Brown University Supplier and Individual Payee Registration Form

NOTE: To be completed ONLY by an authorized representative of the payee organization or individual to be paid.
We require either the individual's name/SSN or the company's name/FEIN, as they appear on your income tax return.
Email is the preferred distribution method for Purchase Orders.
Section 1: Payee's General Information

Permanent Address


Section 2: Payee's Business Information
Please provide one of the following U.S. tax numbersrequired

Corporations/Partnerships must provide an FEIN
Individuals and Sole Proprietors without FEIN must provide a Social Security Number
If you have an International Tax ID number, you must provide it.
Are you a Foreign National/Resident of another country?required

If you are a US Permanent Resident card holder please select No.
required I am a:

Is this business US Small Business Association Certified?required

Check all that apply to this business (Defined as 51% or more)

Businesses that meet these qualifications are required to upload supporting documentation

Bank Account Information (optional)

EFT (Direct Deposit) payments are available for U.S. Banks Only.

This form authorizes Brown University to make payments to a business or individual electronically. deposits funds into the account, the University and the bank are authorized to initiate the transaction(s) necessary to correct the error. This electronic payment authorization will remain in effect until the University has received written notification from the payee to terminate and the University has had reasonable opportunity to act upon it.

Notification of payments will be sent by email, with the payment settling into your bank account within two days. It is the responsibility of the business or individual to notify Brown of any changes pertinent to electronic payments, such as changes in banking information or email address.

How to Find the Routing Number on Your Check
Find Check Routing Number

Funds Transfer: To comply with the requirements of the U.S. Department of Treasury and Office of Foreign Assets Control (OFAC), Brown is obligated to ask the question shown below regarding the transferring funds. If your answer is “Yes”, Brown will issue a paper check in lieu of processing a direct deposit.

Form Questions? Email

The Internal Revenue Services does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.
denotes required fields.Required