the operational boundaries
to be respected by Staff and monitored by
the Board
Manage : Now focused policy and procedural
guidance to ensure on time, on budget, and on
target service delivery
Enable : Advocacy, resource development,
and role discipline
Accomplish : Ensure the work defined by the
direction of the Board of Trustees is accomplished
Board of TrusteesRegular Meeting Agenda153 Fraser Ave and VirtuallyWednesday February 17, 20217:00 PM - 9:00 PMNOTE: Times are approximate and agenda subject to change Virtual Meeting Information https://us02web.zoom.us/j/83576180734 Meeting ID: 835 7618 0734 Phone 1 -669 -900 -9128Roll CallApproval Of AgendaConsent AgendaMinutes February 3, 2021TBM 2021 -02 -03.PdfExecutive Session For a conference with the Town Attorney for the purpose of receiving legal advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b), and for the purpose of determining positions relative to matters that may be subject to negotiations, developing strategy for negotiations, and/or instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding economic incentive program requestExecutive Session For a conference with the Town Attorney for the purpose of receiving legal advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b), and for the purpose of determining positions relative to matters that may be subject to negotiations, developing strategy for negotiations, and/or instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding development matters.Executive Session
For a conference with the Town Attorney for the purpose of receiving legal
advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b),
and for the purpose of determining positions relative to matters that may
be subject to negotiations, developing strategy for negotiations, and/or
instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding
Public Health
Discussion And Possible Action Regarding
Public Health Order Update
Temporary Amendment Order 2 -12 -21.Docx.pdf
Business Enhancement Grant Program
Business Enhancment Grant Reinstatment .Pdf
Business Enhancement Grant Program (PDF)_201905031002280022.Pdf
Business -Enhancement -Grant -Program -PDF COVID -19.Pdf
Economic Development Advisory Committee Applications
EDAC Applications.pdf
Open Forum
a) Business not on the agenda
(If you would like to request time on the agenda please contact the Town
Clerk, Antoinette McVeigh at 970 -726 -5491 ext. 201)
Updates
Staff Update On Technology - Michael
Staff Update On Events, Marketing And Economic Development -
Sarah
Staff Update On Meeting Notices - Antoinette
Adjourn
UPCOMING MEETING
WED. MARCH 3, 2021 BOARD OF TRUSTEES
1.7:00 P.M.2.3.a.Documents:4.5.6.
7.
a.
Documents:
b.
Documents:
c.
Documents:
8.
9.
a.
b.
c.
10.
Board Staff
Direct : Define the service, product or value to
be delivered
Lead : Future focused planning
Protect : Establish the operational boundaries
to be respected by Staff and monitored by
the Board
Manage : Now focused policy and procedural
guidance to ensure on time, on budget, and on
target service delivery
Enable : Advocacy, resource development,
and role discipline
Accomplish : Ensure the work defined by the
direction of the Board of Trustees is accomplished
Board of TrusteesRegular Meeting Agenda153 Fraser Ave and VirtuallyWednesday February 17, 20217:00 PM - 9:00 PMNOTE: Times are approximate and agenda subject to change Virtual Meeting Information https://us02web.zoom.us/j/83576180734 Meeting ID: 835 7618 0734 Phone 1 -669 -900 -9128Roll CallApproval Of AgendaConsent AgendaMinutes February 3, 2021TBM 2021 -02 -03.PdfExecutive Session For a conference with the Town Attorney for the purpose of receiving legal advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b), and for the purpose of determining positions relative to matters that may be subject to negotiations, developing strategy for negotiations, and/or instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding economic incentive program requestExecutive Session For a conference with the Town Attorney for the purpose of receiving legal advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b), and for the purpose of determining positions relative to matters that may be subject to negotiations, developing strategy for negotiations, and/or instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding development matters.Executive Session For a conference with the Town Attorney for the purpose of receiving legal advice on specific legal questions under C.R.S. Section 24 -6 -402(4)(b), and for the purpose of determining positions relative to matters that may be subject to negotiations, developing strategy for negotiations, and/or instructing negotiators, under C.R.S. Section 24 -6 -402(4)(e), regarding Public HealthDiscussion And Possible Action RegardingPublic Health Order UpdateTemporary Amendment Order 2 -12 -21.Docx.pdfBusiness Enhancement Grant ProgramBusiness Enhancment Grant Reinstatment .PdfBusiness Enhancement Grant Program (PDF)_201905031002280022.PdfBusiness-Enhancement -Grant -Program -PDF COVID -19.PdfEconomic Development Advisory Committee ApplicationsEDAC Applications.pdfOpen Foruma) Business not on the agenda(If you would like to request time on the agenda please contact the Town Clerk, Antoinette McVeigh at 970 -726 -5491 ext. 201)UpdatesStaff Update On Technology - MichaelStaff Update On Events, Marketing And Economic Development -SarahStaff Update On Meeting Notices - AntoinetteAdjournUPCOMING MEETINGWED. MARCH 3, 2021 BOARD OF TRUSTEES1.7:00 P.M.2.3.a.Documents:4.5.6.7.a.Documents:b.Documents:c.Documents:8.9.a.b.c.10.Board StaffDirect: Define the service, product or value to
be delivered
Lead : Future focused planning
Protect : Establish the operational boundaries
to be respected by Staff and monitored by
the Board
Manage : Now focused policy and procedural
guidance to ensure on time, on budget, and on
target service delivery
Enable : Advocacy, resource development,
and role discipline
Accomplish : Ensure the work defined by the
direction of the Board of Trustees is accomplished
FRASER BOARD OF TRUSTEES
MINUTES
DATE:February 3, 2021
MEETING:Board of Trustees Regular Meeting
PLACE:Fraser Town Hall Board Room and Virtually
PRESENT
Board:Mayor Philip Vandernail; Mayor Pro-Tem Eileen Waldow; Trustees; Andy
Miller, Brian Cerkvenik, Katie Soles, Parnell Quinn and Ryan Barwick
Staff:Interim Town Manager Wesley LaVanchy; Town Clerk, Antoinette
McVeigh; Town Planner Catherine Trotter; Marketing and Economic
Development Manager, Sarah Wieck; Finance Manager, Beth Williams;
Public Works Director Russell Pennington; Assistant Town Manager
Michael Brack; Police Chief, Glen Trainor
Others:See attached list
Mayor Vandernail called the meeting to order at 6:32 p.m.
