Vendor Number Request / Change Form - Monroe County (Page 2 of 2) in pdf

Department of Human Services

Monroe County, New York

Maggie Brooks

Kelly A Reed

County Executive

Commissioner

INSTRUCTIONS

VENDOR NUMBER REQUEST / CHANGE FORM

When to use this form

* To apply for a NEW Monroe County vendor number

* To change address or name information on an existing vendor number

* To add or change pay type codes

To apply for a new vendor number

* If applying for a vendor number as an individual with a social security number, attach a copy of your

social security card; no substitutions accepted.

* If applying for a vendor number as a company with a tax ID number, attach a copy of a letter received

from the IRS which includes both your tax ID number AND company name. W-9 forms are not accepted.

* Only complete the Company or DBA line if the vendor number is to be assigned to a company with a

tax ID number, or a person whom will be receiving payments under a DBA. If you have a DBA name,

please also include a copy of your DBA papers

To change information on existing vendor numbers

* Complete all information on this form; be sure to provide your existing vendor number

* The only information that can be changed is the address and name; you cannot change which person or

company the vendor number belongs to, the social security number or tax ID number cannot be changed

* When changing a name, be sure to include proper documentation showing the change

 For individuals, please submit a copy of the updated social security card

 For businesses, please submit documentation from the IRS showing the change (must

include both new name and tax ID number on documentation)

* If a payment type needs to be updated, please be sure to include this information as well

* Please Note: If submitting an address change, please also allow 10 business days for processing. Be

advised, that notification will not be sent once an address is changed. The change will take affect once the

next payment is sent.

General Information

* The vendor must send in the ORIGINAL form, with ORIGINAL signatures. Copies or faxes are

not acceptable.

* Please allow at least 10 days once this form is received by Vendor Operations for processing.

* Please do not contact Vendor Operations to obtain your new vendor number. You will receive notice

via mail once a new vendor number is assigned.

* Applying for and receiving a new vendor number, does not entitle you to payment. The appropriate

caseworker must first notify you that you are authorized to receive payment, before a payment will be

issued. If payments are not received even after this notification, you must then contact that caseworker

with any further questions.

Vendor Number Request / Change Form - Monroe County Page 2