WAKE COUNTY, NORTH CAROLINA Information & Instructions for Vendor Enrollment Form (PLEASE READ ALL INSTRUCTIONS CAREFULLY)

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1 WAKE COUNTY, NORTH CAROLINA Information & Instructions for Vendor Enrollment Form (PLEASE READ ALL INSTRUCTIONS CAREFULLY) Purpose In order to become a vendor with Wake County, we require certain information about you or your company. This information will be used to create a vendor record of you or your company in our financial system. Your vendor record must be entered into the financial system before we can issue Purchasing Documents such as PO s and contracts to your company or make any payments to you for goods or services. Contained in the Vendor Enrollment Application are two forms to be filled out (1) the Vendor Enrollment Form/W 9 form and (2) an EFT Authorization form. All forms are required and will need to be completed by you the vendor. If your classification is either Foreign or Non Resident Alien a W 8 form instead of a W 9 form is required. If you need a W 8 form please request one from the address below. Wake County now requires all vendors to enroll in EFT and be paid only by direct deposit. Instructions on how to enroll in EFT are listed in this document. You may fill out the form electronically, print, sign and then submit the form to the Wake County Finance Department, Attn: Vendor Manager either by mail at P.O. Box 550, Raleigh, NC, by fax or by to APVendorSetup@wakegov.com. Instructions for completing the Vendor Enrollment Form: Please fill out this form completely and accurately; inaccuracies could result in non approval by Wake County and a delay in processing of your transactions in our financial system. The following will explain each part of the form and what Wake County is looking for from you the vendor. Vendor Legal Name the company or individual name on file with the Internal Revenue Service (IRS). DBA Name any name other than your legal name in which you may be doing business. Vendor Address: Payment Address address where payments should be mailed. Please DO NOT provide a PO Box, a physical address is needed. Procurement Address address where purchase orders and contracts are to be mailed Address address where 1099 issued by Wake County should be mailed (if applicable). Classification: This section allows you to tell Wake County how your business is defined by the IRS. Individual must use a SSN Sole Proprietorship can use either a SSN or EIN Partnership must use a EIN Corporation must use a EIN Trust must use a EIN NonResident Alien W 8 form is required to be filled out instead of a W 9 form Foreign W 8 form is required to be filled out instead of a W 9 form

2 State Government must use a EIN Other Government must use a EIN Other can use either a SSN or EIN Employer Identification Number (EIN) or Social Security Number (SSN) number the company or individual files on taxes with the IRS. Please note that Wake County does verify all SSN and EIN numbers against the IRS online matching system before the vendor account information is finalized and prior to any payments. Failure to report SSN or EIN numbers correctly may delay your transactions. Business Type describes the type of business, you may check as many as apply. Contact Information the individual Wake County may contact with any questions Certification signature and date of individual completing the Vendor Enrollment Form.

3 Form W-9 Wake County Substitute W-9 Form Revised May 2015 Request for Taxpayer Identification Number and Certification **Please fill out the form completely to prevent delays in processing. All fields are required. Vendor Legal Name: (as shown on income tax return) VENDOR NAME/ADDRESS Vendor DBA Name: Payment Address: Procurement Address: (if different) 1099 Address: (if different) Individual Foreign (W-8 Form required) Sole Proprietorship State Government CLASSIFICATION Partnership Corporation Trust Non-Resident Alien Other Government Other EMPLOYER IDENTIFICATION NUMBER OR SSN Number Select Type: EIN SSN Located in Wake County Located Outside Wake, in NC BUSINESS TYPE (Select all that apply) Located Outside NC, in US Located Outside US Governmental Agency Minority Owned **If your agency qualifies tax exempt under IRS code, select the type below and attach a copy of the tax exempt status determination letter you received from the IRS. Tax Exempt Exemption Type: 501(c)(3) Other (Under IRS Code) CERTIFICATION Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person; and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends you are not required to sign the certification, but you must provide your correct TIN. See section titled Certification in the instructions. CONTACT INFORMATION Name: Phone: Fax: I hereby certify that the information supplied herein is correct. The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. Signature: Date:

