HomeMy WebLinkAboutRes2020-055 Sponsored by: Meszaros
CITY OF SEWARD, ALASKA
RESOLUTION 2020-055
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEWARD,
ALASKA, ESTABLISHING A MUNICIPAL RECOVERY PROGRAM
BUSINESS ECONOMIC RELIEF GRANT AND NON-PROFIT
ASSISTANCE PROGRAM IN RESPONSE TO THE ECONOMIC
UPHEAVAL CAUSED BY THE MEASURES TAKEN IN THE FACE OF
THE COVID-19 PANDEMIC
WHEREAS, on January 31, 2020, United Sates Department of Public Health and Human
Services Secretary Alex Azar declared a public emergency for the novel coronavirus (COVID-19)
beginning on January 27,2020; and
WHEREAS, on March 11, 2020, Governor Mike Dunleavy signed a Public Health
Disaster Emergency Declaration that provided for health mandates to be issued when deemed
necessary by the Alaska Department of Health and Social Services, the Alaska Chief Medical
Officer, the Alaska Division of Public Health, and the Office of the Governor; and
WHEREAS, on March 17, 2020, Governor Dunleavy, in recognition of the tremendous
negative economic consequences of imposing social and business restrictions to avoid a rapid
spread of the virus, created the Alaska Economic Stabilization Team, a bipartisan group of
leaders working with the Dunleavy Administration on a plan to protect the state's economy from
the impact of COVID-19 in Alaska; and
WHEREAS, on March 18, 2020, Seward City Manager Scott Meszaros issued a
Declaration of a Local Emergency, later ratified and extended by the Seward City Council
through a monthly series of Resolutions which at the current time continue being found there to
be "a wide-spread financial and public health emergency that will require unexpected
expenditures of public funds that should be separately accounted, to perhaps be eligible for
Emergency Disaster Relief'; and
WHEREAS, the Dunleavy Administration has issued a series of compulsory, and later
suggestive, directives and mandates that closed many businesses; placed restrictions on those
businesses that might remain open; ceased most interstate and intrastate travel, and generally
kept most citizenry isolated and at home; and
WHEREAS, the Dunleavy Administration has issued a series of compulsory, and later
suggestive directives and mandates including "stay at home" orders, the banning of all
gatherings of more than ten people for social, spiritual, and recreational purposes, and further
imposed that any activities outside the home meet social distancing and personal safety
requirements; and
WHEREAS, the message of avoiding unnecessary personal interactions as a preventive
measure also caused more online shopping, and a reduction of local trade; and
CITY OF SEWARD,ALASKA
RESOLUTION 2020-055
WHEREAS, the cumulative effects of the State mandates and restrictions have caused
significant negative economic impacts on Seward's businesses and workers; and
WHEREAS, businesses are the backbone of the City's economy and provide
employment opportunities and provide essential services to the community; and
WHEREAS, the continued disruption and slow reentry have depleted reserves of many
businesses and created a serious, and in many cases, critical, danger to their economic viability;
and
WHEREAS, the State of Alaska received $562.5 million in federal funding under the
Coronavirus Aid, Relief, and Economic Security (CARES) Act that is directed to Alaska's
municipalities for direct relief designed to help meet each community's costs associated with
coping with COVID-19; and
WHEREAS, funds from this program may be used to provide grants to businesses that
suffered interruptions caused by the required State restrictions and mandates related to COVID-
19; and
WHEREAS,the City of Seward's total allocation is$5,324,326; and
WHEREAS, the first of three equal distributions to the City is scheduled to be in the
amount of$1,470,626; and
WHEREAS, the Seward City Council believes the COVID-19 pandemic and actions
taken as a result to protect public health as described above have created immediate necessity for
economic relief to the small businesses within the City of Seward.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF SEWARD,ALASKA that:
Section 1. The Seward City Council hereby establishes a Coronavirus Aid, Relief, and
Economic Security(CARES)Act Relief Grant Program to respond to the economic hardships for
City operations and direct expenditures, businesses, and citizens in the City of Seward as a
matter of necessity as a result of the COVID-19 pandemic and associated health mandates.
Section 2. That the parameters of this program, a copy of which is annexed hereto, are
adopted as the City of Seward CARES Program Policy under this resolution.
CITY OF SEWARD, ALASKA
RESOLUTION 2020-055
Section 3. The City of Seward will exercise its best efforts to communicate the
opportunity for this program throughout the community and to provide technical assistance to
those working to submit successful applications to the grant program.
Section 4. The City administration will provide regular reports to the Seward City
Council about the status of the City of Seward CARES Program, including information such as
the number of applications received, number of applications processed, and account balances of
the program fund.
Section 5. Nothing in this Resolution shall preclude the Seward City Council from
creating additional distributions to businesses, organizations that follow CARES Act
prescriptions; the provisions of the Resolution become effective upon adoption, and shall
continue until further formal action of the Seward City Council, or until the date that all CARES
Act funds must be expended on the eligible costs by December 30,2020.
Section 6.This resolution shall take effect immediately upon adoption.
PASSED AND APPROVED by the City Council of the City of Seward, Alaska, this
1511'day of July, 2020.
THrC 4F ' W• D.: • • •
Ai
risty Terry, Mayor
AYES: Seese, Baclaan, Butts, McClure, Crites,Terry
NOES: None
ABSENT: Osenga
ABSTAIN: None
ATTEST:
Brenda J. Ballo , MMC
''city c'��of gE'',.
(Cit�o k4 0tt
l • SEAL
** OFAa-
Agenda Statement
Meeting Date: July 15, 2020
To: City Council
From: City Manager, Scott Meszaros
Agenda Item: Resolution of the City Council of the City of Seward, Alaska Establishing
a Municipal Recovery Program Business Economic Relief Grant and Non-
Profit Assistance Program in Response to the Economic Upheaval Caused
by the Measures Taken in the Face of the COVID-19 Pandemic
BACKGROUND & JUSTIFICATION:
The State of Alaska has allocated $5,324,326 in federal funds to the City of Seward under the
Coronavirus Aid, Relief, and Economic Security (CARES Act) to provide municipal relief
towards expenditures incurred in response to COVID-19.
Council took formal action at the July 13, 2020 meeting approving a resolution authorizing the
City Manager to execute an agreement requesting appropriation of this initial CARES Act
funding.
This program is designed to identify broad categories of recipients, including governmental (City
resiliency and recovery), private business and nonprofit organizations, and organizations in our
Community that provide broad services and assistance to individuals within the community. The
intent of the program is to provide financial resiliency and assistance resulting from the COVID-
19 public health emergency and funding allocations.
