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Vendor Information Form

  1. Please enter your company's legal name, or your name if you are an Individual/Sole Proprietor

  2. Please enter your company's business name/disregarded entity, if different from above

  3. ADDRESS

  4. REMIT TO ADDRESS

  5. YOUR COMPANY'S CONTACT INFORMATION

  6. Please enter, if applicable

  7. Please enter your website, if applicable

  8. ACH/EFT BANKING INFORMATION

  9. Please enter the email address of the person you wish to be notified when a payment is sent

  10. Please enter the name of the City of Anderson department, or person, that requested this form to be filled out. If no one, please enter N/A

  11. Please enter your terms, if applicable

  12. Leave This Blank:

  13. This field is not part of the form submission.