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New Vendor Setup Form

2. Date
   Date
4. Vendor Name*
6. Remit to Address:
8. City
9. State
10. Zip Code
12. Phone Number
13. Fax Number
15. Email Address
17. A/R Contact Name
19. W-9
    Blank W-9

    Please email associated W-9 to Accounts Payable. mhooper@co.coffee.al.us
20. 1099 Vendor?

    1. Yes
    2. No
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field