Domestic Vendor Set-up/Maintenance Form

MarketScape (Aprimo) Corporate Accounts Payable

NOTE: This form is for DOMESTIC Vendors only. Please use the Foreign Vendor Setup form from the HELP tab
of the Supplier/Sponsorship Approval tool.

Vendor please return this form to: Your Bank of America Contact

Please check the reason that applies:

Request Setup of New Vendor or a Vendor Name Change
Request Change of Existing Vendor Information (e.g., Remit-To Address. Not for Name Changes)

Required:
W-9 Included - Required for New Vendor or Vendor Name Change*
ACH Authorization Included - Bank of America Preferred Payment Method
Copy of Invoice with Vendor’s Remit-To Address Included - Required by AP Vendor Management
Vendor Type – (Charities, Donations, Interview Expense, Legal Settlements, Municipalities, Sponsorships,
USPS, Utilities) Insert the appropriate letter(s) in the box. Invoice and Vendor Type will be validated

For Changes to existing vendor information, Please indicate vendor number(s) in box(es) below:
                 
                 

Vendor Name:
Payment Remit-To Address:

City:
State:
Zip+4:
Vendor Contact Name:
Vendor Telephone:
Vendor email Address:
LOB Contact Name: Demmeri Gallon
LOB Contact Telephone: 813.225.8392
LOB Contact email Address: Demmeri.Gallon@bofa.com
*Bank of America Corporate Accounts Payable Policy requires a completed IRS Form W-9 with this Document

Signature Date Title

For Supply Chain Management Use Only: ePayables Packet Enclosed? Yes No

Corporate Accounts Payable thanks you in advance for performing the appropriate due diligence and submitting the required supporting documents.

00-08-2166NSBW 04-2007