Common use of Purpose of Form Clause in Contracts

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇▇ the $35 transfer fee to my office account in lieu of having the agent provide the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services at

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, later. Cat. No. 10231X Form W-9 (Rev. 1011-20182017) • Completed Agent Roster Update CONFLICT OF INTEREST QUESTIONNAIRE For vendor doing business with local governmental entity FORM CIQ This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor. OFFICE USE ONLY Date Received Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.) 3 Name of local government officer about whom the information is being disclosed. Name of Officer officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form • Copy CIQ as necessary. A. Is the local government officer or a family member of paid $25 transfer fee the officer receiving or likely to receive taxable income, other than investment income, from IDFP portal • Copy the vendor? Yes No B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of DR approval thru IDFPR portal • Completed Agent Roster Update the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity? Yes No Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1). 7 Signature of vendor doing business with the governmental entity Date Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to provided by Texas Ethics Commission ▇▇▇.▇▇▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ Revised 1/1/2021 A complete copy of Chapter 176 of the $35 transfer fee to my office account in lieu Local Government Code may be found at ▇▇▇▇://▇▇▇.▇▇▇▇▇▇▇▇.▇▇▇▇▇.▇▇▇▇▇.▇▇.▇▇/ Docs/LG/htm/LG.176.htm. For easy reference, below are some of having the agent provide sections cited on this form. Local Government Code § 176.001(1-a): "Business relationship" means a connection between two or more parties based on commercial activity of one of the payment at time of transferparties. Managing Broker Signature Date Please email completed form to Member Services atThe term does not include a connection based on:

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, later. Cat. No. 10231X Form W-9 (Rev. 1011-20182017) • Completed Agent Roster Update Form • Copy This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of paid $25 transfer fee from IDFP portal • Copy the local governmental entity not later than the 7th business day after the date the vendor becomes aware of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor. Date Received completed questionnaire with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As appropriate filing authority not later than the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇▇ 7th business day after the $35 transfer fee to my office account in lieu of having date on which you became aware that the agent provide the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services atoriginally filed questionnaire was incomplete or inaccurate.)

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, later. Cat. No. 10231X Form W-9 (Rev. 1011-20182017) • Completed Agent Roster Update Form • Copy This Compensation Agreement (“Agreement”) is for the payment of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE commissions for SilverScript Insurance Company: Office MLS#: NEW OFFICE , hereinafter referred to as (“Insurance Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below”). Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to This Agreement is between ▇▇▇▇▇▇ Insurance Marketing LLC, hereinafter referred to as (“▇▇▇▇▇▇”) and , hereinafter referred to as (“Agent”). ▇▇▇▇▇▇ and Agent are referred to herein individually as a Party or party and collectively as the $35 transfer fee to my office account in lieu of having the agent provide the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services atParties or parities.

