Vendor information
Banking information
Vendor Number(Code)
Payee Name
Social Security #/Taxpayer Identification #
Direct Deposit Notification Email Address
Type of Account
Bank Account Number
Bank Routing Number
Financial Institution Name
Direct Deposit Payment Option Selected
Assign this bank account to the following addresses:
Certifications
Authorized Signer’s Name
Authorized Signer’s Title
Authorized Signer’s Phone Number
Authorized Signer’s E-mail Address
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