New Vendor Onboarding
Please complete this form to provide the necessary information for registering you as a new vendor.
Legal Business Name:
*
Federal Tax ID/EIN:
*
Point of Contact:
*
First Name
Last Name
Email:
*
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Mailing Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Attach W9 Form:
*
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Attach Outstanding Invoice (If applicable)
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To ensure prompt payments, EPG offers virtual credit card payment processing. ACH payment is also available.
Which payment do you prefer?
*
Virtual Credit Card
ACH
Please provide your Accounts Receivable or payment remittance email address:
*
If you prefer Electronic Funds Transfer (EFT) authorization
The financial institution information you provide will be used to process Electronic Funds Transfer (EFT) payments for all approved and due invoices associated with the legal business name listed above. Please note that EFT payments are limited to checking accounts only.
Financial Institution Information
Name on Checking Account:
First Name
Last Name
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
ABA (Transit Routing) Number:
Checking Account Number:
Name of Financial Institution:
Financial Institution Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
AUTHORIZING SIGNATURE: By signing this document, you are authorizing EFT and/or Virtual Credit Card payment to be sent to the above account.
*
Date Signed:
*
-
Month
-
Day
Year
Date
For questions, please email:
accountspayable@MyEPG.com
Ramiro Idrobo
Phone:407.798.0004
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