Pivot Property Management

Vendor Signup, 1099 & ACH Authorization Form

All vendors, contractors, service providers, and businesses must complete this form before being approved for work or payment. This information is required for vendor verification, tax reporting, insurance compliance, ACH payment setup, and payment security.

Important: Payments cannot be processed until all required vendor information is complete. The bank account name must match the person or business authorized to receive payment, and the account name must be entered exactly as it appears on the bank account.

Business / Vendor Information

Legal Business Name *

DBA / Trade Name

Business Type *

Type of Work / Services Provided *

Business Address *

City *

State *

ZIP Code *

Email Address *

Phone Number *

Primary Contact Name *

Title / Role

Tax Information for 1099 Reporting

This information is required for vendor setup, tax reporting, and 1099 preparation where applicable.

Social Security Number or Tax ID / EIN *

Required for 1099 tax reporting and vendor verification.

Name Associated with SSN / Tax ID *

1099 Mailing Address, if Different

Birthdate of Person Named on Bank Account *

Required for identity and payment verification.

I agree to provide a completed W-9 form before receiving payment.

Bank Account / ACH Payment Authorization

The bank account name must be entered exactly as shown on the bank account. Payments may be delayed or rejected if the account name does not match.

Account Name Exactly as Shown on Bank Account *

Bank Name *

Account Type *

Routing Number *

Account Number *

Confirm Account Number *

Name of Person Authorized on Bank Account *

I authorize management and/or its payment processor to issue payments by ACH/direct deposit to the bank account listed above. I certify that I am authorized to provide this bank information. I understand that incorrect banking information may delay payment, cause rejected payments, or result in fees, and I am responsible for providing accurate information.

Insurance Information

Insurance Company Name *

Policy Number *

Policy Type

Policy Expiration Date

Insurance Agent / Broker Contact Information

I confirm that my insurance information is current and agree to provide updated insurance documents upon request.

Required Attachments

Please upload or provide the following documents before payment can be processed:

Completed W-9 Form
Certificate of Insurance
Government-issued ID, if requested
Voided check or bank verification letter, if requested
Business license, if applicable
Contractor license, if applicable

Upload Documents

Upload W-9

Upload Certificate of Insurance

Upload Voided Check / Bank Letter

Upload License / Additional Document

Identity, Payment & Compliance Disclosure

To comply with vendor verification, banking security, tax reporting, fraud prevention, and applicable federal identification requirements, including requirements commonly associated with the USA PATRIOT Act, management must collect and verify certain identifying information before setting up vendors for payment.

This may include legal name, business name, physical address, date of birth, taxpayer identification number, Social Security number or EIN, insurance information, banking information, and documentation confirming the identity and authority of the person or business receiving payment.

I acknowledge that the information requested is required for vendor verification, payment setup, tax reporting, insurance compliance, and identity/payment security. I certify that all information provided on this form is true, complete, and accurate. I agree to notify management immediately of any changes.

Security Notice: Sensitive vendor information should only be submitted through a secure form or encrypted vendor system. Full Social Security numbers, bank account numbers, tax IDs, and identity documents should not be sent through regular unsecured email.

Vendor Certification & Signature

By signing below, I certify that I am authorized to submit this vendor application and payment authorization. I understand that incomplete or inaccurate information may delay vendor approval or payment.

Printed Name *

Title / Position

Signature *

Date *

Before submitting, please confirm all bank, tax, insurance, and contact information is accurate. Incomplete information may delay vendor approval and payment.

Vendor Signup, 1099 & ACH Authorization Form

Business / Vendor Information

Tax Information for 1099 Reporting

Bank Account / ACH Payment Authorization

Insurance Information

Required Attachments

Upload Documents

Identity, Payment & Compliance Disclosure

Vendor Certification & Signature

Pivot Property Management

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