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, later. Cat. No. 10231X Form W-9 (Rev. 1011-20182017) • Completed Agent Roster Update Form • Copy Deer Processor: Please fill out and mail back with a copy of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A your insurance certificate if needed, to the address above. The business name should be the same as on form W-9. Thank you for helping HSH be in compliance. As a participating HSH Processor I hereby authorize state that I am not an employee of Hunters Sharing the charge Harvest charitable venison donation program, but a subcontractor (sole proprietor) who has signed a valid agreement with HSH for donated deer meat processed and distributed to area Food Banks. I work my own schedule, supply my own tools and work in my own facility inspected and registered by the PA Dept of $35 Agriculture Bureau of Food Safety. In addition, I am fully responsible for decisions on how best to complete the task for my credit card customers, the hunters donating deer to the HSH program. Name Business Name Address City State Zip Code Phone County Email Please check one: I am Sole Proprietor w/o employees. No insurance certificate required. Definitions of Sole Proprietor from SWIF (State Workers’ Insurance Fund) website Pennsylvania Workers’ Compensation Act Section 302 (a) & (b) provides that a contractor is responsible for the payment of compensation benefits to employees of uninsured subcontractors. Contractors shall not subcontract all or any part of contract unless the subcontractors used have presented proof of insurance. Consequently, all contractors should keep workers’ compensation certificates of insurance on file to prove coverage. Sole Proprietors with no employees are not required to carry workers’ compensation insurance. However, detailed information belowmust be provided to SWIF to prove that the individual is a true independent contractor. Agent Signature Date BB If SWIF determines that the sole proprietor is your employee, you will be charged for his/her payroll as per the appropriate classes on your policy. It is your responsibility to provide SWIF with all appropriate documentation to resolve their employment status. Currently workers compensation coverage for sole proprietor(s) is available through the State Workers’ Insurance Fund. 2012a Dear Owner of a Deer Processing Establishment, As a participant in the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to Hunters for Sharing the Harvest program your deer processing establishment must be compliant with federal and/or state laws. Enclosed are the necessary forms and applications for obtaining a Registration from the Pennsylvania Department of Agriculture under the Food Safety Act of 2010 (3 C.S. §§5721 – 5737) as a custom deer processor. This registration application and inspection requirements has been specifically developed in partnership with and in consultation with the Hunters Sharing The Harvest Program’s deer processor/directors ▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇ and ▇▇▇▇▇ ▇▇▇▇▇▇. Our goal is to minimize any inconvenience and make registration easy, while ensuring uniform food safety criteria and quality control in the $35 transfer fee future. Please note the integrity of the HSH venison charity is a foremost concern, and this is a state requirement that will yield long-term positive benefits for you as a deer processor, as well as for the ultimate consumers receiving food assistance. If your processing establishment is approved and inspected by USDA, (US Department of Agriculture), and those same processing facilities are used for custom deer processing, you do not need Registered with the PA Department of Agriculture (PDA). Only facilities not inspected by USDA and who are providing custom deer processing services require registration and inspection by PDA. If any additional retail food store or food processing operation exists at this same establishment, please contact the Department to my office account in lieu discuss proper licensing. The enclosed material must be fully completed and returned to the appropriate Regional Office as listed below. Please note failure to provide all required information could delay your application approval. The Department of having Agriculture, Regional Food Sanitarian and/or Supervisor, will review the agent provide application and contact you if further information or clarification is needed, or if approved to schedule a registration inspection prior to your opening for operation. If your application is disapproved, you will receive a written letter stating the payment reasons for the application disapproval. Applications can be resubmitted at any time. Please allow 3 – 4 weeks for processing. DO NOT SEND MONEY WITH THIS APPLICATION. Registration fees will be collected at the time of transferthe Inspection. Managing Broker Signature Date Please email completed form NO CASH accepted-checks or money orders only, payable to Member Commonwealth of PA. Initial registrations and annual renewals are $35.00 Sincerely, The Bureau of Food Safety & Laboratory Services atStaff 2012a

