ACH Vendor Enrollment Form 2024.pdf

This is an ACH Vendor/Miscellaneous Payment Enrollment Form for UNICOR, Federal Prison Industries, Inc. The form collects essential vendor registration and banking information required for payment processing through automated clearing house (ACH) transactions.

Vendors must provide complete company information including physical address, contact details, and email addresses for both general communication and accounts receivable. The form requires vendors to identify their business classification by checking one category: large business, small business, disadvantaged business, women-owned business, service-disabled business, or veteran-owned business. Banking details must include the nine-digit routing transit number, depositor account title, account number, and financial institution name. Vendors must also provide their SAM UEI number and tax identification number (TIN). The form includes a question regarding shipping costs, with UNICOR stating a preference for FOB Destination pricing (with freight included) to facilitate accurate and timely payment. Finally, vendors must confirm registration and currency in the System for Award Management (SAM) at https://www.sam.gov, which is identified as a mandatory federal requirement that is free to enroll (except for credit card vendors). Enrolled vendors are required to update their SAM profile annually when prompted via email.