County-paid staff must be set up as a supplier of the State of Georgia before any reimbursement requests can be paid. To do this, county-paid staff who have never received a reimbursement from PAC or have not received a reimbursement from PAC within the last year must submit a W9 and Supplier Change Request Form (SCRF, formerly a Vendor Management Form). Additionally, county-paid personnel whose name, address, or banking information has changed must submit a W9 and Supplier Change Request Form (SCRF).

Please scroll to the end of this page to access the forms as well as important directions for completing the forms.

Vendor Setup Processing Times: The State Accounting Office’s (SAO) processing time for vendor set ups can be lengthy. Therefore, we encourage you to submit your documents at least 6 to 8 weeks in advance of the training event you plan to attend to avoid any delays in processing your reimbursement request.

Setting up ACH payments: Setting up ACH (direct deposit) payments via the SCRF is strongly encouraged to speed reimbursement times and reduce the risk of checks lost in the mail.

Additional Supporting Documents: While processing your W9 and SCRF, SAO may require additional documentation such as the first page of your most recent tax return, a copy of your Driver’s License, and/or a utility bill. PAC will follow up with you if any additional documents are required, and they should be provided as promptly as possible.

Subsequent Changes in Personal Information: When submitting your reimbursement request, if the name or reimbursement address differs from what you submitted on your W9 and SCRF, PAC must submit these changes to SAO, which can delay processing. PAC may also request new W9s or SCRFs to support the address or name change. If you are attempting to have your reimbursement sent to your office address, an employment verification letter on your agency’s letterhead that includes the address, the last 4 digits of your SSN, and office manager contact information must be submitted.

Below are detailed steps assist you when completing the W9 and SCRF:

Steps to complete the PAC Online Reimbursement Form

Please download the PAC Reimbursement Guide located on this page for step-by-step directions on completing the PAC Online Reimbursement Form.

Steps to complete the W9 Form

1. W9s must include legal name, personal address, tax classification checked, signature, and date of signature.
2. For individuals, please do NOT include employment office information in line 2.
3. A P.O. Box cannot be used as your sole address. You must submit a physical address as your primary address. P.O. Boxes can be set up as a secondary address by submitting a second  Supplier Change Request Form (SCRF). See below. Note that the address provided on the W9 and the address provided on the SCRF must match.
4. Signatures must be either handwritten “inked” signatures or digital (date/time stamped). They must not be computer generated to typed.

Steps to complete the Supplier Change Request Form (SCRF)

Note that this form has been created, maintained, and is required by the State Accounting Office (SAO). SAO is very strict about how these forms are completed. Please read all directions carefully. Incomplete or improperly completed forms require follow up by PAC and will delay set up.

• Individuals must complete Sections 1,2, and 3 ONLY. In Section 3, individuals should mark “not applicable” where possible, and business should make the relevant selection. Section 4 should be completed ONLY for 1099 status, if known. If unknown, leave it blank (no selections other than 1099 should be made in section 4).  Nothing should be entered in section 5.
• Do NOT select New or Existing at the top of the page. This is for internal use only.

Section 1:

1. 1. Fill out Section 1 completely.
   2. The name and address must match the name and address on the W9.
   3. Physical Address: A physical address MUST be provided. For individuals, this should be your home address, not your office address. Note that for any address provided, the county must be listed after your zip code.
   4. Mailing Address (optional): Please only add this if your mailing address is different than your physical address. A P.O. Box or office address may be indicated in this section. If you add an office address, an employment verification letter on agency letterhead including the address, the last 4 digits of your SSN, and office manager contact information must be submitted.
   5. Payment Remit Address (optional): This is the address where you want payments sent if that address is different from your physical or mailing address. A P.O. Box or office address may be indicated in this section. If you add an office address, an employment verification letter on agency letterhead including the address, the last 4 digits of your SSN, and office manager contact information must be submitted.
   6. For your email address, using all caps is preferred to facilitate easy transmission into SAO’s database.
   7. A contact name and title are required for businesses. Individuals do not need to add this information.
   8. You MUST be reachable at the contact information you provide (email and phone number) as the State Accounting Office or PAC may contact you directly to obtain additional supporting documentation.

Section 2:

1. 1. In this section, you must either:
      • Check the box to opt out of providing banking information
      • Check the box to indicate that ACH is not applicable for the request (if you already receive ACH payment from the state of Georgia), or
      • Provide your banking information to establish ACH payments or change the bank account where you receive ACH payments.
   2. Do not check anything on the third or fourth lines of this section (those that read replace remittance address, replace invoice address). These lines are for PAC use only.
   3. If providing banking information:
      • Provide the name exactly as listed on the bank account
        • Provide the bank name Ensure that the leading/ending zeros on the bank account number are included. Please carefully review routing and account numbers. Bank accounts that cannot be successfully verified by SAO will be denied set up and MUST be paid by check. Select ONE of the boxes, either: “General Bank Account for ALL State of Georgia Agencies” OR “Specific Purpose.” You should only select “Specific Purpose” if you already have a different bank account set up as your “General” bank account. All new submissions should have “General Bank Account for All State of Georgia Agencies” selected.
      • Sign on the “Signature of Company Officer” line of this section. Either a digital signature (date/time stamped) or manual “inked” signature are acceptable. Do NOT use computer generated, cursive font or a typed name for the signature. Do not forget to sign.

Section 3:

1. This section must be completed by both individuals and businesses. Individuals should mark “not applicable” where possible and businesses should make relevant selections.

Section 4:

1. 1. Complete ONLY for 1099 eligibility, if known. If unknown, leave this section blank.
   2. No selections other than 1099 should be made in section 4.

Section 5:

1. 1. Do NOT fill out anything in Section 5. Do NOT sign in Section 5 (bottom of page 2). This section is for the PAC Vendor Liaison only.

• BOTH pages of the completed SCRF and the W9, must be sent directly to fiscal@pacga.org. The Fiscal division will review and let you know if anything is missing or if additional documentation is required by the State Accounting Office (SAO).
• Occasionally, a check must be issued due to delays in ACH setup at the State Accounting Office. This will typically only happen for your first reimbursement from PAC. Please ensure that you have provided a valid address for receiving checks on your reimbursement form.

If you have questions regarding the forms, please contact the PAC Fiscal Division at fiscal@pacga.org for assistance.