Fillable Vendor Authorization/Change Form Amarillo College PO Box 447 (Amarillo College)

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Vendor Authorization/Change Form Amarillo College PO Box 447 (Amarillo College)

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The Vendor Authorization/Change Form Amarillo College PO Box 447 (Amarillo College) form is 1 page long and contains:

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  • 27 check-boxes
  • 40 other fields

Country of origin: US
File type: PDF

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New Change
TIN/EIN
ITIN
Corporation C or S _____
Partnership
Non-Profit/501©Entity
Exempt payee code ________
Foreign Nonresident Individual
Provider of Medical Services Goods Performer Attorney Royalty
Speaker/ Lecturer Services Consultant
State Zip
Foreign Province Country
Contact Name Email
Fax
Email Fax
Name (if different than above)
State Zip
Foreign Province Country
Contact Name Email
Fax
Phone
Department Fax
Email to notify complete vendor setup
Auditor
Send 1099 to this address
Send 1099 to this address
US Agent of Foreign Person/Entity
Foreign Entity (other than individual)
Phone
Primary Name (if different than above)
City
Phone
Limited Liability Company. Enter the tax classification (C = corporation, S = S corporation, P = partnership) _________
Amarillo College
PO Box 447
Amarillo, TX
79178-0001
Individual/Sole Proprietor (US Citizen)
Vendor #
Date:
Exempt from backup withholding
Name Used by IRS
Name
REMIT TO
(if different from above)
SSN
No SSN/TIN
Vendor Name:
Vendor Authorization/Change Form
A vendor signed W-9/W-8 BEN, vendor name, tax ID, type of business, type of purchase/payment, PO address, and requestor information are
REQUIRED for all new vendor set-ups as well as a Conflict of Interest form.
Other (please explain): ___________________
Address
Address
City
T
y
p
e
o
f
B
u
s
i
n
e
s
s
Government Entity
Section A - W-9 (& CIQ if applicable)
Section B - W-8 BEN Required
Email form to Purchasing-department@actx.edu
Remit to address same as PO address
Type of Purchase/Payment
Description of Services/ Reason for payment (required):
PURCHASE ORDER
PO DISPATCH
College Contact (required) -Email notification of vendor set up will be sent to this contact
.
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Vendor AuthorizationChange Form Amarillo College PO Box 447 (Amarillo College)

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Completed 27 July 2020

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