Attachment 5 - DEAMS EFT Enrollment Form Updated 05_2023.pdf

INITIAL SUBMISSION

DATE:

***Special Instructions:

1) Payments processed in DEAMS are made through ITS.gov and cannot be made to Japan Post Bank, Roukin Bank or internet bank accounts.

2) Please contact your bank to verify the bank information below, and ask if any additional information is required to receive payment from overseas. If so, please provide this additional information.

3) Please ask your bank to make sure the Account Name (beneficiary name in English ) provided matches exactly with the English beneficiary name registered on the bank's records. (必ず各取引銀行に海外送金の受け取りに必要な情報を確認の上、ご記入下さい)

4) If you have never submitted this EFT form under any contract payment before, please submit this form for your payment.

And this form can be applied for your future payment also.

If you already have submitted this form before for any of your contractual payment, there is NO need for you to submit again.

5) For MISC payment, you need to submit at least one time using this form for your banking information.

If you have any updates then please re-submit this form checking "UPDATE".

< VENDOR INFORMATION >

1 Vendor (Recipient) Name:

2 Vendor Address:

City:

Province/Country: Zip Code:

3 Contact Name:

4 Contact Phone#: POC Email:

5 CAGE Code: *Notes: 1. If there is no CAGE code , please type "N/A".

2. If vendor has a CAGE code, the information above

MUST match information registered in SAM system.

Zip Code:

< BANK INFORMATION >

6 Bank Name:

Branch Name:

7 Bank Address:

(Checking) (Other)

DFAS Use Only (Form Revised May 2023)

Attention: Please provide us with an updated EFT Form if any of the above information changes as soon as possible. Your attention in this matter will help us to continue providing you with the customer service that you deserve and will help eliminate the possibility of delayed payments to your company.

(Savings)

13 Email address for Payment Voucher (Vendor Only):

(Could be registered up to 5 email addresses) 支払伝票送付が不要の場合は必ずN/Aとご記入下さい。

14 Signature of Vendor: ______________________________________________ ___________________________________________

Signature Typed Name

DEAMS JPY/KRW EFT ENROLLMENT FORM

（Include Japanese/Korean Bank for USD payment)

UPDATE

*Must be in English*

City/Province:

8 Bank Phone#:

9 SWIFT Code:

10 Account Name:

11 Account Number:

12 Account Type:

JPY DEAMS EFT Form