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GOV PHONE NUMBER CURRENT ADDRESSS Include Street City State and Zip Code FOR ALL OTHER INQUIRIES CUSTOMER CARE CENTER 1-877-353-9791 STATION CARE CENTER 1-866-372-1141 PREVIOUS ADDRESSS Include Street City State and Zip Code SUBMIT ALL DOCUMENTATION VIA SECURE FAX 512-460-5221 EFT/ACH Required IAW 31 CFR Part 208 BANK NAME BANK ADDRESSS Include City State and Zip Code NINE-DIGIT BANK ROUTING NUMBER ACCOUNT NUMBER ACCOUNT TYPE CHECKING SAVINGS SIGNATURE NORMAL PROCESSING TIME IS 3 - 5 BUSINESS DAYS. WE DO NOT ACCEPT INVOICES VA FORM APR 2014 10091. FSC VENDOR FILE REQUEST FORM NEW UPDATE PAYEE/VENDOR INFORMATION VA FACILITY INFORMATION STATION NUMBER COMMERCIAL VENDOR REGISTERED IN SAM. GOV Required IAW FAR 4. 1102 STATION CONTACT DUNS NUMBER STATION PHONE NUMBER STATION EMAIL ADDRESS DUNS 4 SSN/TIN PAYEE/VENDOR TYPE Select one NPI C - COMMERCIAL F - FEDERAL AGENCY E - EMPLOYEE O - FOREIGN FACTS ID I - INDIVIDUAL/HONORARIUM A - AGENT CASHIER V - VETERAN U - UTILITY MISCELLANEOUS ACTIONS Select one SMALL BUSINESS - VENDOR MUST BE QUALIFIED AS SMALL BUSINESS IN SAM OR FURNISH SBA CONFIRMATION VENDOR NAME DBA WINRS ASSIGNMENT All applicable documents BILL OF COLLECTIONS SETTLEMENT/TORTS CONTACT ALAC/LGY ACCOUNT EMAIL ADDRESS FOR QUESTIONS REGARDING THIS FORM NVF CONTACT INFORMATION NATIONWIDE VENDOR FILE CUSTOMER SERVICE EMAIL VAFSCVENDOT VA. FSC VENDOR FILE REQUEST FORM NEW UPDATE PAYEE/VENDOR INFORMATION VA FACILITY INFORMATION STATION NUMBER COMMERCIAL VENDOR REGISTERED IN SAM. GOV Required IAW FAR 4. 1102 STATION CONTACT DUNS NUMBER STATION PHONE NUMBER STATION EMAIL ADDRESS DUNS 4 SSN/TIN PAYEE/VENDOR TYPE Select one NPI C - COMMERCIAL F - FEDERAL AGENCY E - EMPLOYEE O - FOREIGN FACTS ID I - INDIVIDUAL/HONORARIUM A - AGENT CASHIER V - VETERAN U - UTILITY MISCELLANEOUS ACTIONS Select one SMALL BUSINESS - VENDOR MUST BE QUALIFIED AS SMALL BUSINESS IN SAM OR FURNISH SBA CONFIRMATION VENDOR NAME DBA WINRS ASSIGNMENT All applicable documents BILL OF COLLECTIONS SETTLEMENT/TORTS CONTACT ALAC/LGY ACCOUNT EMAIL ADDRESS FOR QUESTIONS REGARDING THIS FORM NVF CONTACT INFORMATION NATIONWIDE VENDOR FILE CUSTOMER SERVICE EMAIL VAFSCVENDOT VA. .

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