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Vendor Information/TIN Certification

Vendor Information/TIN Certification (this form replaces the Vendor Administration and 1099 Issuance form)

DO NOT FILE THIS DOCUMENT THROUGH CM/ECF
Please complete the form below. Print, sign and return it via email or mail to:

U.S. Bankruptcy Court
401 West Trade Street, Room 111
Charlotte, NC 28202

FAILURE TO COMPLETE, SIGN AND RETURN THIS FORM WILL RESULT IN NON-PAYMENT

Complete the Financial Information section of the form only if you want to be paid electronically. Otherwise you will receive a paper check from the US Treasury. Please contact the Finance Department if you have questions about completing this form.

AO213.pdf