2. Complete this form, along with the W-9, and return to Hampton County if you wish to be added to our vendor database. You may submit this form online or send by regular mail to:

   Hampton County Government
   Attn: Finance Department
   200 Jackson Avenue East
   Hampton, SC 29924
4. Date:*
6. Vendor Name:*
8. Primary Contact:*
10. Title:*
12. 
    Mailing Address
14. Street:*
16. City:*
18. State:*
20. Zip Code:*
22. Telephone #:*
24. Alternate Phone #:
26. Fax #:*
28. Email Address:*
30. Federal ID #:*
32. 
    Primary product or service offered:
34. 
    Provide additional details of product(s) or service(s) offered that may be helpful:
    
36. 
    Please be reminded that the W-9 form must accompany the Vendor Registration Form. The W-9 form can be downloaded, completed, then sent to Hampton County Finance either:

    1. Mailed
    2. Scanned and emailed as an attachment
    3. Faxed

    Contact information:

    Hampton County Government
    Attn: Finance Department
    200 Jackson Avenue East
    Hampton, SC 29924
    Phone: (803) 914-2110
    Fax: (803) 914-2107
    Email: vendregister@hamptoncountysc.org
    Email: mmeyer@hamptoncountysc.org
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field