Vendor Information Collection

We prioritize the security of your personal and financial information. The data collected in this form is encrypted and stored securely in compliance with industry standards and data protection regulations. It will only be used for the purpose of processing payments and will not be shared or accessed by unauthorized parties. If you have any questions about our data practices, please contact us at privacy@ciesc.org.

Manual Delivery
If you prefer to manually print and bring in your documents (W-9 Form and ACH Form) you may do so anytime Monday through Friday, 9:00am – 3:30pm to our office located at:

3500 Depauw Blvd.
Suite 2020 – Pyramid 2, Floor 2
Indianapolis, IN 46268

Fax Delivery
If you prefer to fax your documents (W-9 Form and ACH Form), please fax each one to the following fax number:

317-342-3049

Digital Submission Form

This field is for validation purposes and should be left unchanged.

Personal Information

We will use this information to send a confirmation email and to verify you have submitted documentation.

Name

First Last

Forms

These forms will be submitted to CIESC for payment verification. These documents will NOT be stored on our servers. Only the CIESC Business Manager, David Stowers, will have access to these documents in order to send your payment.

Not sure how to edit a digital PDF file?

W-9 Form

Please download the w-9 form (click here), fill out the information, and upload here. You may also upload a picture of the filled out form instead of a filled out PDF, if that is easier.

Accepted file types: pdf, jpg, png, Max. file size: 64 MB.

ACH Form

Please download the ACH form (click here), fill out the information, and upload here.
Note: ACH is our preferred method of payment. You may also upload a picture of the filled out form instead of a filled out PDF, if that is easier.