1.Rollcall:
2.Approval of Agenda:
Trustee Soles moved, and Trustee Barwick seconded the motion to approve the
agenda, removing Resolution 2021-02-01 Approving 4E Conveyance to discussion
item c. Motion carried: 7-0.
3.Executive Session:
For a conference with the Water Attorney for the purpose of receiving legal advice on
specific legal questions under C.R.S. Section 24-6-402(4)(b). For the purpose of
determining positions relative to matters that may be subject to negotiations, developing
strategy for negotiations, and/or instructing negotiators, under C.R.S. Section 24-6-
402(4)(e). Regarding Project P. Including Interim Town Manager Wesley LaVanchy,
Plant Superintendent Joe Fuqua, Public Works Director Russell Pennington, Town
Attorney Rod McGowan, Water Attorney Gene Riordan
Trustee Barwick moved, and Trustee Soles seconded the motion to open the Executive
Session. Motion carried: 7-0.
Trustee Barwick moved, and Trustee Cerkvenik seconded the motion to close the
Executive Session. Motion carried: 7-0.
Attorney’s Opinion Required by C.R.S. 24-6-402(2)(d.5)(II)(B). As the attorney
representing the Town of Fraser, I am of the opinion that the entire executive session,
which was not recorded, constituted a privileged attorney-client communication.
Page 2 of 2
_______________________________
Rod McGowan, Town Attorney
4. Consent Agenda:
a)Minutes January 20, 2021
Trustee Miller moved, and Trustee Soles seconded the motion to approve the consent
agenda. Motion carried: 7-0.
5.Discussion And Possible Action Regarding:
a)Cornerstone Attainable Housing Audit
The Board directed staff to contact Cornerstone to clarify the details and amendments in
the audit.
b)United Business Bank Update Approved Signers
Trustee Barwick moved, and Trustee Soles to update the signers at United Business
Bank, removing the previous Town Manager, Jeff Durbin and adding Interim Town
Manager Wesley LaVanchy, all other current signers will remain on the account, Mayor
Philip Vandernail, Mayor Pro-Tem Eileen Waldow and Town Clerk Antoinette McVeigh.
Finance Manager Beth Williams will retain access to the account but will not have
signing ability. Motion carried: 7-0
c)Resolution 2021-02-01 Approving 4E Conveyance
Trustee Soles moved, and Trustee Miller seconded the motion to approve Resolution
2021-02-01 Approving 4E Conveyance. Motion carried: 7-0, Yea Mayor Vandernail and
Trustees Waldow, Miller, Soles, Cerkvenik, Quinn and Barwick
6. Open Forum:
a) Deb Buhayar spoke
7.Updates:
8.Adjourn:
Trustee Soles moved, and Trustee Barwick seconded the motion to adjourn. Motion
carried: 7-0. Meeting adjourned at 7:40 p.m.
_____________________________
Antoinette McVeigh, Town Clerk
TEMPORARY AMENDMENT AUTHORIZATION ORDER
AMENDING JUNE 26, 2020
STANDING PUBLIC HEALTH ORDER
RELATED TO COVID-19 PANDEMIC BEST PRACTICE AND ACTIVITY SPECIFIC PROTECTIVE
MEASURES FOR SAFE OPERATION OF CERTAIN BUSINESSES, ACTIVITIES, AND EVENTS, AS
PERIODICALLY UPDATED IN GRAND COUNTY’S COVID-19 SUPPRESSION PLAN AND
PLAYBOOKS
GRAND COUNTY PUBLIC HEALTH (GCPH) DIRECTOR
Date: FEBRUARY 12, 2021
Please note that due to the constantly changing course of the COVID-19 pandemic and local
health, economic, social, and resource factors, local, state and federal public health guidance and compliance
documents should be consulted regularly as they will necessarily be changing over time. For the public’s ease of
reference, the most up-to-date guidance documents on COVID-19 response and Activity Specific Protective
Measures can be found on the Grand County website at www.co.grand.co.us/covid19.
