Get Va 10091 2022

The VA 10091 is a vital form for vendors to request or update their information within the VA system. This guide will provide you with step-by-step instructions on how to navigate and complete the form online efficiently.

Follow the steps to fill out the VA 10091 online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select the appropriate box to indicate whether you are a new vendor or updating an existing record.
3. Enter the VA facility information. Provide the three-digit station number associated with the VA Station completing the form.
4. Fill in the station contact name, direct phone number, fax number, and email address.
5. Choose the payee/vendor type by checking the appropriate box applicable to your status. Ensure this is completed as it is required.
6. If your vendor type requires additional documentation, select the appropriate miscellaneous actions box as needed.
7. Indicate if you are a commercial vendor registered in SAM.gov and enter your Unique Entity Identifier (UEI), which is required if applicable.
8. Provide your Social Security Number (SSN) or Tax Identification Number (TIN) as required.
9. If you are a medical provider, fill in your National Provider Identifier (NPI) where applicable.
10. Enter the legal name of the payee/vendor as it appears on file with the IRS and use the Doing Business As (DBA) name if applicable.
11. Complete the details for the authorized representative, including their name, email, and phone number.
12. Fill in your current address, as well as the previous address if there are any changes.
13. In the EFT/ACH section, provide the bank name, address, nine-digit routing number, account number, and account type.
14. Print your name and title, followed by the handwritten signature of the authorized representative.
15. Once all fields are completed, ensure to save your changes, download a copy, print, or share the form as needed.

Start filling out your VA 10091 online today to ensure your vendor information is up to date.