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 vendors to conduct business with UNICOR and receive payments via Automated Clearing House (ACH) transfers.

The form requires vendors to provide company identification details including physical address, contact information, email addresses for general inquiries and accounts receivable, and telephone/fax numbers. Vendors must identify their business classification by checking whether they are large or small businesses and whether they qualify as disadvantaged, woman-owned, service-disabled, or veteran-owned enterprises. Banking information required includes the nine-digit routing transit number, depositor account title and number, and financial institution name. The form also requests the SAM UEI Number and Tax Identification Number (TIN), as registration in the System for Award Management (SAM) is identified as a mandatory federal-wide requirement for all vendors except credit card vendors. Additionally, vendors must indicate whether UNICOR should pay for shipping or whether they will provide FOB Destination pricing with freight included, with UNICOR noting a preference for FOB Destination to facilitate accurate and timely payment. Annual profile updates in SAM are required when prompted via email at https://www.sam.gov.