Henry Ford Health System
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AP Vendor Update Response Form

Remittance Address, Payment Terms Confirmation and IRS TIN and W9 compliance: Kindly provide the following information to ensure the most current remittance address, payment terms and W9 are on file with Accounts Payable.  

You must also complete a W9 Form and fax it to 313-874-9490 for this response to be complete.

Click here for W9 Form

* Indicates required information
Date: * 
Vendor Number (#) Referenced on Letter: * 
Name of Parent Company: * 
Name of Division (If Applicable): 
Tax ID Number * 
Remittance Address: * 
P.O. Box/Suite: 
City: * 
State: * 
ZIP Code: * 
Additional Comments: 
Payment Terms: * 
Your Name: * 
Your Phone Number (#): * 
Your Title: * 
 

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