Request Taxpayer Id W9 Form

							                                                                CHECK REQUEST
               Check One:                                Cal Poly Corporation                 Cal Poly Foundation

Date:                                                                       THIS SECTION MUST BE COMPLETED BY REQUESTER
Pay To:                                                                         CSU Student                   CSU or State Agency Employee
       1099 Taxpayer ID:                                                        CPC/CPF Employee              None of the Above

       W9 on File (no ID # required)                                Company Owned in whole or part by CSU or State Agency Employee or Retiree
       Tax ID on file (no ID # required)

Address:                                                      Effective January 1, 2004: Public Contract Code prohibits California State University employees
                                                              (except for those with teaching or research responsibilities) from contracting with, or being
                                                              employed by Cal Poly Corporation if the source of the funds for the goods or services comes from
                                                              CSU funds or a CSU contract, unless required by his/her CSU employment determined by the CSU.
VENDOR #:                                                     PCC 10831

 Prepayment Requested:                                        Approximate Date Expected to Clear:
                                           Description                                                                   Org Key            Object Code
                                                                                                      Amount
(ex. Purpose of expenditure(s), Vendor Name, Invoice Number, Date for each item)                                         (5 digit )          (6 digit)




ATTACH ORIGINAL INVOICES/RECEIPTS/PACKING SLIPS                                        TOTAL:                0.00
      Date Check Needed:                                             Department Approval:
              Requester:                                               Printed Name/Title:
                 Phone #:
          E-Mail Address:                                                        CPC Approval:



                                       CHECK DISTRIBUTION: To be completed by requestor.
    MAIL TO:         ADDRESS SHOWN                                                   PICK UP AT RECEPTIONIST
                     OTHER:

                                                                                        Phone#
                                                                                       or Email:


       Internal Office use only: Accounts Payable
    Invoice:                                    PYR?                                  1099?          Accrue Sales Tax?                W@S




       Revised: 5/19/2011