Fillable Requestfornewvendorformapril2016fillinform ARKANSAS TECH UNIVERSITY

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Requestfornewvendorformapril2016fillinform ARKANSAS TECH UNIVERSITY

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  • 16 check-boxes
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File type: PDF

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ATU REQUEST FOR NEW VENDOR NO.
BEFORE ENTERING YOUR REQUISITION, provide all information available and submit to Procurement
Services either by fax 968-0633 or email to purchasing@atu.edu Procurement 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 by fax or email to the requesting department. If
you have questions or need assistance, please call 968-0269.
Requestor’s Telephone:
Fax:
Email:
Name of Company
or Sole Proprietor
Dba
(Doing business as)
Street Address
PO Box
City, State, Zip
Telephone Number
(IF UNKNOWN MARK N/A)
Fax Number
If fax number is unavailable, forms will be mailed or emailed.
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 Invoice
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:
Assigned Vendor No:
DATE:
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Requestfornewvendorformapril2016fillinform ARKANSAS TECH UNIVERSITY

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Completed 22 March 2020

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