The full funding program document is included with this agenda statement. This document
details the proposed allocation of these funds and steps explaining how businesses and nonprofits
can self-certify that they have been affected by COVID-19 and apply for grants pertaining to this
program.
INTENT:
CONSISTENCY CHECKLIST: Yes No N/A
1.
Comprehensive Plan
2.
Strategic Plan
3. Other (list):
ATTORNEY REVIEW: X Yes No
5
FISCAL NOTE:
Approved by Finance Department:
RECOMMENDATION:
Resolution 2020-055
6
THE CITY OF SEWARD
COVID-19 CARES ACT FUNDING PROGRAM
MUNICIPAL RECOVERY PROGRAM
BUSINESS & NONPROFIT CARES ACT RECOVERY GRANTS
AND
INDIVIDUAL ASSISTANCE VIA COMMUNITY ORGANIZATIONS
INTRODUCTION:
The Seward City Council held a Special Meeting on June 12, 2020 reviewing staff
recommendations and proposing suggestions and an approach to distributing federal funds
received by the City under the Coronavirus Aid, Relief, and Economic Security Act (the "CARES
Act"). There was a subsequent smaller meeting held on June 29, 2020 with the Seward City
Council Budget Committee, Chamber Director, and Administration. In accordance with
program mandates, Council authorizes governmental, private, nonprofit grants, using CARES
Act funds, which are intended to help provide economic relief due to the COVID-19 related
public health emergency as authorized under the CARES Act. The Administration focused on
developing programs outlined by the CARES Act in order to provide meaningful impact to the
community in an expeditious manner, and in hopes of avoiding issues experienced by other
communities which have implemented similar programs.
A wide range of programs and guidance were referenced and considered in creating the
Seward program, along with the need for timely relief support with as few restrictions as
possible to so that funds can be expended as needed, balanced with accountability, and
through a simplified and expeditious process that is in the best interests of both the City and
applicant. The City enacted policy includes clearly defined guidelines to ensure consistent,
standardized process to ensure clear project compliance and auditable disbursements of funds
to qualifying businesses and organizations that will facilitate the most good with the limited
funds available.
The requirements and needs of the City and its constituents have been assessed, and a set of
responsive programs have been developed to help ensure the City succeeds in expending funds
to best serve the citizens and businesses of Seward.
OVERVIEW:
The State of Alaska received $562.5 million in federal funds under the CARES Act. The City of
Seward expects to receive $5,324,326 of those CARES Act funds in three equal installments of
$1,470,626, which are to be used for expenditures incurred in response to and to aid in the
economic recovery from the COVID19 Public Health Emergency. The Administration provided
an approach to distributing the economic recovery funds based upon approaches taken in other
Alaskan communities, input from City staff, and following extensive conference discussions in
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
7
order to identify how to best support the long-term recovery of our local economy. There have
been numerous changes and problematic issues with several early programs, and it is
Administration's intention to ensure that we do not allocate any funds towards non-eligible
purposes. Therefore, the guiding premise underlying the City's program is to "ensure that
assistance is determined to be necessary in response to the COVID-19 public health
emergency..." for qualifying purposed under the CARES Act.
Council took formal action at its July 13, 2020 meeting approving a resolution authorizing the
City Manager to execute an agreement requesting appropriation of the initial CARES Act
funding. The funding allocation plan for expenditures requires approval by City Council. The
funding program is designed to identify broad categories of recipients, including: governmental
(City resiliency and recovery), private business and nonprofit organizations, and organizations in
our Community that provide broad services and assistance to individuals within the community.
The intent of the program is to provide financial resiliency and assistance resulting from the
COVID-19 public health emergency and funding allocations.
Proposed City allocation of CARES Act Funding:
$1,250,000 — First Responder and Incident Management Team Payroll and qualifying related
City emergency expenditures. This allocation includes a reimbursement of City payroll expenses
for Fire Department, Police Department, Public Safety Dispatch, and Incident Management
Team incurred as a result of the COVID-19 public health emergency. This allocation also
includes reimbursement of City purchases incurred to ensure the health and safety of City
employees and residents thorough state recommended improvements.
$1,750,000 — Business Recovery Grants (BRG). This allocation includes grant awards to
qualifying City of Seward businesses affected by COVID-19 to offset impacts or to provide
mitigation. The City will administer a grant program to determine eligibility and requirements
that may apply. The grant program guidelines are outlined in this document.
$250,000 — CARES Act Administration & Non-Payroll Expenditures. This allocation includes
reimbursement of City expenses related to COVID-19, which have been documented
throughout the emergency condition. Items such as legal expenses, finance expenses to
administer and run the program, and other non-first responder related costs associated with
COVID-19. All expenditures from this department will follow all City code requirements.
$1,224,326 —Assistance Grants for Non-Profit Organizations. This allocation will include grants
to nonprofit organizations to assist the Seward community impacted by COVID-19. The City will
administer a grant program to determine eligibility restrictions and requirements that apply. It
is anticipated that a formal call for grant proposals will be noticed to obtain non-profit
organizations financial needs/asks and service programs they would provide under their
request.
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
8
$750,000 — City Resiliency and Recovery. This allocation will include City of Seward capital
projects or expenses intended to mitigate the impacts of COVID-19, to include additional future
emergency operations, partner operations and incident related issues that may arise. The
funding allocation is provided to take operations and resiliency through the end of 2020,
additional preparedness and expenditures from this department will follow all City code
requirements.
BUSINESSES:
The grant categories for small businesses will be divided into four tier levels. The tiers are
based on each business's 2019 total gross sales for four quarters as reported on their tax
returns to the Borough, and are as follows:
• Tier 1 - Up to $2,500 for businesses with 2019 revenues of$20,000 to $100,000;
• Tier 2 - Up to $5,000 for businesses with 2019 revenues of$100,000 to $250,000;
• Tier 3 - Up to $7,500 for businesses with 2019 sales of more than $250,000; and
• Tier 4- Up to $10,000 for businesses with 2019 sales of more than $500,000.
If the demand for grants exceeds the City's available funds, the City reserves the right to
prorate and allocate the grants equally to all recipients in order to stay within available funding.
A business must have been in existence as of January 1, 2020, to qualify. This requirement
would not exclude an existing business with a state license, and that has previously filed tax
returns with the Borough, even though it may have reported no operations in January 2020
(such as a seasonal business).
For purposes of determining eligibility for a new business without a full year's tax returns for
2019, the City would take gross sales reported for any quarters in 2019 or the first quarter 2020
and extrapolate the numbers to estimate a full year's sales for the business.
Businesses that are not required to file sales tax returns with the Borough must provide a copy
of their most recent federal income tax return or other proof of revenues as deemed suitable
by the City review committee to determine the level of grant award they might qualify to
receive.
