Aid 500-13 Partner Information Form

OMB APPROVAL NO. 0412-0577
EXPIRATION DATE: 04/30/2026
ESTIMATED BURDEN: 90 MINUTES

PARTNER INFORMATION FORM
PART 1: INFORMATION ABOUT PRIME AWARD

1.1 Legal Name of Prospective Awardee (Prime Contractor/Recipient)

1.2 Address of Prospective Awardee

1.3 Alternate Address of Prospective Awardee (if applicable)
1.4 Organization Phone Number (include full
phone number, country code, and area/city
code)

1.5 Alternate Phone Number (if applicable)
(include full phone number, country code, and
area/city code)

1.6 Fax Number (if applicable) (include full
phone number, country code, and area/city
code)
1.8 U.S. Organization? ☐ Yes

1.7 Organization Email Address
1.9(a) Value of Total Award (USD)

☐ No

1.9(b) Solicitation/Award Number

PART 2: INFORMATION ABOUT SUBAWARD (to be completed if submitting a subaward)

2.1 Legal Name of Prospective Subawardee (Subcontractor/Subrecipient)
2.2 Website URL of Prospective Subawardee (if applicable)

2.3 Type of Organization
☐ Parent Organization ☐ Branch ☐ Subsidiary

2.4 Address of Prospective Subawardee

2.5 Alternate Address of Prospective Subawardee (if applicable)
2.6 Organization Phone Number (include full
phone number, country code, and area/city
code)

2.7 Alternate Organization Phone Number (if
2.8 Primary Fax Number (if applicable) (include
applicable) (include full phone number, country full phone number, country code, and area/city
code, and area/city code)
code)

2.9 Organization Email Address
2.11 Vetting Category
☐ Subcontract ☐ Subgrant
☐ Other:

2.10 U.S. Organization?

☐ Training

☐ Equipment

2.13 Estimated Subaward Start Date (dd-mm-yyyy)

☐ Yes ☐ No

2.12 Value of Total Subaward (USD) (if applicable)

2.14 Estimated Subaward End Date (dd-mm-yyyy)

2.15 Purpose of Subaward

AID 500-13 (01/2024)

Page 1 of 8

PART 3: CERTIFICATION

The prospective awardee certifies in submitting this form that it has taken reasonable steps in accordance with sound business practices to
verify information included in this form and understands that the U.S. government may rely on the accuracy of such information to process this
request.
3.1 Authorizing Official’s Name (First name, Middle name, Last name)
3.2 Title/Organization
3.3 Signature of Authorizing Official

3.4 Date (dd-mm-yyyy)

PART 4a: KEY INDIVIDUAL INFORMATION

4a.1 Name Listed on Government-Issued Photo ID (First name, Middle
name(s), Last name)
4a.3 Village/City

4a.2 Other Names Used (also known as, nicknames, alias, different
spelling) (if applicable)
4a.7 Date of Birth (dd-mm-yyyy)

4a.8 Gender on government-issued
photo ID

4a.4 District (if applicable)
Place of Birth

4a.5 Governorate, Province, or
State

4a.9 Country of citizenship (if multiple citizenships, list all countries of
citizenship in this block and include additional ID information in the gray
boxes below)

4a.6 Country
4a.10 U.S. Citizen?
☐ Yes
☐ No
(If yes, provide Passport Number below in
“Government-Issued Photo ID Number”
section.)
4a.13 ID Country of Issuance

4a.11 U.S. Lawful Permanent Resident?

4a.14 ID Country of Issuance [complete for
multiple citizenship only]

4a.14.1 Government-Issued Photo ID Type
4a.14.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number
attach clear, legible picture; preferably in color) [complete for multiple citizenship only]

4a.15 ID Country of Issuance [complete for
multiple citizenship only]

4a.15.1 Government-Issued Photo ID Type
4a.15.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number [complete for multiple citizenship only]
attach clear, legible picture; preferably in color)

☐ Yes

☐ No

4a.13.1 Government-Issued Photo ID Type
(please attach clear, legible picture; preferably
in color)

4a.12 (if yes, include Lawful Permanent
Resident Card Number (9 digit A Number#):

4a.13.2 Complete Government-Issued Photo ID
Number

4a.16 Address of Residence

4a.17 Province/Region

4a.18 Tribal Affiliation (if applicable)

4a.19 Primary Personal Phone Number (include full phone number,
country code, and area/city code)

4a.20 Alternate Personal Phone Number (if applicable) (include full
phone number, country code, and area/city code)

Is this a cell phone number?
☐ Yes
4a.21 Primary Personal Email Address

Is this a cell phone number?
☐ Yes
☐ No
4a.22 Alternate Personal Email Address (if applicable)

