Religious Conference Management Assoc Inc CIQ 10.27.2025CITYOF
City of Denton Purchasing
901-B Texas St. Denton, TX 76209
Phone: (940) 349-7100DENTONwww.dentonpurchasing.com
Substitute W-9 Form
The IRS requires all vendors to complete a W-9 Form. The information on this form must be filled out, signed and submitted by a
vendor representative. All information must be completed beforeapurchase order or payment will be issued.
Name as shown on your income tax return:Religious Conference Management Association, Inc.
Tax ID/Social Security #:31-1051699
Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxtaxpayer identification number (or I
am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because (a) I am exempt from
backup witholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding
as a result of failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup
withholding, and 3. I am a US citizen or other U.S. person-for fededral tax purposes as defined at the bottom of this page*.4. 1 unsderstand that I must disclose any conflict of interest in accordance with Section 176.006 (a-1) of the Local Government Code.
Authorized Signature D
Mailing Address:
Company Name: RCMA
Contact Name: Debbie Hochstetler
Address: 7702 Woodland Drive
Suite 120
Indianapolis IN 46278
Check appropriate box for federal tax classification (required):
Debra D. HochstetlerPrinted Name:
Email: dhochstetler@rcmaweb.org
Website: Www.MyRCMA.org
Phone Number: 317-632-1888 x2300
Fax Number:
Individual/Limited OtherSole
Proprietor
Corporation ☐ Partnership D LiabilityCorporation Π Please specify:
Must designate C or s
C
Exempt
Payee Π S
Real EstateBusiness Type:☐Rental/Lease (A1)Π Equipment
Renta/Lease (A-9)Π Royalties (A-2)D Medical/Health Care (A-6)
7)
Services Only (A-
X Merchandise-
Goods Only (A-7)Π Merchandise &
Services (A-7)미 Legal Firm/Attorney (A-C)
Π
Consultant/Prof
Fees (A-7)
Proceeds from
Real Estate
Purchases (S)
Type of Organization:Minority
Owned ☐Female Owned ☑Non Profit Π Historically Underutilized
Business
*Definition of a U.S. Person-For Federal Tax purposes, you are considered a U.S. person if you are: (a) an individual who is a U.S. citizen or
U.S. resident (b) a partnership, corporation, company, or association created or organized in the United States or under the laws of the United
States (c) an estate (other than a foreign estate), or (d) a domestic trust (as defined in Regulations Section 301.7701-7).
COD Page 1 9/23/2011
Vendor Information Not Required for W-9 Form
Remit Address (if different from above)
Company Name:
Contact Name:
Address:
Email:
Phone Number:
Fax Number:
ACH Information-Voluntary
ABA Routing#:
Contact Name :
Bank Account#
Bank Name:
ACH Email:
ACH Email:
Phone Number:
Fax Number:
List Products and/or Services Interested in Bidding:
For Internal Use Only
☐ New Vendor
☐Vendor Change
☐ Refund
Requesting Department:
Vendor Number
Date:
Department Representative (Printed Name)
Purchasing Signature:Date:
I (we) authorize the City of Denton to deposit
payments into the checking account listed. The
authority remains in effect until the City of Denton
has received written notification from me of
termination in time to allow reasonable opportunity
to act on it, or until the City of Denton has sent me
written notice of termination of the agreement.
Vendor Signature
Print Name/Title
Date
COD Page 2 9/23/2011