The business must be (i) located within the City of Seward, (ii) possess all required valid
business licenses; and (iii) current in its sales tax registration with the City of Seward and Kenai
Peninsula Borough. The business owner(s) does not have to be a resident of the City of Seward,
but they must maintain Alaska Residency status.
The program is open to all qualifying businesses, regardless of whether they have applied for or
have obtained any other state or federal COVIDI9-related assistance.
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
9
The program will exclude from eligibility:
• C Corporations traded on a U.S. stock exchange or a corporate-equivalent entity traded
on a foreign stock exchange, and businesses owned in whole or majority-owned by such
a publicly traded corporation.
• National chains that own and operate their premises in Seward; franchise owned-and-
operated businesses in Seward would be eligible.
• Businesses with a City lien for code enforcement, Fire Safety Violations, or legal action
• Businesses with a Borough lien for unpaid sales taxes. A sales tax delinquency would not
disqualify a business from the grant program unless the borough has initiated a lien on
that debt. Businesses that have entered into a payment plan with the Borough and are
adhering to that plan would be eligible for the grant, so long as the lien has been lifted.
• Businesses currently in bankruptcy proceedings at time of application.
• Businesses that lack a permanent physical presence in the City for the sale of goods or
the provision of services with at least one employee assigned to that facility.
• Marijuana related businesses.
Businesses sharing physical quarters may each apply and qualify for their own grant, so long as
each business (i) has its own state license, (ii) files a sales tax return under its own name and
(iii) does not share the same ownership with the other co-located businesses, or a bank
account.
Applicants are required to self-certify, on a form to be developed by the City, that they have
been affected by the COVID-19 public health emergency and resulting economic impacts. The
intent of the federally funded CARES Act program is to assist communities and businesses that
suffered economic harm from the public health emergency. Impacts could include, though are
not limited to, loss of sales due to mandatory shutdown, inventory loss, additional operating
expenses of reopening and protecting staff and customers, including funds already spent for
those purposes.
Steps for businesses to self-certify that they have been affected by COVID-19:
• Businesses shall provide a narrative of how they have been affected by the COVID-19
public health emergency.
• Business will be asked to provide a short reference as to how they might use the
money, making clear that the application question is voluntary and for informational
purposes only to gauge community need and effectiveness of the program.
• Applicants will be required to check a box that states they intend to remain in business
into 2021.
• The grant funds must be fully expended by December 30, 2020.
• The applicant must certify that the information provided is true and accurate and that
they agree to assist in the verification of information provided in the application and to
provide additional information to the City, if requested.
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
10
The application period will remain open until September 25, 2020, or until all funds allocated to
this program component are expended, whichever is earlier. The City or its designee will verify
the information as the applications arrive, and upon approval will distribute funds in
coordinated batches as received.
Review will determine whether the application is complete and if the business is eligible under
the program requirements. The burden of proof is upon the applicant.
An applicant denied may appeal to the City Manager (in writing). Any appeal must be filed in
writing by 5 p.m. the 10th calendar day after the day the applicant received notice from the
City.
It is the City's intent, to the extent allowed by law, that the review process work and
discussions, and the applications themselves, will not be available to the public. The names of
businesses that receive grants and the amount each receives will be considered a public record.
The City reserves the right to amend any criteria or procedures as may be required if new state
or federal guidelines are issued.
The program is limited to businesses economically damaged by the COVID-19 public health
emergency.
NON-PROFITS:
There are a manageable number of non-profits meeting eligibility requirements under the
CARES ACT registered in Seward.
If the demand for grants exceeds the City's available funds, the City reserves the right to
prorate and allocate the grants equally to all recipients in order to stay within available funding.
Annual income will be determined by the nonprofit's most recent IRS Form 990 from 2018 or
2019, or other qualifying verification. For those nonprofits that do not file with the IRS, the City
will accept an audited financial statement or an unaudited statement by a third-party preparer.
The program is open to nonprofits that provide services to residents of the City, regardless of
where the nonprofit has its main office — though the nonprofit must have a physical or service
presence within the City of Seward — and regardless of whether the local chapter or affiliate is
part of a larger statewide or national organization.
The program is limited to nonprofit organizations that suffered economic hardship due to
theCOVID-19 public health emergency. Applicants should request funding to offset expenses; a
grant CANNOT be used to replace revenue (or) to contribute to the organization's revenue
fund.
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
11
Additional eligibility rules and requirements:
• The grants will be available only to IRS certified 501 nonprofits (the full list of IRS 501
nonprofit categories will be on the application).
• The nonprofit must have been in operation serving City of Seward residents since at
least January 1, 2019.
• A majority of the group's local board of directors or local advisory board and its officers
must be Alaska residents. A local affiliate of a national organization must have a local
advisory or governing board
• Faith-based nonprofits are eligible, so long as they provide services which are promoted
and available to the general public without regard to religious affiliation.
• Nonprofit organizations "that are principally engaged in teaching, instructing,
counseling, or indoctrinating religion or religious beliefs, whether in a religious or
secular setting, or primarily engaged in political or lobbying activities" are not eligible (as
per 13 CFR § 120.110(k) in the Code of Federal Regulations)
All grant funds must be fully expended by December 30, 2020.
The program is limited to nonprofits economically damaged by the COVID-19 public health
emergency.
Steps for nonprofits to self-certify that they have been affected by COVID-19:
• The nonprofit will be required to briefly describe how it and/or its work has been
affected, but will not be required to provide financial statements, budgets, receipts or
other records detailing the financial damages.
• The program is open to all qualifying nonprofits, regardless of whether they applied or
obtained any other state or federal COVID-19-related assistance.
• Applicants will be asked to provide a brief report to the City no later than one year after
receipt of the grant funds, reviewing the use of the money. This is voluntary and is
requested to assist the City in evaluating the impact of the program.
• The applicant will need to certify that the information provided is true and accurate, and
they agree to assist in the verification of information provided in the application and to
provide additional information to the City, if requested.
The application period may remain open until September 25, 2020. The review committee will
verify the information as the applications come in and distribute out funds in coordinated
batches.
The review committee will determine whether the application is complete and the nonprofit is
eligible under the program requirements.
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
12
An applicant denied by the review committee may appeal to the City Manager (in writing). Any
appeal must be filed in writing by 5 p.m. the 10th calendar day after the day the applicant
received notice from the City.
It is the City's intent, to the extent allowed by law, that the review committee's work and
discussions, and the applications themselves, will not be available to the public. The names of
businesses that receive grants and the amount each receives will be considered a public record.
The City reserves the right to amend any criteria or procedures as may be required if new state
or federal guidelines are issued.
