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GENERAL INFORMATION

BUSINESS STATUS INFORMATION

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We are required by the IRS to keep IRS Form W-9 on file for all vendors. You can obtain a blank Form W-9 via the attached link: https://www.irs.gov/pub/irs-pdf/fw9.pdf

BANK INFORMATION FOR ACH PAYMENTS

REMITTANCE INFORMATION

AUTHORIZATION

I authorize V P Holdings or subsidiaries and the financial institution listed above to electronically deposit invoice payments into my bank account. If monies to which I am not entitled are deposited into my account by V P Holdings or subsidiaries, I authorize V P Holdings or subsidiaries to direct the bank to return said funds. This authorization will remain in effect until it has been cancelled in writing.

PRODUCTS OR SERVICES YOUR COMPANY PROVIDES

ADDITIONAL DATA

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LIST 3 CREDIT REFERENCES

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