4 Information & Instructions for Vendor ACH Form (PLEASE READ ALL INSTRUCTIONS CAREFULLY) Purpose At Wake County, we realize prompt payment is essential to our vendors. To ensure prompt availability of funds, we are offering a program known as ACH where you will receive payment through direct deposit to your bank account. Payment by ACH will provide several benefits to you. Utilizing this electronic payment program will eliminate the possibility of lost checks and check fraud. It will also eliminate mail time allowing you to receive your payment earlier. Funds will be available to you immediately upon receipt in your bank account. How Does Payment by ACH Work? Vendors in our system are paid check, ACH, or credit card. When a vendor selects ACH as their payment method, he will be selecting electronic payments for all payments from Wake County for which his vendor number is used, which will include payments from multiple departments. Once a vendor is set up for ACH payments, all future payments will be processed by this method until Wake County receives written notification revoking authorization of electronic funds transfer. ACH payments are processed along with check payments during batch payment runs twice each week, currently on Tuesday and Thursday. The ACH file is sent to the bank with effective dates for Wednesday and Friday. Funds are normally available to you within two business days of the effective date of the deposit. You will receive notification of the deposit by indicating when to expect the availability of funds. This notification will have all the information normally contained on the check stub so you can facilitate accounts receivable updating as well. You will not receive separate notification that you have been enrolled in the ACH program. You will receive an of first payment. INSTRUCTIONS FOR ELECTRONIC FUNDS TRANSFER AUTHORIZATION FORM To prevent delay in setting up Electronic Funds Transfers, please follow the instructions below. All fields ARE required in order to be set up. I. Payee/Company Information Vendor Name: Please use legal name of organization, company or individual. This should agree with the name on your W-9 form filed with Wake County. If you have not yet submitted your W-9, please attach with this form to keep in compliance with IRS Standards. Electronic payments will not start if the names do not match. Vendor Address: Please put your current mailing address that payment information is sent to. Contact: Please list name of person we should contact about payment information. Phone: Please list phone number of contact person Tax Identification number: You should list your businesses Federal Tax Identification number. If you list this you should not list a social security number. SS#: If you do not have a Federal Tax Identification Number please list the social security number you want this payment information linked to. II. Bank Information Bank Name: Name of the Financial Institution your payments will be sent to Bank Phone: Phone number of your Financial Institution Account Type: Please indicate whether funds will be deposited into a savings or checking account.

5 Because the numbers on the bottom of your check are not always the numbers banks want you to use for ACH payments (due to mergers and other issues) it is best to verify your Account Number and Depository Routing Number with your Financial Institution. Transit Routing Number: Please clearly write your depository Routing Number. Typing is best for purposes of legibility. Account Number: Please clearly write your account number. Typing is best for purposes of legibility. III. Notification of Payment Wake County will not send paper notification that payments have been sent to your bank. Notification will be sent by e- mail only. Please provide the address to which you would like notifications of payment sent. Electronic payments will not start if you do not provide a valid address. IV. Vendor Authorization Vendor Name: Please print and sign legibly the name of the person authorized to sign this form. Business Title: Please indicate title of person who signed this form. V. Documentation of Bank Account One of the following must be attached to the Electronic Funds Transfer Authorization form in order to ensure accuracy. For direct deposit to checking account, please attach voided check. For direct deposit to savings account, please attach voided deposit slip. Valid and acceptable banking information includes the following: Voided checks for checking accounts and deposit slips for savings accounts. A letter from your bank on their letterhead. The letter must include the name on the account, routing and account numbers, bank representative s contact information and signature. Please note that any voided checks or deposit slips that are NOT pre-printed will not be accepted and will be returned. For example, starter checks are NOT accepted. Any checks with hand-written information will not be accepted, especially if the account number and account names are hand-written. The name on the bank account MUST match the vendor name, whether it is a business or a sole proprietor. These are all true even for account information changes. COMPLETED FORM WITH VOIDED CHECK/SAVINGS DEPOSIT SLIP CAN BE SUBMITTED IN ONE OF THE FOLLOWING WAYS: U.S. MAIL: APVendorSetup@wakegov.com WAKE COUNTY FINANCE DEPARTMENT ATTN: ACH NOTIFICATION 2. FAX: PO BOX 550 ATTN: ACH NOTIFICATION RALEIGH NC Current ACH regulation requires us to have a signed form from the vendor; therefore, and verbal communications will not be accepted. Questions may be directed to Sonya Hicks at

6 For Finance Use Only Entered By: Approved By: Vendor No: VCM No: Electronic Funds Transfer Authorization Please, first read and follow instructions carefully to prevent delay in processing. All fields are required. I (we) authorize Wake County access to the account below in order to electronically deposit or draft funds in accordance with our payment obligations. Further, I (we) certify that the information below is correct. I (we) agree to provide 20 days written notice to Wake County Finance Department, PO Box 550, Raleigh, NC Attn: ACH Notification, prior to revoking this authorization. New Change PAYEE/COMPANY Vendor Name: Vendor Address: City: State: Zip: Contact (Business Only): Tax ID No: Phone: OR SSN: BANK INFORMATION Bank Name: Phone: Account Type: Checking OR Savings Verify Depository Routing Number & Account Number with your bank and indicate below. Routing Number: Account Number: NOTIFICATION OF PAYMENT Paper notifications will not be sent. Remittance information will be sent to you by . Address: Vendor Name (Signature): Date: Vendor Name (Printed): Business Title: **ATTACH VOIDED CHECK HERE (voided deposit slip for Savings account) Revised 3/8/2013