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The VA Form 10091, also known as the Vendor File Request Form, plays a crucial role in the process of establishing or updating vendor records within the Department of Veterans Affairs. This form is essential for both new and existing vendors who wish to receive payments for services rendered to the VA. It requires various pieces of information, including the vendor's name, address, and tax identification details, as well as specific identifiers such as the DUNS number and bank account information for electronic payments. Vendors must also indicate their type—whether they are a commercial entity, federal agency, or individual, among others. Additionally, the form includes sections for miscellaneous actions, allowing vendors to provide relevant documentation for particular circumstances. The completion of this form not only streamlines the payment process but also ensures compliance with federal regulations, such as those outlined in the Privacy Act. Vendors are advised to submit the form via secure fax, and they can expect normal processing times of three to five business days. Understanding the components and requirements of the VA Form 10091 is vital for any vendor aiming to engage with the VA effectively.

Preview - Va 10091 Form

OMB Approved No. 2900-0846

Respondent Burden: 15 Minutes

Expiration Date: 07-31-2019

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VA-FSC VENDOR FILE REQUEST FORM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UPDATE

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VA FACILITY INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

PAYEE/VENDOR INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMERCIAL VENDOR REGISTERED IN SAM.GOV

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Required IAW FAR 4.1102)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATION CONTACT

 

 

 

 

 

 

 

 

 

 

 

 

DUNS NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATION PHONE NUMBER

STATION FAX NUMBER

 

 

 

DUNS+4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATION EMAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

SSN/TIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAYEE/VENDOR TYPE (Select one)

 

 

 

 

 

 

 

 

 

 

 

 

NPI

 

 

 

 

 

 

 

 

 

 

C - COMMERCIAL

 

 

 

F - FEDERAL AGENCY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E - EMPLOYEE

 

 

 

O - FOREIGN FACTS ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SMALL BUSINESS - PAYEE/VENDOR MUST BE QUALIFIED AS SMALL

 

 

 

 

 

 

I - INDIVIDUAL/HONORARIUM

 

 

 

A - AGENT CASHIER

 

 

 

 

 

 

 

 

 

 

BUSINESS IN SAM OR FURNISH SBA CONFIRMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAYEE/VENDOR NAME

 

 

 

 

 

 

 

 

 

 

V - VETERAN

 

 

 

U - UTILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MISCELLANEOUS ACTIONS (Select one)

 

 

 

 

 

 

 

 

 

 

 

 

DBA

 

 

 

 

 

 

 

 

 

 

WINRS

 

 

 

ASSIGNMENT (All applicable documents)

 

 

 

 

 

 

 

 

 

 

BILL OF COLLECTIONS

 

 

 

SETTLEMENT/TORTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ALAC/LGY ACCOUNT #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

FOR QUESTIONS REGARDING THIS FORM:

 

 

 

 

 

 

 

 

 

 

 

 

 

NVF CONTACT INFORMATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VA-FSC CUSTOMER SERVICE HELP DESK:

 

 

 

 

 

CURRENT ADDRESSS (Include Street, City, State and Zip Code)

 

 

 

 

 

 

 

PHONE: 512-460-5380

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMAIL: [email protected]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR ALL OTHER INQUIRIES:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CUSTOMER CARE CENTER: 1-877-353-9791

 

 

 

 

 

PREVIOUS ADDRESSS (Include Street, City, State and Zip Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATION CARE CENTER: 1-866-372-1141

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

PRIVACY ACT STATEMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The following information is provided to comply with the Privacy

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Act of 1974 (P.L. 93-579). All information collected on this form

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

is required under the provisions of 31 U.S.C. 3322 and 31 CFR

 

ACCOUNT TYPE

 

 

 

 

 

 

210. This information will be used by the Treasury Department to

 

 

 

CHECKING

 

 

SAVINGS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

transmit payment data, by electronic means to vendor's financial

 

NAME AND TITLE OF PAYEE/VENDOR

 

 

 

 

 

 

institution. Failure to provide the requested information may delay

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

or prevent the receipt of payments through the Automated

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clearing House Payment System.

 

SIGNATURE OF PAYEE/VENDOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NORMAL PROCESSING TIME IS 3 - 5 BUSINESS DAYS. WE DO NOT ACCEPT INVOICES

VA FORM 10091

SEP 2017

Instructions for FMS Vendor File Request Form

1.NEW box option - Check box if you are a new vendor not in the FMS system.

