ACH Vendor PaymentEnroll Form 2022-02-23 (1).pdf

This is an ACH Vendor/Miscellaneous Payment Enrollment Form for UNICOR, Federal Prison Industries, Inc. The form is a template designed to collect vendor information necessary for payment processing through automated clearing house (ACH) transactions.

The form requires vendors to provide company identification details including physical address, contact information, company size classification (large or small business), and socioeconomic status certifications (disadvantaged, woman-owned, service-disabled veteran-owned). Vendors must supply federal identification numbers including DUN & Bradstreet number, SAMMI/UEI Code, CAGE Code, and Tax Identification Number (TIN). The form also collects banking information necessary for ACH payments, including the nine-digit routing transit number, depositor account title, account number, and financial institution name. Vendors are required to indicate their current registration status in the System for Award Management (SAM) at https://www.sam.gov, which is noted as a free, mandatory federal-wide requirement (not required for credit card vendors) with annual profile updates required. The form addresses shipping terms, indicating UNICOR's preference for FOB Destination with freight included in the price, as this arrangement facilitates accurate and timely payment processing.