Attachment_13_-_DEAMS_YEN_EFT_Enrollment_Form.pdf

INITIAL SUBMISSION UPDATE DATE:

1 Vendor or Claimant's name:

2 Vendor Address:

City:

Province/Country: Zip Code:

3 Contact Name:

4 Contact Phone#: Email:

5 CAGE Code: (*Note: If there is no cage, please type "N/A".)

< BANK INFORMATION >

6 Bank Name:

Branch Name:

7 Bank Code： Branch Code： (金融機関コード) (支店コード)

8 Bank Address:

City/Province: Zip Code:

9 SWIFT Code:

10 Account Name:

(口座名義)

11 Account No. (口座番号)：

12 Account Type: 普通(Saving) 当座(Checking) その他(Others)

13 Applicable Purchase Order/Contract Number:

14 Signature of Vendor:

Supplier #

JPY EFT ENROLLMENT FORM (For DEAMS)

Registered by: Date:

DFAS Japan Use Only (Form as of October 11, 2017)

< VENDOR INFORMATION >

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.

JPY DEAMS EFT Form