Electronic Billing Application

Complete a separate E-billing and EFT application form and W-9 form for EACH VENDOR NUMBER and send the completed applications to us via fax at 213.427.2380 or via mail to the Accounting Department at Lanterman Regional Center, 3303 Wilshire Boulevard, Suite 700, Los Angeles, CA 90010.

If you need to attend a training session, please send the application and W-9 form to us in advance of the meeting you will be attending.

The information on the application should match the information shown in the W-9 form.

If you already are set up for EFT with us, you need not complete that part of the application.

Download the E-billing and EFT application form

Download the W-9 form

Once you have submitted the application, and have completed  the training as noted above, we will notify you via e-mail when the electronic billing has been activated for you to receive electronic invoices.