INDIVIDUAL ASSISTANCE AND OTHERS VIA NON-PROFIT ORGANIZATIONS:
Individual Assistance may be provided via nonprofits to assist City of Seward households for
individuals with direct impacts documented back to impacts related COVID-19.
This program will be provided by our partner non-profit organizations from the non-profit pool
of funds.
The City will review all applications on a rolling basis until all funds are allocated or the end of
the application period. Any decision to grant an application is within sole discretion of the
review committee and is not subject to appeal or challenge.
CONCLUSION:
The City of Seward will administer all grant programs and will likely utilize temporary assistance
for processing or assisting in administration of the grant program. While the program is
intended to provide assistance, unfortunately no one will become whole from it. The goal is to
give some relief so the community, as a whole, can survive until the next year and endure this
financially devastating event.
To ensure the capture of all available funds, the City will monitor the ongoing distribution of
funds and align allocated funding to program designations as rapidly as possible.
In order to reach the small businesses and nonprofit organizations in the City that may be
eligible, a successful community outreach strategy is necessary. This strategy will include the
following:
• Press Releases to local media;
• Direct mail to businesses with active licenses and registered nonprofits; and
• Coordination with the Kenai Peninsula Economic Development District (KPEDD) and
Seward Chamber of Commerce.
Information about the program as well as application forms, FAQs, a summary of the program
and application process, and timetable will be provided on the City's website at
ity..„f waird;_us as well as a direct contact email and phone number for inquiries.
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
13
Applications must be submitted with W-9 form from the Internal Revenue Service. Applicants
who submit incomplete applications or whose requests are denied will be notified via email.
It is the responsibility of the applicant to determine whether:
a. Proceeds from the grant are taxable, or
b. The receipt of a grant under this program precludes eligibility for any other grant aid
programs.
Grants under this program are subject to audit. Businesses are required to maintain records for
a period of 6 years.
(CLEAN)Draft of Seward COVID-19 CARES Grant Program (003)(003).doex
14
Seward CARES Act Business Relief Fund
How to Apply
STEP 1 : CHECK FOR ELIGIBILITY
Review the application materials and all required documents and
eligibility criteria to ensure your business qualifies for this grant.
Businesses must meet the criteria and provide the required
documents to be considered for the Seward Business Relief Fund
Grant Program (the "Program").
Q: Is my business eligible for this grant?
A: The following types of businesses are eligible for the Program
All for-profit businesses conducting at least 30% of its sales or
services in the City in 2019 so long as the business:
1 . Experienced business interruption or closures due to COVID-
19
2. Has not received more than $150,000 in Federal Paycheck
Protection Program (PPP) Loans, with proof of funding
3. Was registered as a business on or before January 1 , 2020
4. Intends to operate after applicable local and state emergency
mandates, regulations, rules, and advisements are repealed or
expire
5. Has committed to following and has not been cited for a
violation of State or local public health mandates, regulations or
rules
00949767.DOCX
6. Does not have any unpaid Seward or Kenai Peninsula Borough
enforcement liens
7. Has not had an owner, officer, partner or principal actor of the
business convicted of fraud, embezzlement or other financial
crimes within the last 3 years
Q: What documents do I need to submit with my application?
A: Business owners will need the following documents before they
fill out the application:
1. Current W-9 ;Form
2. Active state business registration, local Seward Business
license or other documentation
3. 2019 Corporate Tax Return or equivalent
4. If your business received Federal PPP funding, provide proof
such as a confirmation from your lending institution, or a copy of
your PPP executed note.
Depending on the business' legal structure, business owners will
be required to provide:
• Individual (Sole Proprietors and individual/single-owner
LLCs): may submit their 2019 Schedule C (Form 104). If no
2019 Schedule C is available, provide 2018 Schedule C and
most recent Annual or Quarterly Balance Sheet or Profit and
Loss Statement.
• Corporations (C-Corps, S-Corps, corporate Limited Liability
Corporations (LLCs)): may submit their 2019 Corporation
Income Tax Return (Form 1120/Form 1120-S). If no 2019
Corporation Income Tax Return is available, provide 2018
2
00949767.DOCX
Corporation Income Tax Return and Annual or Quarterly
Balance Sheet or Profit and Loss Statement.
• Partnerships: may submit their 2019 Return of Partnership
Income (Form 1065). If no 2019 Return of Partnership
Income is available, provide 2018 Tax Return and Annual or
Quarterly Balance Sheet or Profit and Loss Statement.
• Sole Proprietors: may complete and attach a Sole Proprietor
Certification Statement stating that the business owner is the
sole proprietor and provide proof of profits and losses for
2019 via an income tax return or equivalent documentation.
STEP 2: COMPLETE THE APPLICATION
Complete the application form available online. Applicants are
required to affirm and upload relevant business documents to be
considered for the Program. If you struggle completing the
application online, contact the City Clerk's Office and an
application can be provided to you by email.
STEP 3: APPLICATION REVIEW
A review committee will evaluate the applicant's documents for
eligibility. Applications will be automatically rejected if`documents
are missing, falsified or illegible.
STEP 4: NOTICE TO APPLICANT
Applicants will receive an email notifying them as to whether their
online application has been accepted or denied.
STEP 5: PROCESSING AND DISTRIBUTION
Accepted applications will be processed for grant distribution. The
City of Seward City Manager or his designee will coordinate and
execute grant distribution with approved applicants.
3
00949767.DOCX
SEWARD
Business Relief and Recovery Grant Application
Business name:
Contact name:
Contact address:
(mailing) .....................................................................................................................................................................................................................................................................................................................................................................................................................................
..............................
City: State: zi�jp:
..........:""::.............................................................................................................................................................................................................................................................................................................................................................................................................................................................
......................................................................
Contact phone number:
.......... ......................................................................
Contact email address: .......
Physical address of business:
(business must be located
........ ............ ......... ....................................................
within the City of Seward) City: Stat e.... .... .................................: zi�jp:
.. ............ .................................................................................................................................................................................................................................................................................
...................................................................................................................................................................................................................................................................................................................................................................................................................................IRS Taxpayer Identification Number
or proprietor's Social Security Number:
(SSN will be kept confidential)
Was your business impacted by the COVI D-1 9 public health emergency and are you in need of
economic assistance? I V Yes I V No
(Impacts may include, but are not limited to, loss of sales due to mandatory shutdown, inventory
loss, additional operating expenses of reopening and protecting staff and customers, including
funds already spent for those purposes.)
What is the grant amount you are requesting (check only one):
.........1 $2,500 grant for business with 2019 revenues of$50,000 to $100,000
.........1 $5,000 grant for business with 2019 revenues of$100,000 to $250,000
.........1 $7,500 grant for business with 2019 revenues of$250,000 to $500,000
.........1 $10,000 grant for business with 2019 revenue of more than $500,000
(Grant amounts have been divided into four levels, based on each business' 2019 total gross
sales revenue for four quarters as reported on tax returns to the borough)
How will the grant funds be used?
