Atu Request For New Vendor No
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1ATU REQUEST FOR NEW VENDOR NO.
Date: ____________
BEFORE ENTERING YOUR REQUISITION, provide all information available and fax this form to the
Purchasing Department (968-0633).
Purchasing 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 to the fax number listed below. If you have questions or need assistance,
please call 968-0269.
From: _____________________________
___________________________________
(Department Name)
(Departmental Fax No.)
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
PLEASE CHECK ONE OF THE FOLLOWING
REASON FOR NEW
VENDOR NUMBER
Place Order
Game Official
Stipend
Travel Reimbursement
Refund/Other Reimbursement
IS THIS PERSON A
Yes
No
TECH STUDENT?
PLEASE CHECK ONE OF THE FOLLOWING
BUSINESS
DESIGNATION
Foreign
Individual
Sole Proprietor
(
)
IF KNOWN
LLC
Corporation
Partnership
Medical
Non-Profit
Requested By:
____________________________________________
(Signature)
Approved By:
____________________________________________
(Signature of Immediate Supervisor)
FOR PURCHASING USE:
Date
FEIN, TIN or SSN:
Entered
Assigned Vendor No:
Initials
Form ATU-083
Revised 10-14-11
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