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, later. Cat. No. 10231X Form W-9 (Rev. 1011-20182017) • Completed Agent Roster Update Form • Copy Deer Processor: Please fill out and mail back with a copy of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A your insurance certificate if needed, to the address above. The business name should be the same as on form W-9. Thank you for helping HSH be in compliance. As a participating HSH Processor I hereby authorize state that I am not an employee of Hunters Sharing the charge Harvest charitable venison donation program, but a subcontractor (sole proprietor) who has signed a valid agreement with HSH for donated deer meat processed and distributed to area Food Banks. I work my own schedule, supply my own tools and work in my own facility inspected and registered by the PA Dept of $35 Agriculture Bureau of Food Safety. In addition, I am fully responsible for decisions on how best to complete the task for my credit card customers, the hunters donating deer to the HSH program. Name Business Name Address City State Zip Code Phone County Email Please check one: I am Sole Proprietor w/o employees. No insurance certificate required. Definitions of Sole Proprietor from SWIF (State Workers’ Insurance Fund) website Pennsylvania Workers’ Compensation Act Section 302 (a) & (b) provides that a contractor is responsible for the payment of compensation benefits to employees of uninsured subcontractors. Contractors shall not subcontract all or any part of contract unless the subcontractors used have presented proof of insurance. Consequently, all contractors should keep workers’ compensation certificates of insurance on file to prove coverage. Sole Proprietors with no employees are not required to carry workers’ compensation insurance. However, detailed information belowmust be provided to SWIF to prove that the individual is a true independent contractor. Agent Signature Date BB If SWIF determines that the sole proprietor is your employee, you will be charged for his/her payroll as per the appropriate classes on your policy. It is your responsibility to provide SWIF with all appropriate documentation to resolve their employment status. Currently workers compensation coverage for sole proprietor(s) is available through the State Workers’ Insurance Fund. 2012b Dear Owner of a Deer Processing Establishment, As a participant in the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to Hunters for Sharing the Harvest program your deer processing establishment must be compliant with federal and/or state laws. Enclosed are the necessary forms and applications for obtaining a Registration from the Pennsylvania Department of Agriculture under the Food Safety Act of 2010 (3 C.S. §§5721 – 5737) as a custom deer processor. This registration application and inspection requirements has been specifically developed in partnership with and in consultation with the Hunters Sharing The Harvest Program’s deer processor/directors ▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇ and ▇▇▇▇▇ ▇▇▇▇▇▇. Our goal is to minimize any inconvenience and make registration easy, while ensuring uniform food safety criteria and quality control in the $35 transfer fee future. Please note the integrity of the HSH venison charity is a foremost concern, and this is a state requirement that will yield long-term positive benefits for you as a deer processor, as well as for the ultimate consumers receiving food assistance. If your processing establishment is approved and inspected by USDA, (US Department of Agriculture), and those same processing facilities are used for custom deer processing, you do not need Registered with the PA Department of Agriculture (PDA). Only facilities not inspected by USDA and who are providing custom deer processing services require registration and inspection by PDA. If any additional retail food store or food processing operation exists at this same establishment, please contact the Department to my office account in lieu discuss proper licensing. The enclosed material must be fully completed and returned to the appropriate Regional Office as listed below. Please note failure to provide all required information could delay your application approval. The Department of having Agriculture, Regional Food Sanitarian and/or Supervisor, will review the agent provide application and contact you if further information or clarification is needed, or if approved to schedule a registration inspection prior to your opening for operation. If your application is disapproved, you will receive a written letter stating the payment reasons for the application disapproval. Applications can be resubmitted at any time. Please allow 3 – 4 weeks for processing. DO NOT SEND MONEY WITH THIS APPLICATION. Registration fees will be collected at the time of transferthe Inspection. Managing Broker Signature Date Please email completed form NO CASH accepted-checks or money orders only, payable to Member Commonwealth of PA. Initial registrations and annual renewals are $35.00 Sincerely, The Bureau of Food Safety & Laboratory Services atStaff 2012b

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy Iroquois Valley Farmland REIT, PBC, a Delaware public benefit corporation (the “Company”), has adopted a Dividend Reinvestment Plan (the “DRIP”), dated September 25, 2020. The DRIP is attached to Company's Offering Statement dated July 10, 2020 as Exhibit 3.3 and is summarized in October 2, 2020 supplement appended to the end of the Company’s Offering Circular. This addendum is for investors wishing to enroll in the DRIP simultaneously with their purchase of shares of common stock of the Company. Please review the DRIP, the Offering Circular, and this Enrollment Agreement carefully before enrolling, as they contain important disclosures. For example, participation in the DRIP does not relieve participants of any taxes that may be payable as a result of distributions, even where distributions are paid $25 transfer fee from IDFP portal • Copy in the form of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇▇ the $35 transfer fee to my office account in lieu of having the agent provide the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services atshares rather than cash.