TEMPORARY ORDER AMENDMENT
The Grand County COVID-19 Suppression Plan and Playbooks authorized by, and incorporated within, the
Grand County Public Health Director’s “JUNE 26, 2020 STANDING PUBLIC HEALTH ORDER RELATED
TO COVID-19 PANDEMIC BEST PRACTICE AND ACTIVITY SPECIFIC PROTECTIVE MEASURES
FOR SAFE OPERATION OF CERTAIN BUSINESSES, ACTIVITIES, AND EVENTS, AS PERIODICALLY
UPDATED IN GRAND COUNTY’S COVID-19 SUPPRESSION PLAN AND PLAYBOOKS” (June 26, 2020
Standing Public Health Order) are amended as follows;
1)Temporarily amending Grand County Public Health Director’s June 26, 2020 Standing Public Health
Order, and any previous amendments, from Saturday, February 13, 2021 at 12:01 am until Friday,
February 26, 2021 at 11:59 pm.
2)Activities to Be Amended and Updates to Playbook (note: these updates will be reflected in the relevant
activity specific playbook and include the date of update):
a)Playbook: Events Playbook; Activity: Update language to reflect restrictions on Indoor Events and
Gatherings, not to include Worship.
Update Indoor Event Specific Protective Measures to reflect that all indoor events, both public and
private gatherings within the Town limits of Winter Park and the Town of Fraser shall cease unless
operating under strict protective measures and approval through Grand County Public Health.
b)Playbook: Restaurant Playbook; Activity: Update language to reflect restrictions on dining in.
Update Restaurant Specific Protective Measures to reflect Level Red restrictions for all restaurants
located at or within Winter Park Resort and specific businesses identified and notified, must move to take
out, curbside, delivery, to go, or outdoor dining. Up to 5 members of the public are allowed inside at a
time to pick up food or place an order, given specific precautions are taken by the facility to maintain a
6-foot distance. Outdoor dining is limited to one (1) household per group. Bars shall remain closed.
c)Playbook: Quick Reference Chart; Activity: Update capacities and restrictions.
To update capacities and restrictions for indoor events and gatherings and restaurant activities to reflect
the above Activity Specific Protective Measures.
PURPOSE & FINDINGS
This Temporary Amendment Authorization Order is supported by, and incorporates herein, the Purposes and
Findings set forth in the GCPH June 26, 2020 Standing Public Health Order, including any previous
amendments. Any additional purposes and findings are set forth below:
1)To implement temporary Mitigation Efforts that reflect Level Red Restrictions at targeted areas in Grand
County that have seen high disease activity and recent outbreaks. These heightened restrictions are to be
in effect from Saturday, February 13, 2021 at 12:01 am until Friday, February 26, 2021 at 11:59 pm at
which time these temporary Protective Measures will cease to be in effect unless expressly extended by
order of the Grand County Public Health Director. The goal of implementing these additional measures
is to reduce Grand County’s rising case rates by targeting the areas that are seeing high case rates.
2)To reiterate the importance of following the Overarching Best Practice Protective Measures of wearing a
mask, maintain social distance, working remote when possible, maintaining best hygiene practices,
staying at home when sick, getting tested when symptomatic, and taking personal responsibility for
preventing COVID-19 outbreaks and disease transmission.
EFFECTIVE DATE AND TIME
This Temporary Amendment Authorization Order will become effective on February 13, 2021 at 12:01 am, and
will extend until Friday, February 26, 2021 at 11:59 pm, unless specifically amended, superseded, extended, or
terminated by a subsequent Amendment Authorization Order of the Grand County Public Health Director.
CONTINUED EFFECTIVENESS OF JUNE 26, 2020 STANDING PUBLIC HEALTH ORDER
Except as specifically amended and modified by this Amendment Authorization Order, all Protective Measures,
findings, and other provisions, including authorities and enforcement provisions, of the June 26, 2020 Standing
Public Health Order, including this amendment and any previous amendments, remain in full force and effect.
AUTHORITY AND ENFORCEMENT
This Order is authorized by, and issued and enforceable pursuant to, GCPH’s June 26, 2020 Standing Public
Health Order, and the authorities cited therein. The June 26, 2020 Standing Public Health Order provides that
Activity Specific Protective Measures in Grand County’s COVID-19 Suppression Plan and Playbooks may be
updated at any time by formal amendment of the Grand County Public Health Director, and upon Director
approval will become a part of the June 26, 2020 Standing Public Health Order.
Grand County Public Health is tasked with protecting the health and welfare of the citizens of Grand County, Colorado by investigating and controlling the
causes of epidemic and communicable disease. This Order is necessary to control any potential transmission of disease to others. See section 25-1-508,
Colorado Revised Statutes. Immediate issuance of this Order is necessary for the preservation of public health, safety, or welfare. Any person aggrieved and
affected by this Order has the right to request judicial review by filing an action with the Grand County District Court within 90 days of the date of this Order,
pursuant to section 25-1-515, Colorado Revised Statutes. However, you must continue to obey the terms of this Order while your request for review is pending.
02-12-2020
_________________________________________________________
Abbie Baker, MPH, CHES - Director Date
Grand County Public Health
MEMO TO: Mayor Vandernail and the Board of Trustees
FROM: Sarah Wieck, Marketing & Econ Dev Manager
DATE: 2/10/2021
SUBJECT: Business Enhancement Grant
MATTER BEFORE BOARD:
Business Enhancement Grant reinstatement.
