EURO_VENDOR_EFT_FORM.pdf

REMITTANCE INFORMATION DATE:___________________

Due to the many different and unique banking requirements of the various European countries, we request your assistance in ensuring that your payments are received in a timely manner. The information being requested below will benefit all concerned by having your payments deposited to your bank account as expeditiously as possible.

_____INITIAL SUBMISSION _____UPDATED VENDOR INFOMATION

VENDOR NAME: __________________________________________________________________

VENDOR REMIT TO ADDRESS:____________________________________________________

VENDOR POINT OF CONTACT

NAME: _____________________________________________________

TELEPHONE NUMBER:______________________________________

POSITION TITLE:____________________________________________

APPLICABLE PURCHASE ORDER/CONTRACTS: ____________________________________

PAYMENT METHOD: [ ] EFT [ ] CHECK

BANK OR REMIT TO NAME:________________________________________________________

PAYEE (IF OTHER THAN VENDOR):_________________________________________________

ROUTING NUMBER/SWIFT CODE: _________________________________________________

IBAN: _____________________________________________________________________________

OTHER BANKING INFORMATION (OPTIONAL): _____________________________________

SIGNATURE OF VENDOR:__________________________________________________________

Please provide us with an updated information letter if any of the above banking information changes as soon as possible. Your attention in this matter will only help us to continue to provide you with the customer service that you deserve and will help eliminate the possibility of delayed payments to your company. Our EDM Fax Number to use is as follows: 614-701-2667 (with the proper prefix to dial to the United States).

Reggie Bossie

Accounts Payables Director