How to Fill Out and Submit VA Form 10091: Vendor File Request

To fill out VA Form 10091, choose whether you’re a new vendor or updating an existing one, complete the sections that apply to your payee type, enter banking and tax details that match your IRS records exactly, sign in Section IV, and submit the form either by fax to 512-460-5221 or through the VA’s Customer Engagement Portal. The Financial Services Center (FSC) takes 15 to 30 business days to process a completed form, so send it well before any payment is due.¹

Where to Get the Form and How to Submit It

Two versions of the form exist, and they go to the same place.

The paper PDF is available at va.gov/vaforms. Once you’ve filled it in, fax the completed form to 512-460-5221.¹

The online webform lives at the Customer Engagement Portal, cep.fsc.va.gov. Log in through ID.me and click “Vendor Account Setup and Updates.” The portal runs about 5 to 20 minutes and doesn’t let you save partway through, so gather your tax identifier, banking details, and (if you have one) SAM information before you start. When you click “Finish,” the system produces a case number that begins with “VCOM” followed by a dash and a number, and you should get a confirmation email from FSC.CustomerSupportDoNotReply@va.gov. Save the case number; you’ll need it to check status or call for help.²

At the top of the form, mark either “New Vendor” or “Update Existing Vendor.” That choice determines which sections you need to complete.

Section I: For Station Use Only

Section I holds the requesting VA facility’s station number, contact name, phone, fax, and email, along with the “Payee/Vendor Type” classification (Commercial, Individual, Caregiver, Honorarium, Veteran, Federal Agency, Foreign, Agent Cashier, Utility, or Medical Provider) and a “Miscellaneous Actions” field for special situations like assignments of claims or tort settlements. This section is labeled “For Station Use Only,” meaning the VA facility fills it in, not you.³

Section II: Your Identity and Tax Information

Section II is where you identify yourself for payment and tax reporting. A few fields carry most of the weight.

Box 11 takes your nine-digit tax identifier. The form accepts a Social Security Number for individual U.S. citizens and permanent residents, an Employer Identification Number for businesses and entities like corporations or LLCs, or an Individual Taxpayer Identification Number for people who file taxes but aren’t eligible for an SSN.³

Box 14 takes your legal name, and it must match your IRS records exactly. A mismatch between the name on the form and the name tied to your tax identifier triggers a verification delay and can result in backup withholding on your payments.³

Box 18 is your current mailing address. If you’re updating an existing file and changing that address, Box 19 asks for the previous address on record so the FSC can locate your file.³

Section III: Banking Details for Electronic Payment

Federal regulations require nearly all government payments to move by electronic funds transfer rather than paper check.⁴ Section III captures three pieces of information from your bank:

Box 20, the name of the financial institution holding your account.
Box 21, the nine-digit ABA routing number. This must be the bank’s routing number, not a deposit-slip routing number; deposit slips often carry a different number that will cause the payment to bounce.³
Boxes 22 and 23, the account number and whether it’s checking or savings.

The easiest place to find your ABA routing number is on a voided check, printed as the first nine digits along the bottom edge. If you don’t have checks, your bank can confirm the routing number through online banking or a verification letter. Check every digit. A single wrong number sends the payment back for manual review by FSC staff.

Section IV: Signature and Authorized Representative

The FSC won’t process the form without a valid signature in Section IV. The signer must be either the payee or vendor named in Box 14, or someone designated in writing to act on their behalf. The FSC defines “Authorized Representative” narrowly, so an assistant signing without formal written designation won’t do.³

Section IV includes your printed name, title in Box 24, and signature in Box 25. If you’re a business owner signing for your company, list your corporate title. If you’re an authorized representative, your written designation should be attached or already on file with the FSC.

SAM.gov Rules That Change Which Boxes You Complete

If your entity is registered in the System for Award Management with a Unique Entity Identifier, additional fields apply. The UEI is a 12-character alphanumeric code assigned by SAM.gov, and the EFT Indicator in Box 10 is a four-character code tied to that UEI.³

New vendor registered in SAM: complete Boxes 8 through 11, Boxes 14 through 19, and Sections III and IV. Every detail must match SAM exactly, or the FSC will reject the request.
New vendor not registered in SAM: complete Box 11, Boxes 14 through 19, and Sections III and IV. Skip the UEI and EFT Indicator fields.
Existing vendor registered in SAM: banking changes must be made in SAM first, not on this form. You still use Form 10091 for non-banking updates like an address change, but the banking data flows from SAM.³

Individual veterans, caregivers, and most non-commercial payees don’t have SAM registrations and can skip Boxes 8 through 10. If you’re not sure, search your organization’s name at SAM.gov before you start.

Updating an Existing Vendor File

When your bank account, address, or other details change after you’re already in the VA payment system, submit a new Form 10091 with “Update Existing Vendor” selected at the top. You need to complete Sections II, III, and IV.³

Address changes require Box 19 with your previous address so the FSC can locate your record. Banking updates use the same fields as an initial setup. If you’re a SAM-registered entity changing banking information, that change must be made in SAM.³

Updates take the same 15 to 30 business days. If a payment is coming soon, submit the update well in advance. A payment sent to a closed account while the update is still in the queue can push the delay out by weeks.

Common Reasons the FSC Rejects a Form

Most rejections come from a short list of avoidable errors:

SAM mismatch. If you’re SAM-registered and any field on the form (name spelling, address, EIN) doesn’t match SAM exactly, the request comes back.
Missing or unauthorized signature. Only the payee in Box 14 or a person with written authorization can sign.
Deposit-slip routing number instead of the bank’s ABA routing number.
Blank or wrong EFT Indicator in Box 10 for a SAM-registered vendor.
Missing attachments on special requests. An Assignment of Claims request needs both a Notice of Assignment and an Instrument of Assignment attached, or the FSC won’t process it.
Foreign vendors missing a completed W-8BEN with a foreign identification number.³

Tracking Your Request After Submission

If you submitted online, log back into the Customer Engagement Portal, open “My Profile,” and look under “Vendor File Form Cases.” Click the VCOM case number to see the status. The FSC asks that you wait at least 15 days before calling for an update.²

If you faxed the form, or if the portal didn’t return a case number, call the FSC Customer Care Center at 1-877-353-9791, Monday through Friday, 7:15 a.m. to 4:15 p.m. Central Time. Have your case number ready if you have one. Without it, the help desk may have limited ability to locate your request and could ask you to resubmit.²

The real confirmation is your first electronic deposit landing in the correct account. That tells you the routing number, account number, and payee name all matched.

What You’re Certifying When You Sign

The information on Form 10091 feeds directly into the federal payment system and IRS tax reporting. If your tax identifier doesn’t match the name on your IRS records, the VA may be required to withhold a percentage of your payments as backup withholding until the discrepancy is resolved.

Signing the form is a certification that the information is accurate. Under federal law, knowingly making a false statement on a document submitted to a government agency is punishable by a fine, up to five years in prison, or both.⁵ Verify every field against your bank records and IRS filings before you sign.

1
Department of Veterans Affairs. Instructions for FSC Vendor File Request Form
2
Department of Veterans Affairs. Webform User Guide
3
Department of Veterans Affairs. VA Form 10091 Vendor File Request
4
eCFR. 31 CFR 208.3 – Payment by Electronic Funds Transfer
5
Office of the Law Revision Counsel. 18 U.S. Code 1001 – Statements or Entries Generally