BACKGROUND:
The Town of Fraser recognizes that commercial buildings' character and condition form the
basis of the public's overall impression of our business community and affects the vitality of the
local business. The purpose of the Business Enhancement Grant program is to provide funding
assistance for local companies and organizations to help improve Fraser's economic vitality by
encouraging enhancements to their business property's physical appearance. Local businesses
or organizations may submit an application outlining their proposal and funding request using
the attached application form. Additional materials may be presented to help clarify the
proposal.
April 2020, the board suspended the Business Enhancement grant program due to COVID and
unknown financial implications.
At the end of the year, the board offered the grant to businesses to help with upgrades due to
COVID regulations.
We have 50K in the budget for this program in 2021
ACTION REQUESTED:
Reinstate Business Enhancement Grant
RECOMMENDATION:
Staff discussed the program with EDAC, and their recommendation was to offer it to
businesses in the original state and allow the money to be used for COVID upgrades.
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
Business Enhancement Grant Program:
The Town of Fraser recognizes that the character and condition of commercial buildings
forms the basis of the public’s overall impression of our business community and affects
the vitality of local business. The purpose of the Business Enhancement Grant program
is to provide funding assistance for local businesses and organizations toward
enhancements to the physical appearance of their business property and to encourage
investment and pride in the community thereby helping improve the economic vitality of
Fraser.
Local businesses or organizations may submit an application outlining their proposal and
funding request using the attached application form. Additional materials may be
submitted to help clarify the proposal.
Administrative approval of grant applications is provided by staff for applications that
meet the following criteria:
Maximum grant award of $7,500.
A minimum of 50% of project costs must be provided by applicant.
Projects eligible for administrative approval are limited to publicly displayed art,
landscaping, exterior decorations, building façade improvements/renovations,
painting, signage, awnings, cornices, and related exterior improvements, and
design costs.
Administrative approvals may not exceed the annual budget appropriations for
the program.
Any Business Enhancement Grant Application that does not meet the provisions of the
above paragraph may be considered and approved only by the Town Board. All such
approvals will be on a case by case basis and each application will be considered only
on the merits of the proposal.
Ineligible Projects:
New construction
Property acquisition
Refinancing existing debt
Interior improvements, equipment, fixtures and/or furnishings
Reimbursement for costs incurred prior to business enhancement grant approval
Home occupations
Applications may be submitted by tenants with written approval from property owner.
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
Submittal Requirements:
Completed Business Enhancement Grant Application (see next page).
Site plan, sketch of project location, photographs, etc., to promote the project.
Survey may be required.
Itemized budget.
Landscape proposals must provide a complete plant list with quantities.
This program cannot be used for projects that have been completed or initiated prior to
approval. Upon approval, grant funds are provided after completion of the project and
submission of certification of project expenses. Grantee may be subject to the receipt of
a Form 1099 pursuant to the Internal Revenue Service and therefore must fill out the
attached W-9 form.
For further information about this program or to submit an application, please
contact:
Sarah Wieck, Marketing and Economic Development Manager
970-726-5491x218
swieck@town.fraser.co.us
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
Business Enhancement Grant Application
Business/Organization Name:
Business License Number:
Contact Person:
Mailing Address:
Email Address:
Business Phone:
Total Estimated Cost of Proposal (Attached itemized budget):
Source of Funding in Addition to Grant:
Time-Frame for Implementation:
Purpose of Grant:
How will this proposal benefit Fraser and your business/organization?
Attach site plan or sketch of project location, photographs, etc., to promote the
project. Survey may be required.
Signature of Applicant Date
Please submit application to Sarah Wieck, Marketing and Economic Development Manager
swieck@town.fraser.co.us
Form W-9
(Rev. December 2014)
Department of the Treasury Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.Print or type See Specific Instructions on page 2.1 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
3 Check appropriate box for federal tax classification; check only one of the following seven boxes:
Individual/sole proprietor or
single-member LLC
C Corporation S Corporation Partnership Trust/estate
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶
Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for
the tax classification of the single-member owner.
Other (see instructions) ▶
4 Exemptions (codes apply only to certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
(Applies to accounts maintained outside the U.S.)
5 Address (number, street, and apt. or suite no.)
6 City, state, and ZIP code
Requester’s name and address (optional)
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter.
Social security number
––
or
Employer identification number
–
Part II 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. I 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. I 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 on page 3.
Sign Here Signature of
U.S. person ▶Date ▶
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.gov/fw9.
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 (TIN)
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)
• 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? on 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? on
page 2 for further information.
Cat. No. 10231X Form W-9 (Rev. 12-2014)
Form W-9 (Rev. 12-2014)Page 2
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 Publication 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 28% 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 if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructions on page
3 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
5. 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 Exempt
payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
Also see Special rules for partnerships above.
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 specified
United States persons. Certain payees are exempt from FATCA reporting. See
Exemption from FATCA reporting code on page 3 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.
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, list first, and then circle, the name of the
person or entity whose number you entered in Part I of Form W-9.
a. Individual. Generally, enter the name shown on your tax 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.
Form W-9 (Rev. 12-2014)Page 3
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 in line 3 for the U.S. federal tax classification of the
person whose name is entered on line 1. Check only one box in line 3.
Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a
partnership for U.S. federal tax purposes, check the “Limited Liability Company”
box and enter “P” in the space provided. If the LLC has filed Form 8832 or 2553 to
be taxed as a corporation, check the “Limited Liability Company” box and in the
space provided enter “C” for C corporation or “S” for S corporation. If it is a
single-member LLC that is a disregarded entity, do not check the “Limited Liability
Company” box; instead check the first box in line 3 “Individual/sole proprietor or
single-member LLC.”
