How to complete Award's W9/ACH Form
To complete your Award's W9/ACH form, follow the instructions on 'How to Create/Edit a Custom Form'.
The form name you will select is 'State of Nebraska W9 and ACH Enrollment Form'.
NOTE: You need to fill this form out even if you have had previous Award(s) with DED.
What If I need to update my ACH information after I already completed the form?
If any changes are required to this form, please create a NEW form by using the top navigation: Custom > Choose form (State of Nebraska W9 and ACH Enrollment Form) > +.
Do NOT update the existing form that has already been submitted.
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Here are step-by-step instructions for completing the State of Nebraska W-9 & ACH Enrollment Form pdf:
Section 1–6: W-9 Information
1. Name
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Enter your legal name exactly as it appears on your income tax return.
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Required field — do not leave blank.
2. Business Name
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If applicable, enter your business or disregarded entity name (e.g., LLC name), only if it differs from the name entered in Line 1.
3. Federal Tax Classification
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Check only one box to indicate your federal tax classification:
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Examples: Individual, Sole Proprietor, C Corporation, S Corporation, Partnership, LLC, Government entity, etc.
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If selecting “LLC”, enter the tax classification (C/S/P) in the blank space.
4. Exemptions (if any)
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If applicable, enter your:
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Exempt payee code
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FATCA exemption code
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Leave blank if these do not apply.
5. Address
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Provide your mailing address.
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If your remit (payment) address is different, complete the adjacent “Remit Address” box.
6. City, State, ZIP
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Fill in the city, state, and ZIP code for both addresses if different.
Taxpayer Identification Number (TIN)
Choose and provide only one:
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Social Security Number (SSN) – for individuals/sole proprietors
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Employer Identification Number (EIN) – for entities
Certification
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Carefully review the four certification statements.
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Sign and date the form.
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Print your name and provide a contact phone number.
ACH Enrollment Section (Ensure This is Filled Out Correctly)
This section is required. Follow these steps:
A. Type of Request
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Check one:
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Initial Setup – first time enrolling in ACH
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Change – updating bank details
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Close Account – ending enrollment
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B. Bank Information
Fill out the following accurately:
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Financial Institution Name
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Nine Digit Routing Number – verify with your bank
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Prior Routing Number – required if this is a change request
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Check the box if your bank is outside the U.S.
C. Account Information
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Address of your financial institution
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Depositor Account Number
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Prior Account Number – if updating information
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Check the box if payments will be forwarded internationally
D. Account Type
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Select one:
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Checking
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Savings
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E. Optional Payment Direction
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If this account will not be used for all State of Nebraska payments, specify exceptions here.
F. Email
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Enter a valid email for receiving ACH payment notifications.
G. Signature and Verification
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An authorized individual or entity representative should Sign the form.
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Attach one of the following verification items:
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A voided check or photocopy of a cleared check
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A letter from your financial institution
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A vendor invoice or letter containing printed ACH instructions
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Agency Approval (Final Section)
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Leave this section blank — it is for agency use only.
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Action Item #3 - Make sure organization has at least two users