Request for New Vendor/Vendor Change

New Vendor / Vendor Change
Requestor: ______
Requesting Dept.:______/ Vendor Number: ______
Add Address (below)
To Replace: (Provide Address to be replaced)
To Inactivate: (Provide Address to be inactivated)
Change AP Default:
Approval(s):
AP ______Date:______
Payroll ______Date:______
HR ______Date:______
Terminate Vendor ______Reason: ______

Please attach any back-up documentation, e.g., vendor notification of address change, business name change, etc.

Non-Person Name or Last Name: / First Name: / Middle: / SSN/SIN/TIN: REQUIRED FIELD
______- __ __ - ______
Or CWID:
______
Street Address 1: / Type*:
Street Address 2:
Street Address 3:
City: / State or Province: / County: / Nation: / Zip or Postal Code:
Telephone: / Type**:
Email:
1099 Vendor: ___Yes ___No / Date W-9 Sent: / Date W-9 Received:
eProcurement Vendor: ____Yes ____No
Date Entered: / By:

*Address Types: **Telephone Types:

AP – Accounts Payable B2 – Business (Physical) AP – Accounts Payable FAX - Fax

BI – Billing BU – Business PO – Purchase Order PG – Pager

CO – College of Charleston FO – Foreign BI – Billing BU – Business

HM – Home MA – Mailing CO – College of Charleston HM – Home

PO – Purchase Order TE – Temporary CL – Cell RH – Residence Hall

3/15/2010