Form ATU-083 Revised 2-14-07
ATU REQUEST FOR NEW VENDOR NO. Date: ______________________
BEFORE ENTERING YOUR REQUISITION, provide all information available and fax this form to the
Purchasing Department (968-0633). Purchasing will contact the vendor for their Tax Identification
Number, Business Designation, etc., set up the vendor in the Banner System, note the assigned vendor
number and return this form to the fax number listed below. If you have questions or need assistance,
please call 968-0269.
From: ________________________________ ________________________________
(Department Name) (Departmental Fax No.)
Name of Company
or Sole Proprietor
Dba
(Doing business as)
Street Address
PO Box
City, State, Zip
Telephone Number
Fax Number:
Web Site
E-mail Address
REASON FOR NEW
VENDOR NUMBER
PLEASE CHECK ONE OF THE FOLLOWING
Place Order_____ Game Official _____ Stipend_____
Travel Reimbursement _____ Refund/Other Reimbursement _____
IS THIS PERSON A
TECH STUDENT?
Yes _____ No _____
BUSINESS
DESIGNATION
(
IF KNOWN)
PLEASE CHECK ONE OF THE FOLLOWING
Foreign _____ Individual _____ Sole Proprietor _____
LLC_____ Corporation _____ Partnership _____
Medical_____ Non-Profit _____
Requested By: ____________________________________________
(Signature)
Approved By: ____________________________________________
(Signature of Immediate Supervisor)
FOR PURCHASING USE:
FEIN, TIN or SSN:
Date
Entered
Assigned Vendor No:
Initials
