Get the free Indiana WIC Vendor Notice 16-2

Indiana WIC Vendor Notice 162 Date: December 17, 2015, To: Indiana WIC Vendors From: Indiana WIC Vendor Consultant staff Re: Indiana Eric Vendor Information As vendors were informed at Indiana Wins

How to fill out indiana wic vendor notice

How to fill out Indiana WIC vendor notice:

1. Obtain the Indiana WIC vendor notice form. This form can usually be found on the official website of the Indiana WIC program or by contacting your local WIC office.
2. Fill out the vendor information section. Provide the required details such as the name of your business, address, phone number, and any other requested information.
3. Complete the authorized representative section. If you are the authorized representative of the vendor, fill in your name, title, and contact information. If not, provide the relevant details of the authorized representative.
4. Specify the type of vendor you are. Indicate whether you are a grocery store, pharmacy, farmers market, or other type of WIC vendor.
5. Provide information about the payment options accepted. Specify which types of payments you accept for WIC purchases, such as electronic benefit transfer (EBT) cards or checks.
6. Sign and date the form. Make sure to read any instructions or declarations included on the form and sign and date it accordingly.
7. Submit the completed form. Follow the instructions provided on the form to submit it to the appropriate WIC office. This may include mailing, faxing, or delivering it in person.

Who needs Indiana WIC vendor notice?

1. Indiana businesses that wish to participate in the WIC program as a vendor need to fill out the Indiana WIC vendor notice.
2. Grocery stores, pharmacies, farmers markets, and other retail establishments that plan to accept WIC benefits as a form of payment must complete this notice.
3. Any authorized representative of a vendor who will be responsible for handling WIC transactions should also be familiar with and have access to the Indiana WIC vendor notice.

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