ACH Vendor Enrollment Form.pdf

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

The form requests company identification details including legal business name, physical address, contact person, email, telephone, and fax number. Vendors must indicate 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 federal registration identifiers including Unique Entity ID number, CAGE Code, and Tax Identification Number (TIN). Banking information is mandatory for ACH payments, including the nine-digit routing transit number, depositor account title, account number, and financial institution name. Vendors must confirm whether UNICOR pays shipping costs; UNICOR's stated preference is FOB Destination with freight included in the price, as this facilitates accurate and timely payment processing. Registration and currency in the System for Award Management (SAM.gov) is identified as a federal-wide mandatory requirement for most vendors (not required for credit card vendors), with annual profile updates required via email notification. The form indicates that SAM.gov registration is free and provides the enrollment URL for vendor reference.