CITY OF TROY
VENDOR INFORMATION REQUEST FORM
The City of Troy is in the process of updating our new computer system, so that all the
information is correct. We would appreciate your help in this matter. Please complete the
following information and return to this office as soon as possible so that we may properly
update our system.
VENDOR NAME: _________________________________ONLY ONE
PLEASE USE COMPLETE NAME
NO ABBREVIATIONS OR INITIALS
COMPLETE PURCHASE ORDER ADDRESS
_______________________________________________
______________________________________________
COMPLETE REMIT TO ADDRESS
______________________________________________
______________________________________________
FAX NUMBER:_________________________________
CONTACT PERSON:_______________________________
PLEASE CHECK THE CATEGORY, WHICH ACCURATELY DECRIBES YOU OR YOUR FIRM.
Failure to check one below will hold up your payment.
( ): GU: Government (State, County, City, Etc)
( ): MH: Medical and/or health care corporation
( ): PC: Professional Corporation (Accountant and/or Lawyers Only)
( ): CP: Corporation not catagorized above
( ): NC: Non-Corporation: (Individuals, Businesses, Partnerships, Etc.)
( ): EX: Reimbursement/Refunds (Exempt)
( ): HO: Home and/or Property Owner (Non Corp) Grant Recipient Only
( ): RT: Rental Payments
Please enter your Tax Identification Number or your Social Security Number below.
Tax ID __ __ - __ __ __ __ __ __ __ Soc. Sec. __ __ __ - __ __ - __ __ __ __
Authorized Signature____________________________________