2.UPDATE box option - Check box if you are an existing vendor in the FMS system.

VA Facility Information

3.Station # - This portion pertains to the VA Station submitting this form, provide your station 3 digit station number. FOR STATION USE

ONLY

4.Station Contact Name - VA Station employee. FOR STATION USE ONLY

5.Station Phone - VA Station employee direct number. FOR STATION USE ONLY

6.Station Fax Number - VA Station fax number. FOR STATION USE ONLY

7.Station Email - VA Station employee work email address. FOR STATION USE ONLY

Payee/Vendor Type - Check the appropriate Payee/Vendor Type box. REQUIRED

Miscellaneous Actions - Check the appropriate Payee/Vendor Type box, some additional documentation required.

OPTIONAL

·ALAC Vendors - USE ONLY IF ALAC include the 6 digit account number

·Assignment of Claims- USE ONLY IF ASSIGNMENT include Notice of Assignment & Instrument of Assignment

·Federal Vendors- USE ONLY IF FEDERAL AGENCY include the 2 digit Facts

·Foreign Vendors- USE ONLY FOR FOREIGN COUNTRY include W8Ben with foreign identification number

Payee/Vendor Information

8.Commercial Vendor Registered in SAM.gov - If you are registered in System of Awards Management & have a DUNS number check this box. OPTIONAL

9.DUNS # - Data Universal Numbering System (DUNS) is a unique 9-digit number that is administered by Dun and Bradstreet (D&B)

OPTIONAL

10.DUNS+4 - If you have more than one EFT account number for the same DUNS number and same physical location as defined by the DUNS address complete this section. OPTIONAL

11.SSN/TIN - The Social Security Number (SSN) is the nine-digit number. The Tax Identification Number (TIN) is the nine-digit number which is either an Employer Identification Number (EIN); complete this section with SSN, TIN, EIN or ITIN. REQUIRED

12.NPI - A standard 10 digit unique identifiers for health care providers, complete this section if applicable. OPTIONAL

13.Small Business - Check box if applicable OPTIONAL

14.Vendor Name - Provide legal name as it is on file with the IRS REQUIRED

15.DBA - Doing Business As name complete if applicable OPTIONAL

16.Contact - Name of Point of Contact if additional information is required OPTIONAL

17.Email - Point of Contact email address OPTIONAL

18.Phone - Point of Contact phone number OPTIONAL

19.Current Address - Provide your most current address, city, state & zip code REQUIRED

20.Previous Address - Provide previous address, city, state and zip code REQUIRED FOR ADDRESS CHANGES

EFT/ACH (REQUIRED IAW 31CFR Part 208)

21.US. Bank Name - provide financial institution name city, state & zip code. REQUIRED

22.US. Nine-Digit Bank Routing Number - Provide 9 digit routing number from check ( DO NOT use Deposit slip routing number)

REQUIRED

23.US. Account # - Provide bank account number maximum 17 digits REQUIRED

24.Account Type - Check appropriate box that is associated with account number provide above REQUIRED

25.Name & Title of Payee/Vendor - REQUIRED

26.Signature of Payee/Vendor - REQUIRED

Please fax the completed form to 512-460-5221 for processing.

PRIVACY ACT NOTICE: The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This information will be used by the Treasury Department to transmit payment data, by electronic means to vendor's financial institution. Failure to provide the requested information may delay or prevent the receipt of payments through the Automated Clearing House Payment System.

RESPONDENT BURDEN: The Nationwide Vendor File Division needs this information to establish, modify/change your VA Vendor Record.

31 U.S.C. 3322 and 31 CFR 210, allow us to ask for this information. We estimate that you will need an average of 15 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain.

Document Specifics

Fact Name Details
Form Title VA Form 10091 - Vendor File Request Form
OMB Approval OMB Approved No. 2900-0846
Estimated Completion Time Respondent burden is approximately 15 minutes.
Expiration Date The form expired on July 31, 2019.
Governing Law 31 U.S.C. 3322 and 31 CFR 210 govern the use of this form.
Vendor Registration Vendors must be registered in SAM.gov to complete the form.
Payee/Vendor Types Includes Commercial, Federal Agency, Employee, Foreign, and more.
Privacy Act Compliance Information collected complies with the Privacy Act of 1974.
Submission Method Completed forms must be faxed to 512-460-5221 for processing.
Processing Time Normal processing time is 3 to 5 business days.

