Landowner W-9 & ACH Request Form (MO) | National Bobwhite and Grassland Initiative Foundation

Please enable JavaScript in your browser to complete this form.

Please complete all fields below carefully. Our accounting team uses the information from your Form W-9 for tax reporting and to issue your 1099-G tax form in any year you receive payments from NBGIF. Per IRS rules, your W-9 information will be stored securely for at least four years after the last related tax filing, or longer if needed. We take the protection of your personal information seriously. We also ask for your banking information to send payments directly to your account after you have met all contract obligations and your completed practices pass NRCS check-out standards.

Name of Person Completing this Form

First

Last

Phone you may be reached:

Provide a phone number we may use to reach you if we encounter difficulties or have questions related to the form details.

W-9 fillable pdf form, from the IRS

Click on the link below direct to the IRS website for a blank fillable W-9 form. Complete, date, and sign the W-9, then upload back to NBGI Foundation using the file upload section found below the IRS weblink.

A direct link to IRS publication website for the fillable W-9 form

File Upload

Click or drag a file to this area to upload.

Email address

Please share your email address as the bank ACH submission requires it.

Tax ID# (SSN or EIN)

Name on Bank Account

Additional Bank name information (if needed for LLC, Inc, etc)

you ID# Bank

Name of Bank

Bank Routing Number (ABA Number)

Bank Account Number

Type of Bank Account

Checking
Savings

Confirmation and Verification

I confirm and verify, under penalty of perjury, that the banking details provided on this form are true and correct and that I am the legal owner of the account specified and/or am authorized to share this information with National Bobwhite and Grassland Initiative Foundation, Inc.