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the
appropriate space in 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(f)(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 trust
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
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 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.
Barter exchange transactions and
patronage dividends
Exempt payees 1 through 4
Payments over $600 required to be
reported and direct sales over $5,0001 Generally, exempt payees
1 through 52
Payments made in settlement of
payment card or third party network
transactions
Exempt payees 1 through 4
1 See Form 1099-MISC, Miscellaneous Income, and its instructions.
2 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 6045(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)(i)
E—A corporation that is a member of the same expanded affiliated group as a
corporation described in Regulations section 1.1472-1(c)(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.
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 ITIN, 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. However, the IRS prefers that you use your SSN.
If you are a single-member LLC that is disregarded as an entity separate from its
owner (see Limited Liability Company (LLC) on this page), 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 the chart on page 4 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. You can get Forms W-7 and
SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM
(1-800-829-3676).
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.
Form W-9 (Rev. 12-2014)Page 4
Part II. 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
items 1, 4, or 5 below indicate 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.
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), 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
account)
The actual owner of the account or,
if combined funds, the first
individual on the account1
3. Custodian account of a minor
(Uniform Gift to Minors Act)The minor2
4. a. The usual revocable savings
trust (grantor is also trustee)
b. So-called trust account that is
not a legal or valid trust under
state law
The grantor-trustee1
The actual owner1
5. Sole proprietorship or disregarded
entity owned by an individual
The owner3
6. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i)
(A))
The grantor*
For this type of account:Give name and EIN of:
7. Disregarded entity not owned by an
individual
The owner
8. A valid trust, estate, or pension trust Legal entity4
9. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
The corporation
10. Association, club, religious,
charitable, educational, or other tax-
exempt organization
The organization
11. Partnership or multi-member LLC The partnership
12. A broker or registered nominee The broker or nominee
13. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
The public entity
14. Grantor trust filing under the Form
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1.671-4(b)(2)(i)
(B))
The trust
1 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.
3 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.
4 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 on page 2.
*Note. 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 Publication 4535, Identity Theft Prevention and Victim
Assistance.
Victims of identity theft who are experiencing economic harm or a system
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 emails or phishing schemes. Phishing is the
creation and use of email and websites designed to mimic legitimate business
emails 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.
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
(TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal
Trade Commission at: spam@uce.gov or contact them at www.ftc.gov/idtheft or
1-877-IDTHEFT (1-877-438-4338).
Visit IRS.gov 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.
Business Enhancement Grant Program:
The Town of Fraser recognizes that there has been challenges for businesses due to
COVID-19 restrictions and regulations. As a town we want to support our businesses
with the cost of upgrading your business to compensate for the changes required. The
funds can be used for COVID-19 specific upgrade to your business.
Local businesses or organizations may submit an application outlining their proposal
and funding request using the attached application form. Additional materials may be
submitted to help clarify the proposal.
Administrative approval of grant applications is provided by staff for applications that
meet the following criteria:
•Maximum grant award of $7,500.
•A minimum of 50% of project costs must be provided by applicant.
•Projects eligible for administrative approval are limited to any upgrade to
business due to COVID-19 regulations
•Administrative approvals may not exceed the annual budget appropriations for
the program.
•Projects must be completed by December 31st, 2020
Any Business Enhancement Grant Application that does not meet the provisions of the
above paragraph may be considered and approved only by the Town Board. All such
approvals will be on a case by case basis and each application will be considered only
on the merits of the proposal.
Ineligible Projects:
•New construction
•Property acquisition
•Refinancing existing debt
•Interior improvements, equipment, fixtures and/or furnishings
•Reimbursement for costs incurred prior to business enhancement grant approval
•Home occupations
Applications may be submitted by tenants with written approval from property owner.
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
Submittal Requirements:
• Completed Business Enhancement Grant Application (see next page).
• Site plan, sketch of project location, photographs, etc., to promote the project.
Survey may be required.
• Itemized budget.
• Outline how project will help mitigate COVID-19 regulations at your business.
This program cannot be used for projects that have been completed or initiated prior to
approval. Upon approval, grant funds are provided after completion of the project and
submission of certification of project expenses. Grantee may be subject to the receipt of
a Form 1099 pursuant to the Internal Revenue Service and therefore must fill out the
attached W-9 form.
For further information about this program or to submit an application, please
contact:
Sarah Wieck, Marketing and Economic Development Manager
swieck@town.fraser.co.us
970-726-5491x218
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
Business Enhancement Grant Application
Business/Organization Name:
Business License Number:
Contact Person:
Mailing Address:
Email Address:
Business Phone:
Total Estimated Cost of Proposal (Attached itemized budget):
Source of Funding in Addition to Grant:
Time-Frame for Implementation:
Purpose of Grant:
How will this proposal benefit Fraser and your business/organization?
Attach site plan or sketch of project location, photographs, etc., to promote the
project. Survey may be required.
Signature of Applicant Date
Please submit application to Sarah Wieck, Marketing and Economic Development Manager
swieck@town.fraser.co.us
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
Form W-9
(Rev. December 2014) Department of the Treasury Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
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
3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to
Individual/sole proprietor or
single-member LLC
C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any)
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶
Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner.
