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Landowner W-9 & ACH Request Form (USDA-LAFS)

Step 1 of 5

ACH Enrollment & Identity Verification

This form must be completed by, or on behalf of, an individual seeking reimbursement for completed USDA Forest Service (Southern Region, R8) practices via the National Bobwhite and Grassland Initiative Foundation (NBGIF).


As the designated legal authority, NBGIF requires this information to accurately document the landowner's identity and facilitate the secure electronic transfer of funds. This form collects personal and banking information for the individual who will receive program reimbursements directly using the Social Security Number(SSN) or Employer Identification Number (EIN) in Section A.


The information provided on this form is used exclusively to:

• Verify Identity: Ensure the payee matches the individual or business contracted with NBGIF. This number will be how the 1099-G tax reporting will be submitted.
• Process Payments: Enable Direct Deposit (ACH) for reimbursements once all conservation practices are confirmed as complete by USDA FS or NBGIF technical staff.
• Tax Reporting: Facilitate accurate documentation for any required federal tax reporting (e.g., Form 1099-G).

Note: Payment eligibility and the final reimbursement amount are contingent upon the successful completion and certification of the conservation practices as outlined in your NBGIF & USDA FS contract.