Vendor Information Submission Form

Vendor Information
- Vendor Name: *
- Payee Name:
  (If different from Vendor Name)
- Address: *
- Address (line 2):
- City: *
- State: *
- Zipcode: *
- E-mail: *
  (E-mail addresses will be used for EFT notification purposes only)
- Please choose entity type: * Business Individual
- Federal Tax ID Number:
  (Please email a copy of your W-9 form to accountspayable@lsufoundation.org at your earliest convenience) (No Dashes)
- Please enter your Social Security Number or LSU ID Number.
  
  Social Security Number:
  (Please email a copy of your W-9 form to accountspayable@lsufoundation.org at your earliest convenience) (No Dashes)
- LSU ID Number:
  (No Dashes)
- Contact Name: *
- Contact Phone: * -- Ext.
- Account Type: *
- Bank Name: *
- Routing Number: *
- Account Number: *
- * = Required Field
  
  This web page is secured using an SSL Extended Validation certificate. All information submitted on this page is secured by the LSU Foundation and is only accessible via authorized personnel. If you experience any problems with using this form please send an email to accountspayable@lsufoundation.org.