.............................
... ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
(Optional for informational purposes only to gauge community need and program effectiveness)
18
Please answer the following eligibility questions:
1. My business is a C Corporation traded on a U.S. stock exchange
or a corporate-equivalent entity traded on a foreign stock exchange,
and owned in whole or majority-owned by such a publicly traded
corporation. C::::::::II Yes C:::::::.0 No
2. My business is a national chain that owns and operates a premise
in the City of Seward (individually owned-and-operated local
franchises are eligible).
Yes C:::::::.0 No
3. My business has a City lien or is in violation of a payment agree-
ment with the City. I.........II Yes C:::::::.0 No
4. My business has a Borough lien for unpaid sales taxes.
Yes C:::::::.0 No
5. My business is currently in bankruptcy proceedings.
Yes C:::::::.0 No
6. My business does not have a permanent physical presence in the
City of Seward for the sale of goods or provision of services, with at
least one worker assigned to that facility.
Yes C:::::::.0 No
7. My business is a marijuana business licensed under Alaska
Statute 17.38. I.........II Yes C:::::::.0 No
(If you answered yes to any of the above questions, your business is not eligible for a grant)
Do you intend to remain in business into 2021? Yes No
Applications must be received or postmarked by 5 p.m. on September 25th, 2020, and
may be submitted by email to: XXXXX or hand-delivered or mailed to City of Seward City
Hall at 410 Adams St, Seward, AK 99664, Attn: Grant Review Committee. Applications may
be amended before the deadline. Incomplete applications will be rejected. Applicants will be
notified of the status of their application via email to the contact person listed on the application.
Questions about the grant program, application process, or application status must be directed
to XXXXX, City Project Lead, 907 224 XXXX, or email 6ity
ern lilt add If the demand for
grants exceeds the City's available funds, the City reserves the right to prorate the grants
equally to all recipients to stay within available funding. It is the sole responsibility of the
applicant to determine or to seek independent advice as to the tax implications of receiving the
grant funds.
As an official signer for the applicant, I certify that the information provided in this application is
true and accurate and acknowledge that the funds will be spent by the required deadline of
Dec. 30, 2020. 1 agree to assist in the verification of information provided in this application and
to provide additional information to the city, if requested.
Signed: Date:
Print Name: Title:
19
Farm Request for Taxpayer Give Form to the
(Rev.October2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service i Go to wwwJrs.gov1FormW9 for instructions and the latest information.
1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
2 Business name/disregarded entity name,if different from above
m CD3 Check appropriate box for federal tax classification of the person whose name is entered Wine 1.Check only one of the 4 Exemptions{codes apply only to
0 following seven boxes. certain entities,not individuals;see
EZ
C- instructions on page 3):
p ❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate
diC single-member LLC Exempt payee code(if any)
ao
41 ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)0-
0 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
N LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member L (LC that code if any)
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
y ❑ Other(see instructions)► (4ppl esroaccuunls mainte ned outs de the U.S.J
5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
m
m
6 City,state,and ZIP code
7 List account number(s)here(optional)
Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a -IE
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other
entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a
TIN,later, or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part 11,later.
Sign Signature of
Here U.S.person► Date►
General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise .Form 1099-MISC(various types of income,prizes,awards,or gross
noted.
proceeds)
Future developments.For the latest information about developments .Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.govlFormW9. •Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Farm 1098(home mortgage interest),1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number .Form 1099-C(canceled debt)
(SSN),Individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property}
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Farm W-g(Rev.10-2018)
20
Form W-9(Rev.10-2018) Page 2
By signing the filled-out form,you: Example.Article 20 of the U.S.-China income tax treaty allows an
1.Certify that the TIN you are giving is correct(or you are waiting for a exemption from tax for scholarship income received by a Chinese
number to be issued), student temporarily present in the United States.Under U.S.law,this
2.Certify that you are not subject to backup withholding,or 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
3.Claim exemption from backup withholding if you are a U.S.exempt the first Protocol to the U.S.-China treaty(dated April 30,1984)allows
payee.If applicable,you are also certifying that as a U.S.person,your the provisions of Article 20 to continue to apply even after the Chinese
allocable share of any partnership income from a U.S.trade or business student becomes a resident alien of the United States.A Chinese
is not subject to the withholding tax on foreign partners'share of student who qualifies for this exception(under paragraph 2 of the first
effectively connected income,and protocol)and is relying on this exception to claim an exemption from tax
4.Certify that FATCA code(s)entered on this form(if any)indicating on his or her scholarship or fellowship income would attach to Form
that you are exempt from the FATCA reporting,is correct.See What is W-9 a statement that includes the information described above to
FATCA reporting, later,for further information, support that exemption.
Note:If you are a U.S.person and a requester gives you a form other If you are a nonresident alien or a foreign entity,give the requester the
than Form W-9 to request your TIN,you must use the requester's form if appropriate completed Form W-8 or Form 8233.
it is substantially similar to this Form W-9. Backup Withholding
Definition of a U.S.person.For federal tax purposes,you are
considered a U.S.person if you are: What is backup withholding?Persons making certain payments to you
•An individual who is a U.S.citizen or U.S.resident alien; must under certain conditions withhold and pay to the IRS 24%of such
payments.This is called"backup withholding." Payments that may be
•A partnership,corporation,company,or association created or subject to backup withholding include interest,tax-exempt interest,
organized in the United States or under the laws of the United States; dividends,broker and barter exchange transactions,rents,royalties,
•An estate(other than a foreign estate);or nonemployee pay,payments made in settlement of payment card and
•A domestic trust(as defined in Regulations section 301.7701-7). third party network transactions,and certain payments from fishing boat
operators.Real estate transactions are not subject to backup
Special rules for partnerships.Partnerships that conduct a trade or withholding.
business in the United States are generally required to pay a withholding You will not be subject to backup withholding on payments you
tax under section 1446 on any foreign partners'share of effectively receive if you give the requester your correct TIN,make the proper
connected taxable income from such business.Further,in certain cases certifications,and report all your taxable interest and dividends on your
where a Form W-9 has not been received,the rules under section 1446 tax return.
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 Payments you receive will be subject to backup withholding if:
that is a partner in a partnership conducting a trade or business in the 1.You do not furnish your TJN to the requester,
United States,provide Form W-9 to the partnership to establish your 2.You do not certify your TIN when required(see the instructions for
U.S.status and avoid section 1446 withholding on your share of Part II for details),
partnership income.