Va 10091: Usage Instruction

Completing the VA Form 10091 is essential for vendors seeking to establish or update their information in the VA's vendor system. This form collects necessary details that facilitate the processing of payments and ensures compliance with federal regulations. Follow these steps carefully to fill out the form accurately.

  1. Check the appropriate box for either NEW or UPDATE to indicate your vendor status.
  2. Provide the Station Number, which is a three-digit code for the VA Station submitting the form.
  3. Enter the Station Contact Name, which is the name of the VA Station employee responsible for this submission.
  4. Fill in the Station Phone Number for the contact person.
  5. Include the Station Fax Number for any necessary communications.
  6. Provide the Station Email Address for the contact person.
  7. Select the appropriate Payee/Vendor Type by checking the corresponding box.
  8. Check the box for Commercial Vendor Registered in SAM.gov if applicable.
  9. Enter your DUNS Number, a unique 9-digit identifier.
  10. If applicable, fill out the DUNS+4 section for additional EFT account numbers.
  11. Provide your SSN/TIN, which can be your Social Security Number or Tax Identification Number.
  12. If applicable, enter your NPI, a standard identifier for healthcare providers.
  13. Check the box for Small Business if this applies to you.
  14. Provide your legal Vendor Name as it appears on IRS records.
  15. If applicable, fill in your DBA (Doing Business As) name.
  16. Enter the Contact Name for additional inquiries.
  17. Provide the Email Address for the contact person.
  18. Fill in the Phone Number for the contact person.
  19. Provide your Current Address, including street, city, state, and zip code.
  20. If applicable, fill in your Previous Address for address changes.
  21. For EFT/ACH, provide your Bank Name and Bank Address.
  22. Enter your Nine-Digit Bank Routing Number.
  23. Fill in your Account Number, ensuring it is a maximum of 17 digits.
  24. Select the Account Type associated with the account number provided.
  25. Provide your Name and Title as the payee/vendor.
  26. Sign the form in the Signature of Payee/Vendor section.

After completing the form, fax it to the designated number for processing. Ensure that all required fields are filled out accurately to avoid delays in processing your request.

Learn More on Va 10091

  1. What is the VA Form 10091?

    The VA Form 10091, also known as the Vendor File Request Form, is used by vendors to establish or update their information in the VA's financial management system. This form collects essential details such as the vendor's name, contact information, and banking details to facilitate electronic payments.

  2. Who needs to fill out the VA Form 10091?

    This form must be completed by any vendor wishing to do business with the VA. Whether you are a new vendor or an existing vendor needing to update your information, this form is necessary. Specific categories include commercial vendors, federal agencies, employees, and small businesses.

  3. What information is required on the form?

    Several key pieces of information are required, including:

    • Vendor name as registered with the IRS
    • Social Security Number (SSN) or Tax Identification Number (TIN)
    • Current address and previous address (if applicable)
    • Banking information, including the bank name, routing number, and account number

    Incomplete information may delay processing and payments.

  4. How long does it take to process the form?

    The normal processing time for the VA Form 10091 is approximately 3 to 5 business days. Timely submission of accurate information can help ensure that there are no delays in your vendor record being established or updated.

  5. Where should I submit the completed form?

    Once you have filled out the form, it should be submitted via secure fax to 512-460-5221. Ensure that all required sections are completed to avoid any issues with processing.

  6. What should I do if I have questions about the form?

    If you have any questions regarding the VA Form 10091, you can reach out to the VA-FSC Customer Service Help Desk at 512-460-5380 or email them at [email protected]. They are available to assist you with any concerns you may have.

Common mistakes

Filling out the VA Form 10091 can seem straightforward, but many people make mistakes that can delay processing. One common error is not checking the correct box for whether the vendor is new or an update. This distinction is crucial for the VA to know how to handle the request. If you fail to indicate whether you are a new vendor or an existing one, it can lead to confusion and a longer processing time.

Another frequent mistake involves the DUNS number. Some individuals either forget to provide it or enter an incorrect number. The DUNS number is essential for identifying your business in the System of Awards Management. Without it, your application may be rejected or delayed.

