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Division of Accounting  >>  Employee Vendor Form   

 
STATE OF DELAWARE
EMPLOYEE VENDOR ID REQUEST
The State of Delaware requires the following information for all vendors (payees) before any payments can be made. This information is used to populate and maintain the State's vendor file.
*Required. Complete all required fields if new request or making a change.
* Form Type:
* If Change Profile is selected, briefly describe what has changed from original request:
Taxpayer ID:
* SSN: (no hyphens)
Payment Method: State employees receive personal reimbursement through Direct Deposit.
* Bank Name:
* Account Type:
* Bank Routing Number: help
* Bank Account Number: help
Please allow 7 business days for bank account validation.
Employee Information:
* Employee Name
Employee Address & Contact Information:
* Address Line 1:
Address Line 2:
* City:
*State:
* Zip:
* Contact Name:
* Phone #

Extn

Fax#
* Contact Email Address:
Certificationfication
Under penalties of perjury, I certify that the number shown on this form is my correct taxpayer identification number (SSN).
Electronic System Submission:
Under penalties of perjury I certify that:
* I am the same person (or payee's agent) accessing the system and submitting this form.


* By submitting this form electronically, I am affixing my electronic signature as the payee(or payee's agent) identified on this form and I am in agreement with the State of Delaware to accept and process this transaction in electronic form.

    

 
 
 
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