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ SE ■ Sammamish, WA 98075 ■ phone: ▇▇▇-▇▇▇-▇▇▇▇ ■ fax: ▇▇▇-▇▇▇-▇▇▇▇ ■ web: ▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇ Name of Company: Support Service: Electrical Inspection Primary Contact: Title: Phone Number: Email: Address: What city and state are your offices located? Do your staff have the $35 transfer fee resources available to my office account in lieu complete the scope of having the agent provide the payment at time work remotely? Yes No Number of transfer. Managing Broker Signature Date Please email completed form staff dedicated to Member Services atthis contract: Have you provided on-call services for other jurisdictions? Yes No Cumulative years of experience of staff dedicated to this contract: Brief summary of relevant credentials for staff dedicated to this contract:

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy If, during the term of paid $25 transfer fee from IDFP portal • Copy any Agreement between Supplier and Anthem, Inc. and/or any of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy its affiliates (“Anthem”), Supplier requires the use or disclosure of new license Protected Health Information, including creating, receiving, maintaining, or transmitting Protected Health Information, then Supplier shall be deemed a Business Associate of Anthem and the following provisions shall apply: This agreement (“Agreement”) shall be effective on the date of Supplier’s signature and is between the Supplier (“Business Associate”) identified in this Agreement and Anthem on behalf of itself and its affiliates who are Covered Entities or Business Associates and who have a business relationship with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Business Associate, if any (hereinafter collectively “Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize ”). The purpose of this Agreement is to comply with the charge requirements of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇▇ Health Insurance Portability and Accountability Act of 1996, the $35 transfer fee to my office account in lieu HITECH Act, and their implementing regulations (45 C.F.R. Parts 160-164, including Subpart E of having 45 CFR Part164) ("HIPAA"), any applicable state privacy laws, any applicable state security laws, any applicable implementing regulations issued by the agent provide the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services atInsurance Commissioner or other regulatory authority over data protected herein.

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #AGENT INFORMATION Corporate Individual Joint Name on Contract: Real Estate License #: Name: Email Address: OLD OFFICE CompanyCity: Office MLS#Phone Number: NEW OFFICE CompanyState: Office MLS#Zip: Office PhoneDate of Birth: A Social Security or Tax Identification Number: Agent Number(s): BANK INFORMATION Checking Account Savings Account Credit Union Name of Banking Institution: Branch: Address: City: State: Zip: ABA Routing Number: Account Number: EFT COMMISSION AUTHORIZATION Initial Request Change Request I hereby authorize the charge of $35 Affordable Health Insurance Agency, LLC to initiate credit entries to my credit card information belowbank account. Agent Signature I understand that this authorization will allow AHIA, LLC to debit the above if funds are credited erroneously to this account. This authority is to remain in effect until revoked by me in writing and until the Company actually receives such notice of termination. The Company will make the necessary changes within ten (10) business days of receipt for such notice of termination. All commission accounts within the Company will be included in this request unless specified otherwise. Printed Signature, as it appears on bank records Date BB Signature, as it appears on bank records �������������� Company, the "Parties") and is being executed and is effective as of , 20 (the ). As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇▇ the $35 transfer fee to my office account in lieu of having the agent provide the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services at"Effective Date11