In the cases below,the following person must give Form W-9 to the 3.The IRS tells the requester that you furnished an incorrect TIN,
partnership for purposes of establishing its U.S.status and avoiding 4.The IRS tells you that you are subject to backup withholding
withholding on its allocable share of net income from the partnership because you did not report all your interest and dividends on your tax
conducting a trade or business in the United States. return(for reportable interest and dividends only),or
•In the case of a disregarded entity with a U.S.owner,the U.S.owner 5.You do not certify to the requester that you are not subject to
of the disregarded entity and not the entity; backup withholding under 4 above(for reportable interest and dividend
•In the case of a grantor trust with a U.S.grantor or other U.S.owner, accounts opened after 1983 only).
generally,the U.S.grantor or other U.S.owner of the grantor trust and Certain payees and payments are exempt from backup withholding.
not the trust;and See Exempt payee code, later,and the separate Instructions for the
• In the case of a U.S.trust(other than a grantor trust),the U.S.trust Requester of Form W-9 for more information.
(other than a grantor trust)and not the beneficiaries of the trust. Also see Special rules for partnerships,earlier.
Foreign person.If you are a foreign person or the U.S.branch of a What is FATCA Reporting?
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 The Foreign Account Tax Compliance Act(FATCA)requires a
Pub.515,Withholding of Tax on Nonresident Aliens and Foreign participating foreign financial institution to report all United States
Entities). account holders that are specified United States persons,Certain
Nonresident alien who becomes a resident alien.Generally,only a payees are exempt from FATCA reporting.See Exemption from FATCA
nonresident alien individual may use the terms of a tax treaty to reduce reporting code,later,and the Instructions for the Requester of Form
or eliminate U.S.tax on certain types of income.However,most tax W-9 for more information.
treaties contain a provision known as a"saving clause."Exceptions Updating Your Information
specified in the saving clause may permit an exemption from tax to p g
continue for certain types of income even after the payee has otherwise You must provide updated information to any person to whom you
become a U.S.resident alien for tax purposes. claimed to be an exempt payee if you are no longer an exempt payee
If you are a U.S.resident alien who is relying on an exception and anticipate receiving reportable payments in the future from this
contained in the saving clause of a tax treaty to claim an exemption person.For example,you may need to provide updated information if
from U.S.tax on certain types of income,you must attach a statement you are a C corporation that elects to be an S corporation,or if you no
to Form W-9 that specifies the following five items. longer are tax exempt.In addition,you must furnish a new Form W-9 if
1.The treaty country.Generally,this must be the same treaty under the name or TIN changes for the account;for example,if the grantor of a
which you claimed exemption from tax as a nonresident alien. grantor trust dies.
2.The treaty article addressing the income. Penalties
3.The article number(or location)in the tax treaty that contains the
saving clause and its exceptions. Failure to furnish TIN.If you fail to furnish your correct TIN to a
4.The type and amount of income that qualifies for the exemption requester,you are subject to a penalty of$50 for each such failure
from tax. unless your failure is due to reasonable cause and not to willful neglect.
5.Sufficient facts to justify the exemption from tax under the terms of Civil penalty for false information with respect to withholding.If you
the treaty article. make a false statement with no reasonable basis that results in no
backup withholding,you are subject to a$500 penalty.
21
Form W-9(Rev.10-2018) Page 3
Criminal penalty for falsifying information.Willfully falsifying IF the entity/person on line 1 is THEN check the box for...
certifications or affirmations may subject you to criminal penalties a(n)...
including fines and/or imprisonment.
Misuse of TINS.If the requester discloses or uses TINs in violation of • Corporation Corporation
federal law,the requester may be subject to civil and criminal penalties. • Individual Individual/sole proprietor or single-
* Sole proprietorship,or member LLC
Specific instructions • Single-member limited liability
company(LLC)owned by an
Line f individual and disregarded for U.S.
You must enter one of the following on this line;do not leave this line federal tax purposes.
blank.The name should match the name on your tax return. . LLC treated as a partnership for Limited liability company and enter
If this Form W-9 is for a joint account(other than an account U.S.federal tax purposes, the appropriate tax classification.
maintained by a foreign financial institution(FFI)),list first,and then a LLC that has filed Form 8832 or (P=Partnership;C=C corporation;
circle,the name of the person or entity whose number you entered in 2553 to be taxed as a corporation, or S=S corporation)
Part I of Farm W-9.If you are providing Form W-9 to an FFI to document or
a joint account,each holder of the account that is a U.S.person must . LLC that is disregarded as an
provide a Farm W-9. entity separate from its owner but
a. Individual.Generally,enter the name shown on your tax return.If the owner is another LLC that is
you have changed your last name without informing the Social Security not disregarded for U.S.federal tax
Administration(SSA)of the name change,enter your first name,the last purposes.
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 • Partnership Partnership
your Form W-7 application,line 1 a.This should also be the same as the • Trust/estate Trust/estate
name you entered on the Form 1040/1040All040EZ you filed with your Line 4 Exemptions
application. p
b. Sole proprietor or single-member LLC.Enter your individual if you are exempt from backup withholding and/or FATCA reporting,
name as shown on your 1040/1040A/1040EZ on line 1.You may enter enter in the appropriate space on line 4 any code(s)that may apply to
your business,trade,or"doing business as"(DBA)name on line 2. you.
c. Partnership,LLC that is not a single-member LLC,C Exempt payee code.
corporation,or S corporation.Enter the entity's name as shown on the • Generally,individuals(including sole proprietors)are not exempt from
entity's tax return on line 1 and any business,trade,or DBA name on backup withholding.
line 2. • Except as provided below,corporations are exempt from backup
d. Other entities.Enter your name as shown on required U.S.federal withholding for certain payments,including interest and dividends.
tax documents on line 1.This name should match the name shown on the . Corporations are not exempt from backup withholding for payments
charter or other legal document creating the entity.You may enter any made in settlement of payment card or third party network transactions.
business,trade,or DBA name on line 2.
• Corporations are not exempt from backup withholding with respect to
e. Disregarded entity.For U.S.federal tax purposes,an entity that is attorneys'fees or gross proceeds paid to attorneys,and corporations
disregarded as an entity separate from its owner is treated as a that provide medical or health care services are not exempt with respect
"disregarded entity." See Regulations section 301.7701-2(c)(2)(iii).Enter to payments reportable on Form 1099-MISC.
