East Tennessee State University
Vendor ACH/Direct Deposit Authorization for Payment Not Related to a Purchase Order

A thorough review of the information below will minimize any delays in the processing of your form and ensure a timely processing of any payments to you from ETSU via direct deposit.

Why do I need to submit this form?

• If you do not anticipate receiving a purchase order but need to be setup to receive payment from ETSU via direct deposit, you will need to fill out and submit this form.
  
  
• If you are unsure if you will be receiving a purchase order from ETSU, please contact your ETSU correspondent.
  • In order to receive a purchase order, an ETSU Vendor Application must be submitted instead of this form.
    • Please visit https://www.etsu.edu/bf/forms.php#vendors to access the ETSU Vendor Application.
      
      
• All vendors are run through the IRS database for verification. Please provide the company name and tax ID as you are registered as a business with the IRS.
  
  
• If you are a business outside the United States and do not have a US bank account, this form is not necessary. Please submit a W-8 BEN-E form to your ETSU correspondent.

How do I get access to this form?

• If you have already completed this step:
  • Please continuing reviewing the rest of the additional information below.
    • Then click the link below.
      • Login with the username and password you created in the Dynamic Forms system to submit the form.
        • (You should have received a confirmation email after you created your Dynamic Forms account.)
          
          
• If you have NOT already completed this step:
  • Please continuing reviewing the rest of the additional information below.
    • Then click the link below.
      • Select the “Create New Account” link from the Dynamic Forms login webpage to create your free Dynamic Forms account.
        • You will receive a confirmation email and you will need to then activate your Dynamic Forms account.
        • You will then be able to login and submit your information.

What do I need to know in order for me to help streamline this process?

• Tips:
  • Input EIN/SSN without dashes (example: 123456789, not 123-45-6789)
    
    
  • You will need to attach a completed and signed W9 & voided check/bank letter, please have those ready as PDF or image files when you are ready to submit the application.
    
    
  • DO NOT opt-out of e-signature at the end of the application:
    • You must submit this form by providing your electronic signature in order for it to be accepted as an official authorization of payment by direct deposit.
      • You will receive a confirmation email after you provide your electronic signature and submit the form.
        • There is no need to contact ETSU to confirm the receipt of this form if you receive your confirmation email after submitting the form.
    • If you select opt-out, you will be required to FILL OUT THIS ENTIRE FORM FROM SCRATCH AGAIN in order to resubmit it with your electronic signature.

To proceed to the ETSU Vendor ACH/Direct Deposit Authorization for Payment Not Related to a Purchase Order, please click the link below:
https://dynamicforms.ngwebsolutions.com/Submit/Start/f2275ecf-fc2a-45ca-b2c6-f9695356b528?SSO=N