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Vendor File Request Form - Blank

The document is a form for requesting vendor payment file information. It collects details like vendor contact information, payment method, and bank account details to enable electronic funds transfers. The form has instructions for completing it to ensure prompt data entry and allow the agency to comply with reporting requirements.

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nisa16fitia
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58 views

Vendor File Request Form - Blank

The document is a form for requesting vendor payment file information. It collects details like vendor contact information, payment method, and bank account details to enable electronic funds transfers. The form has instructions for completing it to ensure prompt data entry and allow the agency to comply with reporting requirements.

Uploaded by

nisa16fitia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Post Vendor File Request Form

PRIVACY ACT STATEMENT : This notice is provided under the Privacy Act of 1974, as amended (5 U.S.C. 552a) The information requested is
collected under the authority of the Peace Corps Act 22 U.S.C.2501 et seq.,31 U.S.C. 3322 and 31CFR 208 and 210. This information is used by Peace
Corps and the U.S. Treasury Department to transmit payment data by electronic means to a vendor's financial institution. Failure to provide the requested
information may delay or prevent the receipt of payments through the Electronic Funds Transfer (EFT) Program.

INSTRUCTIONS ON SECOND PAGE


POST CONTACT INFORMATION
Last Name: First Name:
Post LOC Code:
Date:
VENDOR INFORMATION
Reason for Request: New Update – Provide Vendor ID # for Updated Request
Choose an item. If ‘Other’,
REQUIRED: Indicate Reason for Update: Commercial/Individual Name Change
specify:
Choose an
Vendor Type: Choose anitem. If ‘Other’, specify:
option... Federal Agency ALC:
Commercial Name:
If Vendor is an Individual, Last Name: First Name Middle Initial:
Address: City: State: (If applicable)
Country: Gender: M F
Postal Code: (if applicable)
Birth date: (mm/dd/yyyy) Tax ID # (Only US commercial vendors) : US Citizen: Y N
If yes, all PSC hires must send Social Security number by SFTP for
/ / 1099 –MISC tax reporting.
FINANCIAL INSTITUTION INFORMATION

Payment by: Check EFT - If EFT please enter banking information below.

Recipient Bank Name (Vendor’s bank): US Correspondent Bank Information

*For USD payments being made outside US,


Fill-in this US Correspondent Bank information.*
Address:
Bank Name:
City State:

Postal Code: Country:

Provide SWIFT Code /Other Routing Code necessary for SWIFT Code:
Bank:

Bank Account Number:


Direct Forms and questions
Additional Banking Information: (Include any information required by
in-country banking regulations)
to the applicable Vendor Data address:
[email protected]
Type of Account: Checking Savings [email protected]
[email protected]
Currency of the Bank Account: MUST CHECK ONE.

LCU – (Also Provide Currency Code):


USD – (Also Complete Correspondent Bank Information)

PC 709 (10/2010) All previous editions obsolete.

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Instructions to Completing Form 709
A Post Vendor File Request Form must be completed for each vendor that will conduct procurement business
with a Peace Corps representative. Vendor IDs are required to establish obligations and process payments in
Odyssey and to allow the agency to comply with federal reporting requirements. To insure prompt data entry by
vendor maintenance staff, all relevant fields must be completed.

Post Contact Information

The staff person preparing the form enters their last name, first name, Post three digit location code, and
today’s date.

Vendor Information

1. Check New or Updated vendor request. For update, the Vendor Identification number (VIN) must be
provided.

2. REQUIRED: Select the reason for an Update Request from the dropdown menu. Write out reason if
‘Other’ is chosen

3. Select the Vendor Type from the dropdown menu. Write out the type of Vendor if ‘Other’ is chosen.

4. If vendor is a US Federal Agency, provide its Agency Location Code (ALC).

5. If vendor is a commercial entity, enter the vendor name,

6. If vendor is a person, enter the vendor’s last name, first name, middle initial,

7. Provide the vendor’s address, city, state, country, and postal code.

8. If an individual, provide information regarding gender, birth date and US citizenship.

9. If vendor is a US commercial entity, provide their Tax Identification Number.

Financial Institution Information

1. Select the payment type EFT or Check.

2. Enter the Recipient bank name, address, city, postal code, and country.

3. Provide the bank’s Swift Code or other routing information necessary for the local bank.

4. Provide the vendor’s bank account number.

5. Enter any other banking information, particularly that required by in-country banking regulations.

6. Select the type of bank account.

7. Select the bank account currency.

US Correspondent Bank Information

**Note: Only for situations of USD payments being made to a bank outside the US. The correspondent bank
must be in the United States.**

1. Enter the bank name.

2. Provide the bank’s Swift Code.

PC 709 (10/2010) All previous editions obsolete.

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