| New Vendor Information Form | |
| Basic Information | |
| Company's the Vendor Will Supply (LLC, NBMS, NBI): | |
| Vendor Type (Organization or Person): | |
| Vendor Name: | |
| International Vendor? | |
| Vendor Address: | |
| Vendor Remittance (Billing) Address: | |
| Contact Information (Phone, email, etc): | |
| Sales Tax Required | |
| Payment Information | |
| Terms of Payment (Net 20, Net 30, etc): | |
| Payment Method (Paymode, Payment Mgr, Check,Wire): | |
| 1099 Info: | |
| Individual - Yes 1099 Send to Anne | |
| C or S Corporation - No 1099 | |
| Partnership/LLC Send to Anne | |