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Complete and Return Form W-9

We ask that you please complete Form W-9 and return it to Louisiana Farm Bureau Mutual Insurance Company so any portion of your payment is not withheld should the proposal be successful.

If we do not have a properly completed Form W-9 for you on file, that may result in the withholding and paying over to the IRS 24%
of any cash payment that you would otherwise be entitled to receive (backup withholding).

You may submit the form either electronically or by mail.

To submit by mail:

Download and print Form W-9 using the link below, then mail it to:

Louisiana Farm Bureau Mutual Insurance Company
P.O. Box 95005
Baton Rouge, LA 70895-9987

To submit electronically:

Click here to complete and submit Form W-9 online.

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