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 The following codes identify payees that are exempt from backup
name shown on the income tax return on which the income should be withholding. Enter the appropriate code in the space in line 4.
reported.For example,if a foreign LLC that is treated as a disregarded 1—An organization exempt from tax under section 501(a),any IRA,or
entity for U.S.federal tax purposes has a single owner that is a U.S. a custodial account under section 403(b)(7)if the account satisfies the
person,the U.S.owner's name is required to be provided on line 1.If requirements of section 401(f)(2)
the direct owner of the entity is also a disregarded entity,enter the first 2—The United States or any of its agencies or instrumentalities
owner that is not disregarded for federal tax purposes.Enter the
disregarded entity's name on line 2,"Business name/disregarded entity 3—A state,the District of Columbia,a U.S.commonwealth or
name."If the owner of the disregarded entity is a foreign person,the possession,or any of their political subdivisions or instrumentalities
owner must complete an appropriate Form W-8 instead of a Form W-9. 4—A foreign government or any of its political subdivisions,agencies,
This is the case even if the foreign person has a U.S.TIN. or instrumentalities
Line 2 5—A corporation
If you have a business name,trade name,DBA name,or disregarded 6—A dealer in securities or commodities required to register in the
entity name,you may enter it on line 2. United States,the District of Columbia,or a U.S.commonwealth or
possession
Line 3 7—A futures commission merchant registered with the Commodity
Check the appropriate box on line 3 for the U.S.federal tax Futures Trading Commission
classification of the person whose name is entered on line 1.Check only 8—A real estate investment trust
one box on line 3. 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
22
Form W-9(Rev,10-2018) Page 4
The following chart shows types of payments that may be exempt M--A tax exempt trust under a section 403(b)plan or section 457(g)
from backup withholding.The chart applies to the exempt payees listed plan
above,1 through 13. Note:You may wish to consult with the financial institution requesting
IF the payment is for... THEN the payment is exempt this form to determine whether the FATCA code and/or exempt payee
for... code should be completed.
Interest and dividend payments All exempt payees except Line 5
for 7 Enter your address(number,street,and apartment or suite number).
Broker transactions Exempt payees 1 through 4 and 6 This is where the requester of this Form W-9 will mail your information
through 11 and all C corporations. returns.If this address differs from the one the requester already has on
S corporations must not enter an file,write NEW at the top.If a new address is provided,there is still a
exempt payee code because they chance the old address will be used until the payor changes your
are exempt only for sales of address in their records.
noncovered securities acquired Line 6prior to 2012.
Barter exchange transactions and Exempt payees 1 through 4 Enter your city,state,and ZIP code.
patronage dividends Part I. Taxpayer Identification Number (TIN)
Payments over$600 required to be Generally,exempt payees Enter your TIN in the appropriate box.If you are a resident alien and
reported and direct sales over 1 through 52 you do not have and are not eligible to get an SSN,your TIN is your IRS
$5,000, individual taxpayer identification number(ITIN).Enter it in the social
security number box.If you do not have an ITIN,see Now to get a TIN
Payments made in settlement of Exempt payees 1 through 4 below.
payment card or third party network transactions If you are a sole proprietor and you have an EIN,you may enter either
your SSN or EIN.
See Form 1099-MISC,Miscellaneous Income,and its instructions. If you are a single-member LLC that is disregarded as an entity
2 separate from its owner,enter the owner's SSN(or EIN,if the owner has
However,the following payments made to a corporation and one).Do not enter the disregarded entity's EIN.If the LLC is classified as
reportable on Form 1099-MISC are not exempt from backup a corporation or partnership,enter the entity's EIN.
withholding:medical and health care payments,attorneys'fees,gross Note:See What Name and Number To Give the Requester, later,for
proceeds paid to an attorney reportable under section 6045ft and 9
payments for services paid by a federal executive agency. further clarification of name and TIN combinations.
Exemption from FATCA reporting code.The following codes identify How to get a TIN.If you do not have a TIN,apply for one immediately.
payees that are exempt from reporting under FATCA.These codes To apply for an SSN,get Form SS-5,Application for a Social Security
apply to persons submitting this form for accounts maintained outside Card,from your local SSA office or get this form online at
of the United States by certain foreign financial institutions.Therefore,if www.SSA.gov.You may also get this form by calling 1-800-772-1213.
you are only submitting this form for an account you hold in the United Use Form W-7,Application for IRS Individual Taxpayer Identification
States,you may leave this field blank.Consult with the person Number,to apply for an ITIN,or Form SS-4,Application for Employer
requesting this form if you are uncertain if the financial institution is Identification]dumber,to apply for an EIN.You can apply for an EIN
subject to these requirements.A requester may indicate that a code is online by accessing the IRS website at www.irs.gov/Businesses and
not required by providing you with a Form W-9 with"Not Applicable"(or clicking on Employer Identification Number(EIN)under Starting a
any similar indication)written or printed on the line for a FATCA Business.Go to www.irs.gov/Forms to view,download,or print Form
exemption code. W-7 and/or Form SS-4. Or,you can go to www.irs.gov/OrderForms to
place an order and have Form W-7 and/or SS-4 mailed to you within 10
A—An organization exempt from tax under section 501(a)or any business days.
individual retirement plan as defined in section 7701(a)(37) If you are asked to complete Form W-9 but do not have a TIN,apply
B—The United States or any of its agencies or instrumentalities for a TIN and write"Applied For"in the space for the TIN,sign and date
C—A state,the District of Columbia,a U.S.commonwealth or the form,and give it to the requester.For interest and dividend
possession,or any of their political subdivisions or instrumentalities payments,and certain payments made with respect to readily tradable
D—A corporation the stock of which is regularly traded on one or instruments,generally you will have 60 days to get a TIN and give it to
more established securities markets,as described in Regulations the requester before you are subject to backup withholding on
section 1.1472-1(c)(1)(i) payments.The 60-day rule does not apply to other types of payments.
E—A corporation that is a member of the same expanded affiliated You will be subject to backup withholding on all such payments until
you provide your TIN to the requester.
group as a corporation described in Regulations section 1.1472-1(c)(1)(i)
Note:Entering"Applied For"means that you have already applied for a
F—A dealer in securities,commodities,or derivative financial TIN or that you intend to apply for one soon.
instruments(including notional principal contracts,futures,forwards,
and options)that is registered as such under the laws of the United Caution:A disregarded U.S.entity that has a foreign owner must use
States or any state the appropriate Form W-8.
G—A real estate investment trust Part II. Certification
H—A regulated investment company as defined in section 851 or an To establish to the withholding agent that you are a U.S.person,or
entity registered at all times during the tax year under the Investment resident alien,sign Form W-9.You may be requested to sign by the
Company Act of 1940 withholding agent even if item 1,4,or 5 below indicates otherwise.
—A common trust fund as defined in section 584(a) For a joint account,only the person whose TIN is shown in Part I
J—A bank as defined in section 581 should sign(when required).In the case of a disregarded entity,the
K—A broker person identified on line 1 must sign.Exempt payees,see Exempt payee
L—A trust exempt from tax under section 664 or described in section code,earlier.
