Usaid Non-Employee Vendor Request / Update Form
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2USAID NON-EMPLOYEE VENDOR REQUEST / UPDATE FORM
To sync a SAM vendor, or to add/update a SAM exempt A&A vendor, email this form to
vrequest@usaid.gov.
To add non-US currency payment line to an existing A&A vendor, please consult with your
OFM to submit this form to you Vendor Processing Mission. The Vendor Processing Mission
list can be found
here
on the Phoenix Guides and Procedures page under the Vendor
subsection in the right column.
Per ADS 545, personally identifiable information (PII) must be encrypted in order to send the file via email. When
submitting this form, zip and encrypt it with a password and then send the password in a separate email.
Request Type
Add New Vendor
Update Existing Vendor
Vendor Code ___________________________________ Vendor Address Code ___________________
General Vendor Information
Vendor Name _________________________________________________________________________
DUNS* _____________________ DUNS+4 ____________________ CAGE/NCAGE ________________
Is vendor active in SAM?
Yes
No
In Progress
If “no”, please select reason for exemption**
Assistance: Agency determines that it must protect the personal safety of the entity's clients [CFR 25.110 (i)]
SSN/EIN___________________
TIN Type
SSN
EIN
1099 Vendor
Currency/Currency Code (only for Trust Funds) ______________________________________________
See Banking Information section below to specify payment currency information
Use for:
Billing
Procurement
Payment
Vendor Type
US Federal Agency
State & Local Government
US Business
Grant Recipient
Foreign Business
Foreign Government
Personal Services Contractor (US PSC)
Private Voluntary Organization (PVO)
Foreign Service National (FSN/TCN PSC)
Public International Organization (PIO)
Invitational Traveler
Vendor Contact Name __________________________________________________________________
Phone Number ________________________________________________________________________
Email Address _________________________________________________________________________
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