Supplier_Information_Form.pdf

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Seal of Board of Governors of the Federal Reserve System.

See attached instructions. Information with asterisks (*) are mandatory.

Supplier Information Form Board of Governors of the Federal Reserve System OMB No. 7100-0180 Approval Expires September 30, 2021 *Doing Business With:

E-mail the completed form to Board-Vendors@frb.gov. For inquiries, contact 202-452-2481.

[03-300-900]—04/2019

FR 1400B

Page of Supplier Information Form—(Continued)

FR 1400B

[03-300-900]—04/2019 Page of Supplier Information Form—Instructions

FR 1400B

[03-300-900]—04/2019 Page of 9.0.0.2.20120627.2.874785 Supplier Information—FR 03-300-900 Federal Reserve Board Supplier Information—FR 03-300-900 PCS Information Solutions C. *Identification Number:

A. *Primary Contact D. *Address:

B. Secondary Contact C. *Preferred e-mail address to receive Notice of Payment B. Size of Business D. *How did you meet the Board?

A. Location of Registered Office

V. *MODE OF PAYMENT

IV. SUPPLIER CLASSIFICATION (Only applies to taxable suppliers; select all that apply.)

III. CONTACT INFORMATION

I. GENERAL INFORMATION

Account Type:

Foreign Beneficary Bank:

U.S. Correspondent Bank:

C. Ownership A. Non-taxable (Skip section IV.)

B. Taxable (Attach tax forms; see Instructions for details.)

Specify (if appropriate):

II. *SUPPLIER TYPE (Select only one.)

International Bank Account Number (IBAN) or Clave Bancaria Estandarizada (CLABE) (as applicable)

• Only used if EFT or U.S. Correspondent Bank on wire payments to foreign corporation or speakers is not available; must provide valid requirement on why check is requested and must be approved by the Board.

• Check will be mailed to the address provided in Section I-D.

• For foreign suppliers, check cashing fees with foreign banks will NOT be included in the payment unless negotiated per the contract.

For Internal Use Only:

VI. *AUTHORIZATION

I authorize the Board of Governors of the Federal Reserve System to make payments using the information provided above. I will notify the Board as soon as possible if the above information changes.

Title Name Signature Date (mm/dd/yyyy) Privacy Act Statement PURPOSES. The FR 1400B collects information used in the competitive process of soliciting proposals and evaluating bids and contracts submitted by vendors. It is also utilized to collect information from speakers in order to permit reimbursements.

AUTHORITY. Sections 10 and 11 of the Federal Reserve Act (12 USC 244 and 248) and Executive Order 9397.

EFFECTS OF NONDISCLOSURE. For prospective vendors that decide to submit proposals to the Board, the FR 1400B is required to obtain a benefit, in order to be eligible for the award of a contract. Some of the requested information, including the Social Security number if the registrant is an individual, is mandatory and will be marked as such. Some requested information may not be required in order to complete the form and failure to provide such information will not affect the processing of the form. Failure to provide any information that is marked as mandatory may result in the denial, disapproval, or delay in the consideration, selection or continuation of an official Board contract.

ROUTINE USES. The information you provide will be stored in the system of records entitled BGFRS-9, “FRB --Supplier Files," located at https://www.federalreserve.gov/files/BGFRS-9-supplier-files.pdf and published at 73 FR 24984 at 24994-95 (May 6, 2008). All or part of the information may be disclosed outside of the Board in accordance with routine uses, A, C, D, G, I, and J, and records may also be used to disclose information to the Internal Revenue Service to report payments that may be considered income to the suppliers. See "General Routine Uses of Board Systems of Records" located at https://www.federalreserve.gov/files/SORN-page-general-routine-uses-of-board-systems-of-records.pdf and published in the Federal Register at 83 FR 43872 (August 28, 2018) at 43873-74.

NOTE: Information with asterisks (*) are mandatory Section I. General Information A. If supplier's income is taxable, enter the name as it appears on supplier's tax form. See Section II-B.

B. This is the supplier's registered business or Doing-Business-As (DBA) name, if different from A. This only applies to suppliers with taxable income.

C. This is the supplier's U.S. taxpayer identification number. Some suppliers may also provide their Dun & Bradstreet (D&B) Data Universal Numbering System (DUNS) Number in addition to taxpayer identification number.

D. This is the supplier's remittance address which is also used as the check payment address.

Section II. Supplier Type A. Non-taxable suppliers are suppliers whose income are not taxable.

B. Taxable suppliers are suppliers whose income are taxable.

Local suppliers must submit Internal Revenue Service (IRS) Form W-9 (http://www.irs.gov/pub/irs-pdf/fw9.pdf). If supplier is already in the system and had previously submitted the form, submission of another form is not required unless updating information.

Foreign individual suppliers must submit IRS Form W-8BEN and Form 8233 (http://www.irs.gov/Forms-&-Pubs). However, foreign individuals who provided personal services only (for example, speaker providing services) must only submit Form 8233.

Section V. Mode of Payment ► Electronic Funds Transfer (EFT) is the default mode of payment. Indicate the account type if it is savings or checking. Enter the ACH 9-digit routing or ABA number and account number.

► Wire payment is only applicable to foreign corporations or foreign speakers. The Board will not make a wire payment directly to a foreign beneficiary bank. The foreign beneficiary bank used for wire payment must have a U.S. correspondent bank that will accept payment and forward to the foreign beneficiary bank in order to process this. Enter the account number and International Bank Account Number (IBAN). Enter foreign beneficiary bank's Society for Worldwide Interbank Financial Telecommunication (SWIFT) and/or Bank Identifier Code (BIC), name, and address. Enter U.S. correspondent bank's ACH 9-digit routing/ABA number, name, and address.

► Check is only used if EFT is not available. The supplier must provide valid requirement on why check is requested. The request will be reviewed by the Board and check will be processed upon approval. Check will be mailed to the address provided in Section I-D. For foreign suppliers, check cashing fees with foreign banks will NOT be included in the payment unless negotiated per the contract.

Section VI. Authorization Sign the form (either wet or electronic), and enter name, title of signee and date of signature.

E-mail the completed form to Board-Vendors@frb.gov.

For inquiries, contact 202-452-2481.

Other foreign suppliers (not individuals) must submit appropriate IRS Form(s) (e.g., W-8BEN-E, W-8CE, W-8ECI, W-8EXP, W-8IMY, or others) (http://www.irs.gov/Forms-&-Pubs).

Foreign suppliers are required to submit tax form(s) every tax year. Without these forms, the Board is required to withhold 30% taxes from foreign suppliers compensation payments. It is the supplier's responsibility to review and complete these forms to determine whether or not a tax treaty exists between U.S. and the supplier's country and to determine whether or not the supplier is exempt from taxes.

Section III. Contact Information A., B. Enter primary contact, and enter secondary if available.

C. Notice of payment is sent through e-mail so it is mandatory that the supplier provide an e-mail address either from A,B, or specified that is appropriate to send the notice.

Section IV. Supplier Classification A. Indicate location of supplier's registered office, if it is local (within U.S.) or foreign (outside U.S.).

B. Indicate size of business. For details on Small Business Size Standards, go to https://www.sba.gov/category/navigation-structure/contracting/contracting-officials/small-business-size-standards C. Indicate ownership of business, if it is minority-, service-disabled veteran-, veteran-, or women-owned.

D. Indicate how the supplier met the Board.

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