Please complete and mail/drop-off the W-9 form to:

    • Jackson County Health Department
    • 415 Health Department Road
    • P.O. Box 307
    • Murphysboro, IL 62966


W-9 Forms can also be faxed to 684-6023, attn: Business office, or e-mailed to This email address is being protected from spambots. You need JavaScript enabled to view it.

For additional questions regarding the completion of the W-9 form,

please call JCHD at 618-684-3143, ext. 185.