Other (see instructions) ▶
Exemption from FATCA reporting
code (if any)
(Applies to accounts maintained outside the U.S.)
5 Address (number, street, and apt. or suite no.) Requester’s name and address (optional)
6 City, state, and ZIP code
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter.
Social security number
– –
or
Part II 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. I 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. I 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 on page 3.
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.gov/fw9.
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 (TIN)
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)
• 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? on 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? on
page 2 for further information.
Sign Here Signature of
Print or type See Specific Instructions on page 2. Employer identification number
–
Cat. No. 10231X Form W-9 (Rev. 12-2014)
Form W-9 (Rev. 12-2014) Page 2
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 Publication 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 28% 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 if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructions on page
3 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
5. 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 Exempt
payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
Also see Special rules for partnerships above.
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 specified
United States persons. Certain payees are exempt from FATCA reporting. See
Exemption from FATCA reporting code on page 3 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.
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, list first, and then circle, the name of the
person or entity whose number you entered in Part I of Form W-9.
a. Individual. Generally, enter the name shown on your tax 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.
Form W-9 (Rev. 12-2014) Page 3
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 in line 3 for the U.S. federal tax classification of the
person whose name is entered on line 1. Check only one box in line 3.
Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a
partnership for U.S. federal tax purposes, check the “Limited Liability Company”
box and enter “P” in the space provided. If the LLC has filed Form 8832 or 2553 to
be taxed as a corporation, check the “Limited Liability Company” box and in the
space provided enter “C” for C corporation or “S” for S corporation. If it is a
single-member LLC that is a disregarded entity, do not check the “Limited Liability
Company” box; instead check the first box in line 3 “Individual/sole proprietor or
single-member LLC.”
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the
appropriate space in 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(f)(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 trust
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
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 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.
Barter exchange transactions and
patronage dividends
Exempt payees 1 through 4
Payments over $600 required to be
reported and direct sales over $5,0001
Generally, exempt payees
1 through 52
Payments made in settlement of
payment card or third party network
transactions
Exempt payees 1 through 4
1 See Form 1099-MISC, Miscellaneous Income, and its instructions.
2 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 6045(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)(i)
E—A corporation that is a member of the same expanded affiliated group as a
corporation described in Regulations section 1.1472-1(c)(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.
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 ITIN, 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. However, the IRS prefers that you use your SSN.
If you are a single-member LLC that is disregarded as an entity separate from its
owner (see Limited Liability Company (LLC) on this page), 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 the chart on page 4 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. You can get Forms W-7 and
SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM
(1-800-829-3676).
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.
Form W-9 (Rev. 12-2014) Page 4
Part II. 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
items 1, 4, or 5 below indicate 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.
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), 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
2. Two or more individuals (joint
account)
3. Custodian account of a minor
(Uniform Gift to Minors Act)
4. a. The usual revocable savings
trust (grantor is also trustee)
b. So-called trust account that is
not a legal or valid trust under
state law
5. Sole proprietorship or disregarded
entity owned by an individual
6. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i)
(A))
The individual
The actual owner of the account or,
if combined funds, the first
individual on the account1
The minor2
The grantor-trustee1
The actual owner1
The owner3
The grantor*
For this type of account: Give name and EIN of:
7. Disregarded entity not owned by an individual
8. A valid trust, estate, or pension trust
9. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
10. Association, club, religious,
charitable, educational, or other tax-
exempt organization
11. Partnership or multi-member LLC
12. A broker or registered nominee
13. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
14. Grantor trust filing under the Form 1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1.671-4(b)(2)(i)
(B))
The owner
Legal entity4
The corporation
The organization
The partnership
The broker or nominee
The public entity
The trust
1 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.
3 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.
4 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 on page 2.
*Note. 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 Publication 4535, Identity Theft Prevention and Victim
Assistance.
Victims of identity theft who are experiencing economic harm or a system
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 emails or phishing schemes. Phishing is the
creation and use of email and websites designed to mimic legitimate business
emails 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.
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
(TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal
Trade Commission at: spam@uce.gov or contact them at www.ftc.gov/idtheft or 1-
877-IDTHEFT (1-877-438-4338).
Visit IRS.gov 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.
Town of Fraser
PO Box 370, Fraser, CO 80442 office 970-726-5491 fax 970-726-5518
www.frasercolorado.com
MEMO TO: Mayor Vandernail and the Board of Trustees
FROM: Sarah Wieck, Marketing & Econ Dev Manager
DATE: 2/10/2021
SUBJECT: EDAC Open member positions
MATTER BEFORE BOARD:
EDAC open member positions
BACKGROUND:
EDAC has two open spots and 5 applications. Attached are all applications
ACTION REQUESTED:
Fill the two open spots in EDAC
From:noreply@civicplus.com
To:Antoinette McVeigh
Subject:Online Form Submittal: Committee Application
Date:Wednesday, January 20, 2021 11:08:35 AM
Committee Application
First Name Autumn
Last Name Bishop
Address PO BOX 1870
City Fraser
State CO
Zip Code 80446
Phone Number 303-725-8554
Email Address autumngranby@gmail.com
Committee applying for Economic Development Committee
What interests you about
serving on this committee?
I own a business in town and would love to gain knowledge
and energy from other members, as well as contribute to the
discussion of the economic development of this great town.
