📝 Vendor Information & Payment Instructions
Please complete all sections of this form accurately and thoroughly. This information is essential for processing payments and maintaining our vendor records. Please note: YCAN contracts vendor registration, management, and payment processing out to The Align Team. They are the entity that will contact you regarding invoices and issue payments on our behalf.
Vendor Contact Information
Please provide the designated contact person who YCAN or our payment processing center should reach out to regarding invoices, payment status, or any billing questions.
Primary Contact Person
*
First Name
Last Name
Title
ie owner/property manager
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
How would you like to be paid (check all that apply)
*
Check
ACH
Legal Name on Account: The name of the business or individual as it appears on the bank account. This must match the name on the W-9 to prevent payment errors.
Bank Account Number: The vendor's specific checking or savings account number where the funds should be deposited.
Bank Name: The name of the vendor's financial institution.
Bank Routing Number (ABA Routing Transit Number): The nine-digit code that identifies the vendor's financial institution.
Account Type:
Checking
Savings
📜 Tax Information & IRS Reporting
The information below is required to process your payment and is used by YCAN to comply with IRS mandates for reporting payments totaling over $600 annually, if applicable. Important Note on Multiple Businesses: If you operate multiple businesses that use different Tax IDs (TINs/SSNs), you must complete a separate form for each business. If you have multiple properties or subsidiaries that operate under the same Tax ID, you may list them on this form.
Legal Business Name or Individual Name Listed on Tax Returns
*
Doing Business As (DBA) Name (if applicable):
Required Taxpayer Identification (TIN/SSN)
*
Vendor Type
*
LLC. Enter the tax classification S-Corp
LLC. Enter the tax classification C-Corp
LLC. Enter the tax classification Partnership
Sole Proprietorship
Partnership
Non-Profit Organization
Government Entity
Other
Legal Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
🏷️ Services/Goods Provided
Please briefly describe the services or goods you provide, and select the primary category for accurate assistance processing:
Description of Services/Goods:
*
Do you operate multiple properties or subsidiaries under this Tax ID (TIN/SSN) that YCAN may be paying?
*
Yes
No
If YES, is the payment address for YCAN checks different from the mailing address listed on the W-9?
Yes
No
If YES, please provide the specific Name to Be Listed on Check and Payment Mailing Address:
Name to Be Listed On Check
Mailing Address For Payment to me mailed
City
State / Province
Postal / Zip Code
If YES, please provide the specific Name to Be Listed on Check and Payment Mailing Address:
Name to Be Listed On Check
Mailing Address For Payment to me mailed
City
State / Province
Postal / Zip Code
Primary Category of Services/Goods:
*
Rent/Housing (Landlord/Owner)
Rent/Housing (Property Management Co.)
Motel
Transportation Service
Childcare Provider
Utility Provider
Other
🖋️ Vendor Certification & Integrity Statement
*
I, the undersigned representative of this business/entity, hereby certify that the information provided on this form is true, accurate, and complete to the best of my knowledge. I further certify that no conflict of interest exists between this business/entity and any current staff member or board member of the Yellowstone Country Assistance Network (YCAN).
Other
If you need to provide us any addition information or clarification please do so here.
Certification I, the undersigned, certify that the information provided herein is true and accurate to the best of my knowledge.
This is the version of the IRS Form We are Requesting
Upload Current IRS Form W9
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Please make sure you use version 2024 of the form
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