Remittance Data Entry Form.doc

The PDF document is a remittance data entry form that needs to be filled out by the requesting department along with a signed IRS Form W-9. It includes fields for the remittance name, address, city, state, zip code, phone, fax, taxpayer identification number (TIN), reason for payment (procurement or non-procurement), and verification of the TIN. Additionally, there is a section for right of way vendor code entry which requires details like account number, closing date, and amount. The form also includes sections for review and completion by the requesting department and the department entering the vendor code.