People often overlook the requirement for a Social Security Number (SSN) or Tax Identification Number (TIN). This information is mandatory. Failing to include it will prevent the VA from processing your request. Make sure you double-check this section to ensure accuracy.

In addition, many applicants neglect to include their current and previous addresses. It is vital to provide complete address information, including street, city, state, and zip code. Missing this information can lead to miscommunication and delays in payment.

Another area of concern is the bank information section. Individuals sometimes provide incorrect routing or account numbers. Remember that the routing number must be a nine-digit number from a check, not from a deposit slip. Double-check these numbers to avoid complications.

Some vendors forget to sign the form. This is a required step. Without a signature, the form is incomplete, and the VA will not process it. Ensure you sign and date the form before submission.

Another mistake is not providing a valid email address or phone number for follow-up. If the VA has questions about your submission, they need a way to contact you. Missing contact information can lead to delays in resolving any issues.

Many people also fail to check the box indicating their payee/vendor type. This selection is crucial for the VA to categorize your application correctly. Make sure to select the appropriate type, whether you are a commercial vendor, federal agency, or another category.

Lastly, some applicants do not submit all required documentation. If you are applying as a federal vendor or a foreign vendor, additional documents may be necessary. Ensure you review the requirements carefully and include any needed attachments.

By avoiding these common mistakes, you can help ensure a smoother process when submitting the VA Form 10091. Attention to detail is key. Take your time to fill out the form accurately, and you will likely see faster results.

Documents used along the form

The VA Form 10091 is essential for vendors looking to establish or update their information within the Department of Veterans Affairs' vendor system. Alongside this form, several other documents may be required to ensure compliance and facilitate a smooth registration process. Below is a list of forms and documents that are often used in conjunction with the VA Form 10091, each serving a specific purpose.

  • W-9 Form: This form is used by vendors to provide their Taxpayer Identification Number (TIN) to the IRS. It is essential for tax reporting purposes and must be submitted by vendors to ensure accurate tax processing.
  • W-8BEN Form: Foreign vendors use this form to certify their foreign status and claim any applicable tax treaty benefits. It is crucial for compliance with U.S. tax laws and to avoid unnecessary withholding on payments.
  • Notice of Assignment: This document is required when a vendor assigns their rights to receive payment to another party. It outlines the details of the assignment and must be submitted to ensure proper payment processing.
  • Instrument of Assignment: This legal document formalizes the assignment of payment rights from one party to another. It provides the necessary details regarding the assignment and is often required alongside the Notice of Assignment.
  • ACH Authorization Form: This form authorizes the VA to deposit payments directly into a vendor's bank account. It includes banking information and ensures timely payment processing through electronic means.
  • Small Business Certification: Vendors claiming small business status may need to provide documentation verifying their eligibility. This certification is vital for vendors seeking to qualify for small business set-asides and contracts.
  • Federal Vendor Registration: Federal vendors must provide proof of registration in the System for Award Management (SAM). This registration is necessary for compliance with federal contracting regulations.
  • DBA Registration: If a vendor operates under a "Doing Business As" name, they may need to submit documentation that verifies this name registration. This ensures that all business transactions are legally recognized.
  • Vendor Profile Update Form: Existing vendors may need to submit this form to update their information in the VA system, including changes in contact details or banking information.
  • Certificate of Insurance: Some contracts may require vendors to provide proof of insurance coverage. This document protects both the vendor and the VA from potential liabilities during the course of business.

Each of these documents plays a critical role in the vendor registration process with the VA. Ensuring that all necessary forms are completed and submitted accurately can help streamline the onboarding process and facilitate timely payments. Vendors are encouraged to review the requirements carefully to avoid delays and ensure compliance with all regulations.

Similar forms

The VA Form 10091 is similar to the IRS Form W-9, which is used by individuals and businesses to provide their Taxpayer Identification Number (TIN) to those who will be paying them. Both forms require the disclosure of identifying information, such as names and addresses, to facilitate payment processing. The W-9 form is essential for tax reporting purposes, ensuring that the IRS has accurate records of income paid to vendors. Similarly, the VA Form 10091 collects data necessary for the Department of Veterans Affairs to process vendor payments accurately and in compliance with federal regulations.

