RCUH Policies and Procedures
FOR U.S. CITIZEN & U.S. COMPANY VENDORS ONLY DO NOT USE THIS FORM FOR NON-U.S. VENDORS
1. Enter the Name as shown on Line 1 of the vendor’s W-9
2. Enter the Business Name/disregarded entity name as shown on Line 2 of the vendor’s W-9.
If Line 2 of the W-9 is blank, re-enter the Name from Line 1. This is the vendor name that will print on the check.
Last Name First Name MI
3. Enter the Vendor’s Address. Only a U.S. addresses is allowed.
Department/Office (May be left blank) Address (Number, Street, and Apt/Suite/Room No.)
City State Zipcode
4. SELECT ONE BOX BELOW
ATTACH THE W-9 FORM AS A FILE ATTACHMENT BELOW: If individual Vendor, WH-1 FORM can substitute.
OR a W-9 is not required because the Vendor is:
Federal; United States government or any of its agencies or instrumentalities. State, including District of Columbia, government or any of its agencies.
IF YOU CLICKED ON FEDERAL OR STATE ABOVE, GO TO #8
University of Hawaii (UH) Employee
IF YOU CLICKED RCUH OR UH EMPLOYEE BOX ABOVE, GO TO #7
5. SELECT THE FEDERAL TAX CLASSIFICATION:
Individual/Sole Proprietor or Single-Member LLC
Individual/Sole Proprietor – UH Student or RCUH Student Employee Corporation
LLC – C Corporation
LLC – S Corporation
LLC – Partnership
EXEMPT PAYEE Check this box onliy if the vendor marked itself Exempt on the W-9. Ask the vendor to provide their IRS tax exemption letter. The W-9 must be signed and dated.
NOTE: Please use the “Update File Attachments” button to save this field. Clicking the “Save” button below will not save this field.
Update File Attachments
6. Enter the Taxpayer’s Identification Number (TIN) from Part 1 of the W-9 form:
Social Security Number (SSN) Employer’s Identification Number (EIN) – – OR –
7. Enter the UH or RCUH Employee Number:
UH Employee Number
RCUH Employee Number
I CERTIFY THAT THIS VENDOR RECORD IS FOR A U.S. CITIZEN OR FOR A U.S. DOMESTIC ENTITY.
IF A W-9 IS NOT ATTACHED, THE VENDOR MEETS ONE OF THE EXCEPTIONS LISTED IN BOX 4 ABOVE.
9. This form was completed by:
Name Phone Number (nnn-nnnn) Email Address Your Fiscal Administrator Your Fiscal Administrator’s Email Address