Why should the Town
Board consider you for
appointment/reappointment
to this committee?
I own a business that supports local makers and artists as
part of our mission. I contribute to the offerings of this locale
to travelers and locals with our affordably curated goods. I
am committed to being open daily to provide a reliable
presence. I am community minded and volunteer my time as
a board member of the Granby Chamber of Commerce as
well as chairing the Public Art Committee for the Town of
Granby.
What relevant experience,
skills, and/or talents do you
feel would help you be a
contributing member to this
committee?
I offer a business owner's perspective. I was born and raised
in Denver and have lived in Grand County for 12 years and
am committed to being a positive force in any way I can, in
my chosen county, a place I wish to live for the rest of my
life. I am very creative and energetic. I was the general for
an extensive renovation of a dilapidated building in Granby
that now hosts the Best of Grand business Two Pines
Supply. We are proud of the main street improvements we
have made in this county and how they benefit the business
climate, look and feel of our small towns. Having gone
through that renovation adds to my knowledge and
experience pertaining to the challenges individuals and
towns face in beautifying and breathing life into their
downtowns.
What additional skills,
knowledge, and/or
experience would you feel
could help you be a better
committee member?
I was a realtor for 23 years and own property throughout the
county as well as manage short term rentals. This adds to
my outlook in terms of the issues that face a small town like
Fraser, that is an extension of resort areas on all sides, as
well as being a recreation and vacation destination on it's
own.
What do/would you enjoy
most about serving on this
committee?
The collaborative and brainstorming process, learning more
about local issues, forward momentum toward common
goals.
What do/would you enjoy
least about serving on this
committee?
I am pretty busy, I wish I had more time, but this is important
and I will carve out the needed time.
What is the purpose of the
committee?
Economic develop that seeks to meet and blend the needs
and objectives of business owner's, residents and visitors.
What are the goals of the
committee?
I will be excited to learn what they are!
Electronic Signature
Agreement
I agree.
Electronic Signature Autumn C. Bishop
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From:noreply@civicplus.com
To:Antoinette McVeigh
Subject:Online Form Submittal: Committee Application
Date:Tuesday, January 26, 2021 4:04:07 PM
Committee Application
First Name Jamie
Last Name Jensen
Address 129 Mills Meadow
City Fraser
State CO
Zip Code 80442
Phone Number 720-939-3068
Email Address jkjensen1099@gmail.com
Committee applying for Economic Development Committee
What interests you about
serving on this committee?
My husband and I recently moved to Fraser fulltime last
summer. We have spent the last 10 years in the Fraser
valley when our work schedules permitted us too. We both
grew up in small towns and my career was spent in the
Boulder Valley working for an independent health system,
where our goal was to build and provide a healthy
community. During my career I spent the last 7 years
building a population health department where the
importance of social determinants to health were a large
focus of mine. Those being, secure and affordable housing,
mental health access, affordable healthcare and secure and
stable employment. Fraser has so much to offer but certainly
obstacles exist to boost its potential. I would love to be
involved in the community and to make a positive difference
while getting to know my neighbors.
Why should the Town
Board consider you for
appointment/reappointment
to this committee?
I believe my career working in the Boulder Valley provided
great experience for this appointment. I worked with the city
council as I was the lead on several design and facility
builds for the health system. I am well aware of how, in the
case of Boulder, a high cost of living will impede a skilled
workforce that is needed not only enhance a community but
to stabilize a community. I have a passion for small rural
communities as I grew in rural IL on a corn and soybean
farm, while my husband grew up on a ranch in rural
Montana.
What relevant experience,
skills, and/or talents do you
feel would help you be a
contributing member to this
committee?
As mentioned above, I believe my health care experience,
while also owning a business with my husband, has
prepared me well for this committee. Building and
maintaining positive relationships were a keen skill as I
worked closely with physicians and certain high functioning
individuals that were fiercely independent.
What additional skills,
knowledge, and/or
experience would you feel
could help you be a better
committee member?
Working with city and organizational leaders to push an
agenda to help bring new services and/or enhance existing
services was a key element of my position in Boulder. I can
be resourceful, patient (when needed) and thoughtful to
those around me.
What do/would you enjoy
most about serving on this
committee?
Helping the community in which I live. Getting to know my
community in which I live and making a difference.
What do/would you enjoy
least about serving on this
committee?
With COVID I would not enjoy meeting in person to serve on
this committee. Until it is safe to do so, I prefer to meet via
Zoom then in person when it is safe to do so.
What is the purpose of the
committee?
To advise the town council and planning committee on their
goals or otherwise that would enhance and grow Fraser in
conjunction with Winter Park when needed.
What are the goals of the
committee?
The goals of this committee would be to work in tandem with
the goals of the city council and to serve in an advisory
capacity while also bringing forth new ideas to strengthen
the economic development to the town of Fraser.
Electronic Signature
Agreement
I agree.
Electronic Signature Jamie D. Jensen
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From:noreply@civicplus.com
To:Antoinette McVeigh
Subject:Online Form Submittal: Committee Application
Date:Wednesday, January 20, 2021 12:02:14 PM
Committee Application
First Name Kelsey
Last Name Young
Address 101 Doc Susie AVE A3
City Fraser
State CO
Zip Code 80442
Phone Number 7207222798
Email Address kelso2726@gmail.com
Committee applying for Economic Development Committee
What interests you about
serving on this committee?
