Northwestern University
Vendor Code Request Form for INDIVIDUALS

Use this form to ADD or UPDATE information for U.S. non-employees to be paid through Accounts Payable in the financial system. First determine if the individual should be processed through Payroll instead; see below. Confirm that a vendor code does not already exist and/or verify the accuracy of data already entered. Errors in the vendor database may result in financial liability to the payee and the department requesting payment. This form must be completely filled in and legible, and must include the correct SSN or TIN. If completed correctly, entry into the system will be up to two (2) working days. Fax or mail this form to POPS. The following guidelines are important:

For additional information see the Financial Systems website at http://www.nwu.edu/finsys/polcydoc/plcymenu.htm or contact POPS.

1. Identification number, name, and address.

Social Security Number (SSN) or Taxpayer Identification Number (TIN) = __ __ __ - __ __ - __ __ __ __

Name= __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

- list the last name first and then as much of the first name that fits

Address= __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

City=__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ State= __ __ Zip= __ __ __ __ __ - __ __ __ __

Telephone Area Code= __ __ __Number= __ __ __ - __ __ __ __Extension= __ __ __ __ __ __

Fax Area Code= __ __ __Number= __ __ __ - __ __ __ __

2. Signature and Payment Information

"I attest that I am a U.S. citizen or U.S. resident."

Signature _________________________________________________________
                  The signature of the individual to be added to the vendor database is required.

Purpose of payment= ___Consulting/Speaker Fees/Services ___Honorarium ___Reimbursement ___ Other

Description ________________________________________________________________________

3. Responsible Department Information.

Name= _________________________________________ Department= _________________________

Date=___________Phone= ___________ Fax= ___________

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For POPS use only.   HRIS review ___   Date processed= __ __ / __ __ / __ __ Initials= ________         Rev 5/99
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Purchase Order Processing Services (POPS) - 2020 Ridge Avenue, Rm. 272 - Evanston, IL 60208-4320
Fax 847-467-2741 Phone 847-467-2696 Manager 847-491-8123 E-Mail nu-pops@nwu.edu