VA · Official form

VA Form 10091: VA-FSC Vendor File Request Form

VA Form 10091 establishes or updates a payee record in the VA Financial Services Center (FSC) vendor file so VA can send payments, usually by direct deposit, to the right bank account.

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What is VA Form 10091?

Before the VA Financial Services Center can pay a person or business, that payee needs a vendor file record with correct tax identification and banking information. VA Form 10091 collects those details: payee name, address, Social Security number or EIN, and the bank routing and account numbers for electronic payment.

The form is used by commercial vendors doing business with VA and by individuals receiving certain VA payments outside the regular benefits systems, such as caregiver stipends or reimbursements. It is usually submitted through, or at the direction of, the VA program office or facility that will authorize the payment.

Who files VA Form 10091?

Businesses and individual vendors that need to be paid by the VA Financial Services Center
Caregivers and other individuals directed by a VA program office to set up direct deposit for program payments
Existing payees updating banking details, addresses, or tax identification information
VA program offices submitting the form on behalf of a new payee

How to fill out VA Form 10091

Confirm with the VA program office or facility requesting the form how they want it routed back to them.
Complete the payee information, including your legal name as it appears with the IRS and your SSN or EIN.
Enter your bank routing and account numbers exactly; a voided check helps you verify them.
Sign and date the form.
Return it as instructed, typically to the requesting VA office or to the VA-FSC using the fax number or secure submission method shown in the current form instructions.

Worth knowing: This form carries banking and taxpayer information. Submit it only through the secure channel your VA program office or the VA Financial Services Center specifies, never by regular unencrypted email.

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These are the form's own fields, in the order they appear on the pages. Fill in what you know; anything left blank stays a fillable field in the PDF, so you can finish it in any PDF reader. Nothing you type here is sent to VA.

Page 3 29 fields

NEW radio button

DATE. Enter 2 digit month, 2 digit day and 4 digit year.

I. V A FACILITY INFORMATION. (For Station Use Only) 1. STATION NUMBER.

N C A Radio Button

2. STATION CONTACT.

3. STATION PHONE NUMBER.

4. STATION FAX NUMBER.

5. STATION EMAIL ADDRESS.

6. PAYEE / VENDOR TYPE (Select one). C - COMMERCIAL / A L A C radio button

FACTS I D. 2 characters max.

7. MISCELLANEOUS ACTIONS (Select one). W I N R S radio button

L G Y ACCOUNT NUMBER. 6 characters max.

II. PAYEE / VENDOR INFORMATION. 8. COMMERCIAL VENDOR REGISTERED IN SAM.GOV (Required I A. W F A. R 4.1102). check box

9. UNIQUE ENTITY IDENTIFIER (U E I). 12 characters max.

10. E F T IDENTIFER

11. SOCIAL SECURITY NUMBER / T I N. 9 characters max.

12. N P I. 10 characters max.

13. SMALL BUSINESS - PAYEE / VENDOR MUST BE QUALIFIED AS SMALL BUSINESS IN SAM OR FURNISH S B A. CONFIRMATION. check box

14. PAYEE / VENDOR NAME.

15. DOING BUSINESS AS (D B A)

16. PAYEE/VENDOR EMAIL ADDRESS.

17. PAYEE/VENDOR PHONE NUMBER.

18. CURRENT ADDRESS (Include Street, City, State and Zip Code).

19. PREVIOUS ADDRESS (Include Street, City, State and Zip Code).

III. E F T / A C H (Required I A. W 31 C F R Part 208). 20. CURRENT BANK NAME.

21. CURRENT BANK NINE-DIGIT ROUTING NUMBER. Enter 9 digit number.

22. CURRENT BANK ACCOUNT NUMBER. 17 characters max.

23. CURRENT ACCOUNT TYPE. CHECKING radio button

24. NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

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Frequently asked questions

Is this the form for VA disability or pension direct deposit?

No. Compensation and pension direct deposit is managed through VA.gov, the VA benefits hotline, or the direct deposit enrollment forms for benefit payments. VA Form 10091 is for the FSC vendor file, which handles payments like vendor invoices and certain program payments such as caregiver stipends.

Why does VA need my Social Security number or EIN on this form?

The vendor file must match IRS records so payments are reported correctly. Your taxpayer identification number is how FSC ties the payment record to you or your business. Because the form contains banking and tax data, send it only through the channel your VA contact specifies.

VA Form 10091: VA-FSC Vendor File Request Form

What is VA Form 10091?

Who files VA Form 10091?

How to fill out VA Form 10091

Quick fill VA Form 10091 on this page

Frequently asked questions

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SF 1199A Direct Deposit Sign-Up Form

VA Form 10-10CG: Application for Comprehensive Assistance for Family Caregivers Program

VA Form 10-3542: Veteran/Beneficiary Claim for Reimbursement of Travel Expenses