To help make sure Fraser keeps a small town feel and to
protect our locally owned businesses.
Why should the Town
Board consider you for
appointment/reappointment
to this committee?
Because I live in town and work in town and know many of
the locals.
What relevant experience,
skills, and/or talents do you
feel would help you be a
contributing member to this
committee?
Not much, but sometimes a fresh mind is a good thing.
What additional skills,
knowledge, and/or
experience would you feel
could help you be a better
committee member?
I'm smart, quick to learn, and although I think I have a good
understanding of how things work around here I'd like to
know more, and be involved in the process.
What do/would you enjoy
most about serving on this
committee?
Keeping Fraser, Fraser
What do/would you enjoy
least about serving on this
committee?
Probably having to deal with old ideals and "because it
works" attitudes or having to deal with greed.
What is the purpose of the
committee?
To help the business and residents of Fraser thrive.
What are the goals of the
committee?
To help the business and residents of Fraser thrive.
Electronic Signature
Agreement
I agree.
Electronic Signature Kelsey P Young
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From:noreply@civicplus.com
To:Antoinette McVeigh
Subject:Online Form Submittal: Committee Application
Date:Thursday, January 28, 2021 2:54:57 PM
Committee Application
First Name Lewis
Last Name Gregory
Address 72 Meadow
City Fraser
State CO
Zip Code 80442-2515
Phone Number 843 442-1535
Email Address lewgreg@comcast.net
Committee applying for Economic Development Committee
What interests you about
serving on this committee?
Provide local input for the direction of economic
development and assure sensible growth for the Town of
Fraser that is consistent with the wishes of the residents.
Why should the Town
Board consider you for
appointment/reappointment
to this committee?
I am a new full time resident of Fraser (July 2020).
Previously involved in city government (Planning
Commission) in Isle of Palms, SC and active with town
council on a number of issues including starting a Farmers
Market for the island.
What relevant experience,
skills, and/or talents do you
feel would help you be a
contributing member to this
committee?
As above. In addition, I am a board certified pediatrician with
25 years of management experience as a physician
executive. In addition to MD degree, I have completed a
MBA program.
What additional skills,
knowledge, and/or
experience would you feel
could help you be a better
committee member?
As above. Also, can bring a fresh perspective to the town.
What do/would you enjoy
most about serving on this
committee?
Getting involved in city government and contributing to a
coherent strategy of economic growth for the community.
What do/would you enjoy
least about serving on this
committee?
nothing
What is the purpose of the
committee?
Promote the economic development of the community
What are the goals of the
committee?
same as above, in addition to making sure that it is
consistent with the strategic direction on the City.
Electronic Signature
Agreement
I agree.
Electronic Signature Lewis Gregory
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From:noreply@civicplus.com
To:Antoinette McVeigh
Subject:Online Form Submittal: Committee Application
Date:Wednesday, February 10, 2021 1:42:05 PM
Committee Application
First Name Mark
Last Name Wanning
Address Cozens Pointe Cir-G-103-763
City Fraser
State CO
Zip Code 80442
Phone Number 402-981-0536
Email Address mwanning@outlook.com
Committee applying for Economic Development Committee
What interests you about
serving on this committee?
I have been on Planning and Zoning Board in a small town
in Iowa and having moved here a couple years ago, decided
that I liked being involved in a smaller community. When I
became aware of an opening on Fraser's board, I thought it
was my opportunity to get involved..
Why should the Town
Board consider you for
appointment/reappointment
to this committee?
I would think that the Board would consider putting me on
EDAC because I have some experience of being on a town
board and have been alive long enough to have some sense
of direction. I don't have an agenda of my own that I'm
looking to fulfill, but I have an interest in the direction the
town of Fraser may take..
What relevant experience,
skills, and/or talents do you
feel would help you be a
contributing member to this
committee?
As I have submitted above, I have been on small town
boards where we had to decide what was best for the town.
I think I can fairly evaluate both sides of a situation and
decide which plan would be best in a certain situation..
What additional skills,
knowledge, and/or
experience would you feel
could help you be a better
committee member?
I have worked in various employments and even owned my
own business. I feel I know how to make a tough decision if
needed, and as I have only my wife and no other strings or
baggage in town that may influence my decision, I would not
have the pressure that some may have with long
associations in town.
What do/would you enjoy
most about serving on this
committee?
I would enjoy knowing what was being proposed in town and
and perhaps being part of the decision make involved in
making it happen. I would also like being a part of a team of
good hard working people with a single goal.
What do/would you enjoy
least about serving on this
committee?
I would always feel empathy for some whose hopes had
been dashed by this committee. It is not enjoyable to crush
a dream. But I also know that sometimes denying a person's
dream makes them stronger and better.
What is the purpose of the
committee?
I believe the purpose of this committee is to review plans
and ideas for developing businesses in the town. Once the
decision is made to accept or deny the plan, I would assume
it refers the results to the Board of Trustees that will make
the final decision.
What are the goals of the
committee?
I feel the goals of this committee should be to place the town
of Fraser on an economic path that gives the town the best
advantage to sustain a realistic and sustainable direction of
economic growth. A growth that generates a viable
atmosphere of fairness and realistic opportunities for all.
Electronic Signature
Agreement
I agree.
Electronic Signature Mark W Wanning
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