Fillable VA Form 10091, FSC Vendor File Request 2025

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4.1 out of 5

35 votes

The document outlines the instructions for completing the VA Form 10091, which is used to gather essential payment data from vendors to establish or update vendor records for processing electronic payments. It specifies requirements for new and existing vendors, including registration in the System of Awards Management (SAM), necessary information fields, and the role of an Authorized Representative in certifying the accuracy of the provided information.

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Click ‘Get Form’ to open the Fillable VA Form 10091 in our platform.
Begin with Section I: VA Facility Information. Enter the Station Number, Contact Name, Phone Number, Fax Number, and Email Address as required.
Move to Section II: Payee/Vendor Information. If you are a new vendor registered in SAM, complete boxes 8-11 and 14-19. Ensure all information matches your SAM registration.
For existing vendors, make sure any banking changes are updated in SAM. Complete the necessary fields including Payee/Vendor Name and Email.
In Section III: EFT/ACH, provide your current bank details including Bank Name, Routing Number, Account Number, and Account Type.
Finally, in Section IV: Authorized Representative, fill in the name and title of the authorized representative and ensure they sign the form.

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Versions	Form popularity	Fillable & printable
2023	4.1 Satisfied (35 Votes)
2022	4.8 Satisfied (84 Votes)
2021	4.8 Satisfied (205 Votes)
2017	4.3 Satisfied (195 Votes)
2016	4 Satisfied (28 Votes)
2016	4.6 Satisfied (49 Votes)
2014	4.3 Satisfied (382 Votes)

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How to fill out form 10091?

How to fill out VA Form 10091? Read the instructions carefully to understand what information is required on VA Form 10091. Fill in your personal details, ensuring accuracy in names, addresses, and Social Security numbers. Complete all sections relevant to your claim or request.

How to submit VA 10091 form?

Frequently used VA forms You can now do many form-based tasks online, like filing a disability claim and applying for the GI Bill or VA health care. Well walk you through the process step-by-step.

Where do I fax VA form 10091?

Miscellaneous Actions - Check the appropriate Payee/Vendor Type box, some additional documentation required. Please fax the completed form to 512-460-5221 for processing.

What is the VA FSC vendor file request form?

Please fax the completed form to 512-460-5221 for processing. PRIVACY ACT NOTICE: The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C.

Can you fill out VA forms online?

The Veterans Benefits Administration (VBA) uses VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA), to request private medical records and information regarding the source of records in support of claims for compensation and/or pension benefits.

va 10091 form

Fillable va form 10091 fsc vendor file request online Fillable va form 10091 fsc vendor file request pdf Fillable va form 10091 fsc vendor file request 2022 VA 10091 form 2024 VA FSC Customer Engagement Portal va form 10-320 VA Vendor Portal va form sf-1199a

How do I submit documents to the VA?

If youve already filed a disability claim, you have up to a year from the date the VA received your claim to submit additional supporting documentation. This evidence can include things like medical records, test results, and doctors reports. You can upload these documents through the claim status tool on VA.gov.

Can you submit VA forms online?

Frequently used VA forms You can now do many form-based tasks online, like filing a disability claim and applying for the GI Bill or VA health care.