OTHER-2022-048-NCADFP Grant Contract

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NC Office of the State Controller Substitute W-9 Instructions Page 2 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 Exempt payees 1 through 4 dividends Payments over $ 600 required to be reported and Generally, exempt payees 1 through 52 direct sales over $5 ,000' Payments made in settlement of payment card Exempt payees 1 through 4 or third party network transactions ' See Form 1099- MISC, Miscellaneous Income, and its instructions . Z However, the following payments made to a corporation and reportable on Form 1099- MISC are not exempt from backup withholding : medical and health care payments, attorneys ' fees, gross proceeds paid to an attorney, 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 - 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 possession of the United States, 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 Reg. 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 Reg . section 1 . 14724 ( 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 1 - 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 Section 2 - Certification To establish to the paying agency that your TIN is correct, you are not subject to backup withholding, or you are a U .S . person, or resident alien, sign the certification on NC Substitute Form W-9 . You are being requested to sign by the State of North Carolina . For additional information please refer to the IRS Form W- 9 located on the IRS Website ( https ://www .irs. gov/) .