Vendor Payment - Request Form - Slaton Financial Services

Vendor Name(Required)

Business Name/Your Name

Contact Name

First Last

Email(Required)

If you qualify to receive a 1099 from your client we will email you the 1099

Enter Email Confirm Email

1099 Information

Does your client have your W9 on file?(Required)

Please know that if you say "Yes" and we do not have your W9 on file. Payment will not process until we have your W9 on file. Address for W-9 https://www.irs.gov/pub/irs-pdf/fw9.pdf

Yes

No, please complete it. Then you can click "Yes" and upload it in this form

No, I am Incorporated and do not need to supply a W9.

No, I am being reimbursed, I do not need a W9.

Job Details

Business you did service for?(Required)

Your Client's Name

Date Service Was Provided(Required)

Invoice # / What was done?(Required)

Invoice number (if you have one). If not, please describe what service you provided.

How Much Are You Charging?(Required)

File Upload - **Your W-9 Must be signed and filled out accurately**

Please upload an invoice, take a picture and upload to verify services provided, etc.

Drop files here or

Max. file size: 25 MB, Max. files: 5.

Comments

Please let us know any other information you think we need to know.

Method of Payment

Do you want to be paid via ACH or Check?(Required)

ACH

Check

Do you want us to mail it or will you pick it up?(Required)

Mail it to me. Use the address from my W9

I will come pick it up at Slaton Financial

if you have a different mailing address, enter that information in the comments.

Do we have your ACH information on file?(Required)

Yes

Enter Bank ACH Information

Date you authorize payment to be processed?(Required)

Selecting today is the normal answer, even though payment might not actually be processed today.

Bank Information(Required)

Bank Information Bank Name Bank City Bank State Bank Zip

Bank Routing Number(Required)

9 Digit Number

Bank Account Number(Required)

Is this a Checking or Savings Account?

Please choose one

Checking

Savings

Upload Proof From Bank (only 1 file needed)(Required)

Types of proof that is needed: 1) Voided check. 2) Letter from bank. 3) Screenshot from bank app 4) Bank statement **a page that has your routing and account number** (Please redact your bank balance. We do not need to see that. If you do not give a voided check, know that we need the information that is on check. The bank name, your name and address, routing and account number)

Accepted file types: jpg, gif, png, pdf, Max. file size: 25 MB.