☐ No

4a.23 Current Employer

4a.24 Organizational Rank or Title

4a.25 Professional Licenses and State-Issued Certifications (if applicable)
AID 500-13 (01/2024)

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PART 4b: KEY INDIVIDUAL INFORMATION

4b.1 Name Listed on Government-Issued Photo ID (First name, Middle
name(s), Last name)

4b.3 Village/City

4b.2 Other Names Used (also known as, nicknames, alias, different
spelling) (if applicable)

4b.7 Date of Birth (dd-mm-yyyy)

4b.8 Gender on government-issued
photo ID

4b.4 District (if applicable)
Place of Birth

4b.5 Governorate, Province, or
State

4b.9 Country of citizenship (if multiple citizenships, list all countries of
citizenship in this block and include additional ID information in the gray
boxes below)

4b.6 Country
4b.10 U.S. Citizen?
☐ Yes
☐ No
(If yes, provide Passport Number below in
“Government-Issued Photo ID Number”
section.)
4b.13 ID Country of Issuance

4b.11 U.S. Lawful Permanent Resident?

4b.14 ID Country of Issuance [complete for
multiple citizenship only]

4b.14.1 Government-Issued Photo ID Type
4b.14.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number
attach clear, legible picture; preferably in color) [complete for multiple citizenship only]

4b.15 ID Country of Issuance [complete for
multiple citizenship only]

4b.15.1 Government-Issued Photo ID Type
4b.15.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number [complete for multiple citizenship only]
attach clear, legible picture; preferably in color)

☐ Yes

☐ No

4b.13.1 Government-Issued Photo ID Type
(please attach clear, legible picture; preferably
in color)

4b.12 (if yes, include Lawful Permanent
Resident Card Number (9 digit A Number#):

4b.13.2 Complete Government-Issued Photo ID
Number

4b.16 Address of Residence

4b.17 Province/Region

4b.18 Tribal Affiliation (if applicable)

4b.19 Primary Personal Phone Number (include full phone number,
country code, and area/city code)

4b.20 Alternate Personal Phone Number (if applicable) (include full
phone number, country code, and area/city code)

Is this a cell phone number?
☐ Yes
4b.21 Primary Personal Email Address

Is this a cell phone number?
☐ Yes
☐ No
4b.22 Alternate Personal Email Address (if applicable)

☐ No

4b.23 Current Employer

4b.24 Organizational Rank or Title

4b.25 Professional Licenses and State-Issued Certifications (if applicable)

AID 500-13 (01/2024)

Page 3 of 8

PART 4c: KEY INDIVIDUAL INFORMATION

4c.1 Name Listed on Government-Issued Photo ID (First name, Middle
name(s), Last name)

4c.3 Village/City

4c.2 Other Names Used (also known as, nicknames, alias, different
spelling) (if applicable)

4c.7 Date of Birth (dd-mm-yyyy)

4c.8 Gender on government-issued
photo ID

4c.4 District (if applicable)
Place of Birth

4c.5 Governorate, Province, or
State

4c.9 Country of citizenship (if multiple citizenships, list all countries of
citizenship in this block and include additional ID information in the gray
boxes below)

4c.6 Country
4c.10 U.S. Citizen?
☐ Yes
☐ No
(If yes, provide Passport Number below in
“Government-Issued Photo ID Number”
section.)
4c.13 ID Country of Issuance

4c.11 U.S. Lawful Permanent Resident?

4c.14 ID Country of Issuance [complete for
multiple citizenship only]

4c.14.1 Government-Issued Photo ID Type
4c.14.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number
attach clear, legible picture; preferably in color) [complete for multiple citizenship only]

4c.15 ID Country of Issuance [complete for
multiple citizenship only]

4c.15.1 Government-Issued Photo ID Type
4c.15.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number [complete for multiple citizenship only]
attach clear, legible picture; preferably in color)

☐ Yes

☐ No

4c.13.1 Government-Issued Photo ID Type
(please attach clear, legible picture; preferably
in color)

4c.12 (if yes, include Lawful Permanent
Resident Card Number (9 digit A Number#):

4c.13.2 Complete Government-Issued Photo ID
Number

4c.16 Address of Residence

4c.17 Province/Region

4c.18 Tribal Affiliation (if applicable)

4c.19 Primary Personal Phone Number (include full phone number,
country code, and area/city code)

4c.20 Alternate Personal Phone Number (if applicable) (include full
phone number, country code, and area/city code)

Is this a cell phone number?
☐ Yes
4c.21 Primary Personal Email Address

Is this a cell phone number?
☐ Yes
☐ No
4c.22 Alternate Personal Email Address (if applicable)

☐ No

4c.23 Current Employer

4c.24 Organizational Rank or Title

4c.25 Professional Licenses and State-Issued Certifications (if applicable)

AID 500-13 (01/2024)

