ࡱ>  *ubjbj(( qBgqBg  <<8|T$.(x(c-e-e-e-e-e-e-$013|-9|-<<t-%#%#%#R<8c-%#c-%#%#VW*@t+H>L"AX* O--0.*xb4b4+b4+4L6%#,>--_!.b4 X :  VENDOR REGISTRATION FORM WASHINGTON ELEMENTARY SCHOOL DISTRICT NO. 6 4650 W. Sweetwater Ave., Glendale, AZ 85304-1505 Email:  HYPERLINK "mailto:purchasing@wesdschools.org" purchasing@wesdschools.org or Fax: 602 347 3521 Vendor Name/DBA Name:DateMailing Address:WebsiteStreetPhone CityStateZIP CodeContact Name TitleRemit Address ( Please mail payments to this address. Contact EmailWESD account #Payee Name for CheckPurchase Orders to be sent Via:Street (Where to mail remittance/check)( Please mail: " select remit or mailing address (remit address (mailing addressCityStateZIP Code( E-mail (provide email)Is your company on a cooperative contract? (No (Yes If yes, please list:We are not tax-exempt, is sales tax charged? (No (Yes  Do you accept Visa Payments? (No (Yes Contact email address?Do you offer a prompt payment discount? (No (Yes If yes, what are the terms?________% ________DaysAre you or a family member currently employed with ̽? (No (YesHave you ever been employed by ̽? (No (Yes When:Is your Business: ( Certified Small Business ( Disabled Veteran Business Enterprise ( LGBTQ Owned ( Minority Business Enterprise ( Native American Owned ( US DOT Certified DBE ( Veteran Owned ( Woman Business Enterprise  W-9 Request for Taxpayer Identification Number and Certification The District must have a W-9 on file for every vendor. YOU WILL NOT BE REGISTERED WITHOUT W-9 INFORMATION.  A copy of the Form W-9 with instructions is available on the IRS website: HYPERLINK "http://www.irs.gov/FormW9" www.irs.gov/FormW9. Link: https://www.irs.gov/pub/irs-pdf/fw9.pdf Federal Taxpayer Identification Number (TIN)Social Security Number, OR Employer Identification NumberIndividual/Sole proprietor Corporation Partnership other ________________ Name as Shown on Federal Tax Documents (Individual/Sole proprietor provide owners name)Under penalties of perjury, I certify that:The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and I am a U.S. person (including a U.S. resident alien). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. 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