Vendor MBE Form

Dear Vendor:

In compliance with the Department of Housing and Urban Development (HUD) and Federal regulations, we request you answer the questions below.

• A Section 3 Contractor is one who hires low and very low income residents or provides subcontracting to businesses owned by low and very low income residents.

• Racial/Ethnic/Gender Codes are needed to track minority owned businesses. Please use the code that applies to the highest percentage of any one group that is no less than 51% of ownership.

Additionally, we are required to have a completed W-9 form for all vendors. If we do not have one on file we must withhold taxes at 31% on any money owed you. Please submit a completed and signed W-9 below.

Upload Completed W-9 Here:

Browse Files

Click here to open, download, and fill out the Vendor IRS Form W-9

Your prompt response is greatly appreciated.

Thank you,

HAYC Accounting Department

Name (Business):

Taxpayer Identification or Social Security Number:

Phone Number:

Area CodePhone Number

Email:

Are you incorporated?

YesNo

Are you a Section 3 contractor?

YesNo

Racial/Ethnic/Gender Codes (choose one):

	Yes	No
1 = White Americans
2 = Black Americans
3 = Native Americans
4 = Hispanic Americans
5 = Asian/Pacific American
6 = Hasidic Jews
7 = Women Owned Business