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to (▇▇▇) ▇▇▇-▇▇▇▇ (▇▇▇) ▇▇▇-▇▇▇▇ FAX ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ P a g e | 1 You are being given access to the $35 transfer fee District-provided technology resources listed below. It is important that you read the applicable District policies, administrative regulations, and this agreement form. [See policies CQ and DH, and provisions on use of electronic media in the employee handbook.] Employees should contact the Technology at ▇▇▇-▇▇▇-▇▇▇▇ if you have questions or need help understanding this material. The following guidelines apply to my office all District networks, e-mail accounts, devices connected to the District’s networks, and all District-owned devices used on or off school property, whether connected to the District’s network or connected through a non-district network such as home internet or personal data plans or any other means of access. Additionally, the District prohibits harassment through electronic means regardless of the device used, the network used, or the location of use. [See District policies DH, DIA, and FFH] Inappropriate use of the District’s technology resources may result in suspension of access or revocation of the privilege of using these resources, as well as other disciplinary or legal action, in accordance with applicable District policies, administrative regulations, and laws. You are being given access to the following technology resources: • A District e-mail account; • A District e-mail account, including access to cloud-based (online) document storage and collaboration space; • District computer hardware, software, and printers on your school campus; • District networks, including document storage space; • Access to District-owned technology resources for use at home; and • District-filtered Internet access. Please note that the Internet is a network of many types of communication and information networks. It is possible that you may run across some material you might find objectionable. While the District will use filtering technology to restrict access to such material, it is not possible to absolutely control access to all content. It will be your responsibility to follow the rules for appropriate use and report inappropriate internet sites to the Technology Department. If you are being issued a District-owned technology device that can be used off campus, you will be given additional materials addressing the proper use, care, and return of these devices. (▇▇▇) ▇▇▇-▇▇▇▇ (▇▇▇) ▇▇▇-▇▇▇▇ FAX ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ P a g e | 2 • You will be assigned an individual account for access to approved District technology resources, and you are responsible for not sharing your password or other account information with others. • District technology resources are primarily for instructional and educational purposes. Limited personal use is allowed only if the rules in lieu this agreement are followed and the use does not interfere with your assigned duties. • You must comply with the Public Information Act, the Family Educational Rights and Privacy Act (FERPA), and any other applicable law or policy regarding records retention and confidentiality of having student and District records. • You must maintain the agent provide confidentiality of health or personnel information concerning colleagues, unless disclosure serves lawful professional purposes or is required by law. • Please remember that all communications sent through District e-mail accounts may be perceived as communications on behalf of the payment District. Consequently, all e-mails sent from District e-mail accounts are subject to the District’s acceptable use policy, and an employee who violates the policy may be disciplined accordingly. • When communicating through e-mail or other electronic means, you must use appropriate language and etiquette as you would when communicating face to face. Always be respectful. • Only authorized District staff may communicate with District students through electronic means, including social media, e-mail, and text messaging. If you are unsure whether or not you are authorized to communicate with a student through electronic means, ask your supervisor. [See DH] • Before use on a District device or for a District purpose, digital subscriptions, online learning resources, online applications, or any other program must be approved by Technology or principal. District staff should not accept terms and conditions or sign user agreements on behalf of the District without preapproval. • Copies of potentially sensitive or confidential District records should not be sent, viewed, or stored using an online application not approved by the District. • You must immediately report any suspicious behavior or other misuse of technology to your supervisor or other campus administrator. • You will be held responsible at time all times for the proper use of transferyour account, and the District may suspend or revoke your access if you violate the rules. Managing Broker Signature Date Please email completed form (▇▇▇) ▇▇▇-▇▇▇▇ (▇▇▇) ▇▇▇-▇▇▇▇ FAX ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ The following are examples of inappropriate use of technology resources: • Using the resources for any illegal purpose, including threatening school safety; • Accessing the resources to Member Services atknowingly alter, damage, or delete District property or information, or to breach any other electronic equipment, network, or electronic communications system in violation of the law or District policy; • Damaging electronic communications systems or electronic equipment, including P a g e | 3 knowingly or intentionally introducing a virus to a device or network, or not taking proper security steps to prevent a device or network from becoming vulnerable; • Disabling or attempting to disable or bypass any Internet filtering device; • Encrypting communications to avoid security review; • Using someone’s account without permission; • Pretending to be someone else when posting, transmitting, or receiving messages; • Attempting to read, delete, copy, modify, or interfere with another user’s posting, transmission, or receipt of electronic media; • Using resources to engage in conduct that harasses others; • Sending, posting, or possessing materials that are abusive, obscene, pornographic, sexually oriented, threatening, harassing, damaging to another’s reputation, or illegal, including material that constitutes prohibited harassment and “sexting;” • Using inappropriate language such as cursing, vulgarity, ethnic or racial slurs, and any other inflammatory language; • Posting or transmitting pictures of students without obtaining prior permission from all individuals depicted or from parents of depicted students who are under the age of 18; • Violating others’ intellectual property rights, including downloading or using copyrighted information without permission from the copyright holder; • Wasting school resources through improper use of the District’s technology resources, including sending spam; and • Gaining unauthorized access to restricted information or resources. (▇▇▇) ▇▇▇-▇▇▇▇ (▇▇▇) ▇▇▇-▇▇▇▇ FAX ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ P a g e | 4 The following are possible consequences of inappropriate use of technology resources: • Suspension of access to the District’s technology resources; • Revocation of the account; or • Other disciplinary or legal action in accordance with the District’s policies and applicable laws.