Another document comparable to the VA Form 10091 is the ACH Authorization Form. This form is utilized to authorize electronic payments directly from a bank account. Both forms focus on ensuring that payment information is accurate and that the recipient has authorized the transfer of funds. The ACH Authorization Form requires banking details, including routing and account numbers, much like the VA Form 10091, which also collects banking information for electronic fund transfers. This parallel is crucial for efficient payment processing in both instances.

The VA Form 10091 shares similarities with the Vendor Registration Form used by various state and local governments. These forms often require similar information, such as business names, addresses, and tax identification numbers, to establish a vendor's eligibility to do business with the government. Both forms serve the purpose of ensuring that vendors meet specific criteria and comply with regulations before receiving payments for services rendered or goods provided.

Additionally, the VA Form 10091 is akin to the SF-3881 form, also known as the Automated Clearing House (ACH) Vendor/Miscellaneous Payment Enrollment Form. This form is used by federal agencies to collect banking information from vendors for electronic payments. Both forms require similar banking details, including account numbers and routing information, to facilitate timely and accurate payments. They aim to streamline the payment process and ensure compliance with federal financial regulations.

Finally, the VA Form 10091 is comparable to the Form 941, which is used by employers to report payroll taxes. While the contexts differ, both forms require accurate identification and financial information to ensure compliance with federal regulations. The Form 941 collects data about employee wages and taxes withheld, while the VA Form 10091 gathers information necessary for vendor payments. Both forms are critical for maintaining proper financial records and ensuring that payments are processed correctly within the respective systems.

Dos and Don'ts

When filling out the VA Form 10091, there are important dos and don’ts to keep in mind. This will help ensure that your submission is complete and processed without delays.

  • Do read all instructions carefully before starting.
  • Do provide accurate and complete information in all required fields.
  • Do check the box for whether you are a new vendor or an existing vendor.
  • Do include your DUNS number if you are registered in SAM.gov.
  • Do sign the form before submission.
  • Don't leave any required fields blank.
  • Don't use deposit slip routing numbers for your bank information.
  • Don't forget to provide your current and previous addresses if applicable.
  • Don't submit the form without checking for errors or missing information.
  • Don't include invoices with your form submission, as they are not accepted.

Misconceptions

  • Misconception 1: The VA 10091 form is only for new vendors.

    This form is used for both new vendors and existing vendors updating their information. There are specific checkboxes to indicate whether you are a new vendor or updating an existing record.

  • Misconception 2: You must be a small business to fill out the VA 10091 form.

    While there is an option to indicate if you are a small business, it is not a requirement. Any vendor, regardless of size, can complete the form as long as they meet the necessary criteria.

  • Misconception 3: The form does not require a DUNS number.

    A DUNS number is essential for completing the VA 10091 form. Vendors must provide this unique identifier to ensure their information is accurately processed.

  • Misconception 4: Submitting the form guarantees immediate payment.

    Filling out the VA 10091 form does not guarantee immediate payment. The normal processing time is between 3 to 5 business days, and delays can occur if information is incomplete.

  • Misconception 5: You can submit invoices through this form.

    The VA 10091 form is not designed for invoice submission. It is strictly for vendor registration and updates. Invoices must be submitted through the appropriate channels.

Key takeaways

When filling out the VA Form 10091, there are several important points to keep in mind. This form is essential for vendors who wish to establish or update their information in the VA Vendor File. Here are some key takeaways:

  • Purpose of the Form: The VA Form 10091 is used to collect necessary information from vendors to facilitate payments through the Automated Clearing House Payment System.
  • Registration Requirement: Vendors must be registered in the System for Award Management (SAM.gov) and provide their DUNS number if applicable.
  • Types of Payees: It is crucial to select the correct payee/vendor type, such as commercial, federal agency, or individual, as this determines the processing requirements.
  • Documentation: Some actions may require additional documentation, such as proof of assignment or foreign identification, so be prepared to provide these if necessary.
  • Accurate Information: Ensure that all information, including addresses, bank details, and contact information, is accurate and up-to-date to avoid payment delays.
  • Submission Method: Completed forms should be faxed to the designated number, ensuring that all required fields are filled out before submission.
  • Processing Time: After submission, normal processing time for the form is typically between 3 to 5 business days.

By following these guidelines, vendors can effectively navigate the process of filling out and using the VA Form 10091, ensuring that their information is correctly recorded and payments are processed smoothly.