ACH Vendor Enrollment Form 2022.pdf

This is an ACH Vendor/Miscellaneous Payment Enrollment Form for UNICOR, Federal Prison Industries, Inc. The form is designed for vendors to provide banking and company information necessary to receive electronic payments from UNICOR through Automated Clearing House (ACH) transfers.

The form requires vendors to submit standard company information including legal name, physical address, contact details, and telephone/fax numbers. Vendors must identify their business classification by checking one category: Large Business or Small Business, and may also indicate if they are Disadvantaged, Woman-Owned, Service-Disabled, or Veteran-Owned. Banking details required include the company's DUN & Bradstreet number, Tax Identification Number (TIN), nine-digit routing transit number, depositor account title, account number, and financial institution name. A critical requirement is current registration in the System for Award Management (SAM) at https://www.sam.gov, which is a federal-wide mandatory requirement for non-credit card vendors and must be renewed annually upon email notification. The form also addresses shipping terms, noting UNICOR's preference for FOB Destination with freight included in the vendor's price to facilitate accurate and timely payment. Vendors must indicate whether UNICOR pays shipping costs as part of their quote submission.