ACH Vendor Enrollment Form 2022.pdf

This is an ACH Vendor/Miscellaneous Payment Enrollment Form for UNICOR (Federal Prison Industries, Inc.). The form is a vendor registration and payment setup document designed to enable companies to receive payments from UNICOR through Automated Clearing House (ACH) transfer.

The form collects essential vendor information including company name, physical address, contact details, email, telephone, and fax number. Vendors must identify their business classification by selecting one category: Large Business, Small Business, Disadvantaged Business, Woman-Owned Business, Service Disabled Veteran-Owned Business, or Veteran-Owned Business. The form requires the vendor's Unique Entity ID number and Tax Identification Number (TIN), along with complete banking details for ACH payments, including the nine-digit routing transit number, depositor account title, account number, and financial institution name. UNICOR's shipping preference is FOB Destination with freight included in the price to facilitate accurate and timely payment, and vendors must indicate whether UNICOR pays shipping. A critical requirement is that vendors must be registered and current in the System for Award Management (SAM) at https://www.sam.gov, which is a mandatory federal-wide enrollment at no cost (except for credit card vendors). Vendors are required to annually update their SAM profile when prompted via email notification.