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) Form W-9 (Rev. 10-2018) Page3 IF the entity/person on line 1 is a(n) ... THEN check the box for ... • Completed Agent Roster Update Corporation Corporation • Individual • Sole proprietorship, or • Single-member limited liability company (LLC) owned by an individual and disregarded for U.S. federal tax purposes. Individual/sole proprietor or single- member LLC • LLC treated as a partnership for U.S. federal tax purposes, • LLC that has filed Form 8832 or 2553 to be taxed as a corporation, or • Copy of paid $25 transfer fee LLC that is disregarded as an entity separate from IDFP portal its owner but the owner is another LLC that is not disregarded for U.S. federal tax purposes. Limited liability company and enter the appropriate tax classification. (P= Partnership; C= C corporation; or S= S corporation) • Copy of DR approval thru IDFPR portal Partnership Partnership • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 TrusVestate TrusVestate Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇▇ the $35 transfer fee to my office account in lieu of having the agent provide the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services atcriminal penalties including fines and/or imprisonment.

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy 8038-G (Rev. October 2021) Department of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe Treasury Internal Revenue Service a Go to ▇▇▇.▇▇▇.▇▇▇/▇▇▇▇▇▇ for instructions and the $35 transfer fee latest information. OMB No. 1545-0047 Part I Reporting Authority Check box if Amended Return a 4 Number and street (or P.O. box if mail is not delivered to my office account in lieu street address)▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇ Room/suite 5 Report number (For IRS Use Only) 3 6 City, town, or post office, state, and ZIP codeCoalinga, CA 93210 7 Date of having issue January 26, 2024 8 Name of issueCALIFORNIA MUNICIPAL LEASE-PURCHASE AGREEMENT No. 10575 9 CUSIP number None Part II Type of Issue (Enter the agent provide issue price.) See the payment at time of transfer. Managing Broker Signature Date Please email completed form to Member Services atinstructions and attach schedule.

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, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) • Completed Agent Roster Update Form • Copy of paid $25 transfer fee from IDFP portal • Copy of DR approval thru IDFPR portal • Completed Agent Roster Update Form • Copy of new license with new office information from IDFPR portal MORe Agent ID #: Real Estate License #: Name: Email Address: OLD OFFICE Company: Office MLS#: NEW OFFICE Company: Office MLS#: Office Phone: A I hereby authorize the charge of $35 to my credit card information below. Agent Signature Date BB . As the Ma_n_a_gin_g B_ro__k_e_r I hereby authorize MORe to ▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇, Greenville, PA 16125 1-866-HSH-2141 Deer Processor: Please fill out and mail back with copy of insurance certificate if needed, to the $35 transfer fee address above as quickly as possible. Business name should be the same as on form W-9. Thank you for helping HSH be in compliance. Statement: As a participating HSH Processor I hereby state that I am not an employee of Hunters Sharing the Harvest charitable venison donation program, but a subscontractor (sole proprietor) who has signed a valid agreement with HSH for donated deer meat processed and distributed to area Food Banks. I work my office account own schedule, supply my own tools and work in lieu my own facility inspected and registered by the PA Dept of having Agriculture Bureau of Food Safety. In addition I am fully responsible for decsions on how best to complete the agent provide task for my customers, the payment at time of transferhunters donating deer to the HSH program. Managing Broker Signature Date Name Business Name Address City State Zip Code Phone Fax Email Please email completed form to Member Services atcheck one: I am Sole Proprietor w/o employees. No certificate required.