Septic Replacement Fund (SRF) W-9 Supplemental Information Form
Supplemental form collecting property type, ownership, and IRS W-9 tax information required alongside the NYS Septic Replacement Fund grant application.
- Jurisdiction
- Lewis County, New York
- Fields
- 18
- Includes
- Signatures
Create a free account to fill this form, sign it and download it ready to file. No card needed.
- Your answers print onto the health department's own PDF
- Sign on screen: phone, tablet or laptop
- Save it and come back to it
Fill it online
Type into the real county form. No printing, no retyping.
The county's own PDF
Your answers print onto the health department's document, not a lookalike.
Download and file
Get the finished PDF and hand it in exactly as they expect it.
What this form asks for
Have these to hand before you start.
- Applicant Name
- Property Address
- Untitled field (Check Box1)
- Untitled field (Check Box2)
- Untitled field (Check Box3)
- Untitled field (Check Box4)
- Untitled field (Check Box5)
- Untitled field (Check Box6)
- Untitled field (Check Box7)
- Untitled field (Check Box8)
- Untitled field (Check Box10)
- Untitled field (Check Box9)
- Untitled field (Check Box11)
- Date
- Untitled field (Check Box12)
- Untitled field (Check Box13)
- Date 2
- Notes/ Comments
Where it goes
Submit together with the NYS Septic Replacement Program Fund Grant Application to Lewis County Planning and Community Development.
Filed with megankrokowski@lewiscountyny.gov.
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- The county's own PDF, not a lookalike
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- Saved for 6 months
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