Page 4 of 8

PART 4d: KEY INDIVIDUAL INFORMATION

4d.1 Name Listed on Government-Issued Photo ID (First name, Middle
name(s), Last name)

4d.3 Village/City

4d.2 Other Names Used (also known as, nicknames, alias, different
spelling) (if applicable)

4d.7 Date of Birth (dd-mm-yyyy)

4d.8 Gender on government-issued
photo ID

4d.4 District (if applicable)
Place of Birth

4d.5 Governorate, Province, or
State

4d.9 Country of citizenship (if multiple citizenships, list all countries of
citizenship in this block and include additional ID information in the gray
boxes below)

4d.6 Country
4d.10 U.S. Citizen?
☐ Yes
☐ No
(If yes, provide Passport Number below in
“Government-Issued Photo ID Number”
section.)
4d.13 ID Country of Issuance

4d.11 U.S. Lawful Permanent Resident?

4d.14 ID Country of Issuance [complete for
multiple citizenship only]

4d.14.1 Government-Issued Photo ID Type
4d.14.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number
attach clear, legible picture; preferably in color) [complete for multiple citizenship only]

4d.15 ID Country of Issuance [complete for
multiple citizenship only]

4d.15.1 Government-Issued Photo ID Type
4d.15.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number [complete for multiple citizenship only]
attach clear, legible picture; preferably in color)

☐ Yes

☐ No

4d.13.1 Government-Issued Photo ID Type
(please attach clear, legible picture; preferably
in color)

4d.12 (if yes, include Lawful Permanent
Resident Card Number (9 digit A Number#):

4d.13.2 Complete Government-Issued Photo ID
Number

4d.16 Address of Residence

4d.17 Province/Region

4d.18 Tribal Affiliation (if applicable)

4d.19 Primary Personal Phone Number (include full phone number,
country code, and area/city code)

4d.20 Alternate Personal Phone Number (if applicable) (include full
phone number, country code, and area/city code)

Is this a cell phone number?
☐ Yes
4d.21 Primary Personal Email Address

Is this a cell phone number?
☐ Yes
☐ No
4d.22 Alternate Personal Email Address (if applicable)

☐ No

4d.23 Current Employer

4d.24 Organizational Rank or Title

4d.25 Professional Licenses and State-Issued Certifications (if applicable)

AID 500-13 (01/2024)

Page 5 of 8

PART 4e: KEY INDIVIDUAL INFORMATION

4e.1 Name Listed on Government-Issued Photo ID (First name, Middle
name(s), Last name)

4e.3 Village/City

4e.2 Other Names Used (also known as, nicknames, alias, different
spelling) (if applicable)

4e.7 Date of Birth (dd-mm-yyyy)

4e.8 Gender on government-issued
photo ID

4e.4 District (if applicable)
Place of Birth

4e.5 Governorate, Province, or
State

4e.9 Country of citizenship (if multiple citizenships, list all countries of
citizenship in this block and include additional ID information in the gray
boxes below)

4e.6 Country
4e.10 U.S. Citizen?
☐ Yes
☐ No
(If yes, provide Passport Number below in
“Government-Issued Photo ID Number”
section.)
4e.13 ID Country of Issuance

4e.11 U.S. Lawful Permanent Resident?

4e.14 ID Country of Issuance [complete for
multiple citizenship only]

4e.14.1 Government-Issued Photo ID Type
4e.14.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number
attach clear, legible picture; preferably in color) [complete for multiple citizenship only]

4e.15 ID Country of Issuance [complete for
multiple citizenship only]

4e.15.1 Government-Issued Photo ID Type
4e.15.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number [complete for multiple citizenship only]
attach clear, legible picture; preferably in color)

☐ Yes

☐ No

4e.13.1 Government-Issued Photo ID Type
(please attach clear, legible picture; preferably
in color)

4e.12 (if yes, include Lawful Permanent
Resident Card Number (9 digit A Number#):

4e.13.2 Complete Government-Issued Photo ID
Number

4e.16 Address of Residence

4e.17 Province/Region

4e.18 Tribal Affiliation (if applicable)

4e.19 Primary Personal Phone Number (include full phone number,
country code, and area/city code)

4e.20 Alternate Personal Phone Number (if applicable) (include full
phone number, country code, and area/city code)

Is this a cell phone number?
☐ Yes
4e.21 Primary Personal Email Address

Is this a cell phone number?
☐ Yes
☐ No
4e.22 Alternate Personal Email Address (if applicable)

☐ No

4e.23 Current Employer

4e.24 Organizational Rank or Title

4e.25 Professional Licenses and State-Issued Certifications (if applicable)

AID 500-13 (01/2024)

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PART 4f: KEY INDIVIDUAL INFORMATION

4f.1 Name Listed on Government-Issued Photo ID (First name, Middle
name(s), Last name)