4947(a)(1) Signature requirements.Complete the certification as indicated in
items 1 through 5 below.
23
Form W-9(Rev.10-2018) Page Jr
1.Interest,dividend,and barter exchange accounts opened For this type of account: Give name and EIN of:
before 1984 and broker accounts considered active during 1983. 14.Account with the Department of The public entity
You must give your correct TIN,but you do not have to sign the
certification. Agriculture in the name of a public
entity(such as a state or local
2.Interest,dividend,broker,and barter exchange accounts government,school district,or
opened after 1983 and broker accounts considered inactive during prison)that receives agricultural
1983.You must sign the certification or backup withholding will apply.If program payments
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 15.Gmntortrust filing underthe Form The trust
certification before signing the form. 1041 Filing Method or the Optional
3.Real estate transactions.You must sign the certification.You may Form 1099 Filing Method 2(see
cross out item 2 of the certification. Regulations section 1.671-4(b)(2)(i)(B))
4.Other payments.You must give your correct TIN,but you do not List first and circle the name of the person whose number you furnish.
have to sign the certification unless you have been notified that you If only one person on a joint account has an SSN,that person's number
have previously given an incorrect TIN."Other payments"include must be furnished.
payments made in the course of the requester's trade or business for 2 Circle the minor's name and furnish the minor's SSN.
rents,royalties,goods(other than bills for merchandise),medical and
health care services(including payments to corporations),payments to s You must show your individual name and you may also enter your
a nonemployee for services,payments made in settlement of payment business or DBA name on the"Business name/disregarded entity"
card and third party network transactions,payments to certain fishing name line.You may use either your SSN or EIN(if you have one),but the
boat crew members and fishermen,and gross proceeds paid to IRS encourages you to use your SSN.
attorneys(including payments to corporations). °List first and circle the name of the trust,estate,or pension trust.(Do
5.Mortgage interest paid by you,acquisition or abandonment of not furnish the TIN of the personal representative or trustee unless the
secured property,cancellation of debt,qualified tuition program legal entity itself is not designated in the account title.)Also see Special
payments(under section 529),ABLE accounts(under section 529A), rules for partnerships, earlier.
IRA,Coverdel[ESA,Archer MSA or HSA contributions or *Note:The grantor also must provide a Form W-9 to trustee of trust.
distributions,and pension distributions.You must give your correct Note:If no name is circled when more than one name is listed,the
TIN,but you do not have to sign the certification. number will be considered to be that of the first name listed.
What Name and Number To Give the Requester Secure Your Tax Records From Identity Theft
For this type of account: Give name and SSN of: Identity theft occurs when someone uses your personal information
1.Individual The individual such as your name,SSN,or other identifying information,without your
2.Two or more individuals(joint The actual owner of the account or,if permission,to commit fraud or other crimes.An identity thief may use
account)other than an account combined funds,the first individual on your SSN to get a job or may file a tax return using your SSN to receive
maintained by an FFI the account' a refund.
3.Two or more U.S.persons Each holder of the account To reduce your risk:
(joint account maintained by an FFI) •Protect your SSN,
4.Custodial account of a minor The minor2 •Ensure your employer is protecting your SSN,and
(Uniform Gift to Minors Act) •Be careful when choosing a tax preparer.
5.a.The usual revocable savings trust The grantor-trustee' If your tax records are affected by identity theft and you receive a
(grantor is also trustee) notice from the IRS,respond right away to the name and phone number
b.So-called trust account that is not The actual owner printed on the IRS notice or letter.
a legal or valid trust under state law
If your tax records are not currently affected by identity theft but you
6.Sole proprietorship or disregarded The ownW think you are at risk due to a lost or stolen purse or wallet,questionable
entity owned by an individual credit card activity or credit report,contact the IRS Identity Theft Hotline
7.Grantor trust filing under Optional The grantor' at 1-800-908-4490 or submit Form 14039.
Form 1099 Filing Method 1(see For more information,see Pub.5027,Identity Theft Information for
Regulations section 1.671-4(b)(2)(i) Taxpayers.
(A)) Victims of identity theft who are experiencing economic harm or a
For this type of account: Give name and EIN of: systemic problem,or are seeking help in resolving tax problems that
8.Disregarded entity not owned by an The owner have not been resolved through normal channels,may be eligible for
individual Taxpayer Advocate Service(TAS)assistance.You can reach TAS by
9.A valid trust,estate,or pension trust Legal entity" calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD
1-800-829-4059.
10.Corporation or LLC electing The corporation Protect yourself from suspicious emails or phishing schemes.
corporate status on Form 8832 or Phishing is the creation and use of email and websites designed to
Form 2553 mimic legitimate business emails and websites.The most common act
11.Association,club,religious, The organization is sending an email to a user falsely claiming to be an established
charitable,educational,or other tax- legitimate enterprise in an attempt to scam the user into surrendering
exempt organization private information that will be used for identity theft.
12.Partnership or multi-member LLC The partnership
13.A broker or registered nominee The broker or nominee
24
Form W-9(Rev.10-2018) Page 6
The IRS does not initiate contacts with taxpayers via emails.Also,the Privacy Act Notice
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers,passwords,or similar secret access Section 6109 of the Internal Revenue Code requires you to provide your
information for their credit card,bank,or other financial accounts. correct TIN to persons(including federal agencies)who are required to
If you receive an unsolicited email claiming to be from the IRS, file information returns with the IRS to report interest,dividends,or
forward this message to phishing@irs.gov.You may also report misuse certain other income paid to you;mortgage interest you paid,the
of the IRS name,logo,or other IRS property to the Treasury Inspector acquisition or abandonment of secured property;the cancellation of
General for Tax Administration(TIGTA)at 1-800-366-4484.You can debt;or contributions you made to an IRA,Archer MSA,or HSA.The
forward suspicious emails to the Federal Trade Commission at person collecting this form uses the information on the form to file
spam@uce.gov or report them at www.ftc.gov/complaint.You can information returns with the IRS,reporting the above information.
contact the FTC at www.fic.gov/rdtheff or 877 It3THEFT(877 438-4338). Routine uses of this information include giving it to the Department of
If you have been the victim of identity theft,see www.IdentityTheft.gov Justice for civil and criminal litigation and to cities,states,the District of
and Pub.5027. Columbia,and U.S.commonwealths and possessions for use in
administering their laws.The information also may be disclosed to other
Visit www.irs.gov/tdentity'Fheft to learn more about identity theft and countries under a treaty,to federal and state agencies to enforce civil
how to reduce your risk. 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.
25