4f.3 Village/City

4f.2 Other Names Used (also known as, nicknames, alias, different
spelling) (if applicable)

4f.7 Date of Birth (dd-mm-yyyy)

4f.8 Gender on government-issued
photo ID

4f.4 District (if applicable)
Place of Birth

4f.5 Governorate, Province, or
State

4f.9 Country of citizenship (if multiple citizenships, list all countries of
citizenship in this block and include additional ID information in the gray
boxes below)

4f.6 Country
4f.10 U.S. Citizen?
☐ Yes
☐ No
(If yes, provide Passport Number below in
“Government-Issued Photo ID Number”
section.)
4f.13 ID Country of Issuance

4f.11 U.S. Lawful Permanent Resident?

4f.14 ID Country of Issuance [complete for
multiple citizenship only]

4f.14.1 Government-Issued Photo ID Type
4f.14.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number
attach clear, legible picture; preferably in color) [complete for multiple citizenship only]

4f.15 ID Country of Issuance [complete for
multiple citizenship only]

4f.15.1 Government-Issued Photo ID Type
4f.15.2 Complete Government-Issued Photo ID
[complete for multiple citizenship only] (please Number [complete for multiple citizenship only]
attach clear, legible picture; preferably in color)

☐ Yes

☐ No

4f.13.1 Government-Issued Photo ID Type
(please attach clear, legible picture; preferably
in color)

4f.12 (if yes, include Lawful Permanent Resident
Card Number (9 digit A Number#):

4f.13.2 Complete Government-Issued Photo ID
Number

4f.16 Address of Residence

4f.17 Province/Region

4f.18 Tribal Affiliation (if applicable)

4f.19 Primary Personal Phone Number (include full phone number,
country code, and area/city code)

4f.20 Alternate Personal Phone Number (if applicable) (include full
phone number, country code, and area/city code)

Is this a cell phone number?
☐ Yes
4f.21 Primary Personal Email Address

Is this a cell phone number?
☐ Yes
☐ No
4f.22 Alternate Personal Email Address (if applicable)

☐ No

4f.23 Current Employer

4f.24 Organizational Rank or Title

4f.25 Professional Licenses and State-Issued Certifications (if applicable)

AID 500-13 (01/2024)

Page 7 of 8

PAPERWORK REDUCTION ACT STATEMENT

Public reporting burden for this collection of information is estimated to average 90 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. The Agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Agency for International
Development, Office of Security (SEC), Washington, D.C. 20523-2600.

PRIVACY ACT STATEMENT

Authority: USAID derives its authority to collection information for vetting purposes from, among other sources, Executive Order
13224; Section 7034(e) of the Consolidated Appropriations Act, 2018 (P.L. 115-141), and subsequent appropriations acts; and 18
U.S.C. 2339A, 2339B, and 2339C.
Purpose: Information in this form is used to conduct screening of individuals and entities as required by applicable U.S. laws and
implementing procedures to help ensure that USAID funds do not inadvertently provide support to individuals or entities deemed
a national security risk.
Routine Uses: Disclosure of the information provided on this form will be done in accordance with the Privacy Act, as well as with
USAID’s System of Records Notice concerning the Partner Vetting System (USAID-27, 86 FR 3109 (Dec. 5, 2012, modified Jan. 14,
2021)), which establishes the routine uses and Privacy Act exceptions that apply to this system of records.
Disclosure: Providing personally identifiable information is voluntary, but failure to provide certain information may result in
denial of your application for a USAID contract, grant, cooperative agreement, or other funding.
●
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●

INSTRUCTIONS

Complete all fields and “if applicable” fields if the information exists or applies. For “if applicable” fields, enter “N/A” if not
applicable.
Any prospective awardee must complete a separate form for each prospective subawardee and must complete Parts 2, 3, and
4.
If the prospective awardee/subawardee is a branch organization, a separate form must be completed for the parent
organization.
If the request is for trainees/individual beneficiaries, please leave Part # 2 blank, except cells 2.11 - 2.15

PART 1: INFORMATION ABOUT AWARD
Enter information on awardee and on award or assistance.
PART 2: INFORMATION ABOUT SUBAWARD
Enter information on subawardee and subaward if applicable.
PART 3: CERTIFICATION
The authorizing official must complete the certification section by printing their name, title and name of organization, signing
their name, and printing the date where indicated. This certifies that the signer has taken reasonable steps in accordance with
sound business practices to verify information included in this form and understands that the U.S. government may rely on the
accuracy of such information to process this request.
PART 4: KEY INDIVIDUAL INFORMATION
Please visit www.usaid.gov/partner-vetting for a link to the “USAID Guidance on Completion of the Partner Information Form”
document containing more information on “key individuals.”

AID 500-13 (01/2024)

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