Financial Supplier Accounting Profile

FINANCIAL SUPPLIER ACCOUNTING PROFILE

Supplier Identification

Tax Identification Number (EIN/SSN):

Corporation    LLC    Sole Proprietor    Partnership    Government / Public Entity    Other:

Primary Addresses & Contacts

Same as Primary Address:

Accounts Payable Contact

Invoicing Preferences

Preferred Invoice Delivery Method:    Email    Mail    EDI    Supplier Portal

Invoice Frequency:

Net 30    Net 45    Net 60    Other:

Banking / Electronic Payment Details (for ACH / Wire)

Please provide correct banking details. Supplier assumes sole responsibility for errors in bank information and resulting misdirected funds.

Authorization for Electronic Payment: I authorize deposits to the account above. I will notify the counterparty in writing within 10 days of any change to banking information.

Credit References

Provide up to three trade or bank references to support credit terms.

Attachments

Attachments submitted with this profile (check all that apply):
Voided check    Bank letter confirming account    Tax documentation (as required)    Business license / registration

Terms, Representations, and Certification

By submitting this Financial Supplier Accounting Profile, the Supplier certifies that all information provided is true, correct and complete to the best of the Supplier's knowledge. Supplier authorizes verification of the information provided, including credit references and banking information, and agrees to provide supporting documentation upon request.

Supplier represents and warrants that it is duly authorized to receive electronic funds transfers and that the bank account information supplied is complete and accurate. Supplier agrees to indemnify and hold harmless the counterparty for any losses, claims or costs resulting from Supplier's failure to provide accurate remittance or banking information or failure to notify the counterparty in writing within 10 days of changes thereto.

The counterparty's acceptance of this profile does not constitute a waiver of any terms contained in purchase orders, master agreements, or other governing contracts. Payment terms, dispute resolution, and tax withholding obligations remain subject to the governing agreement between the parties.

Change Notification

Supplier must provide written notice to accounts payable of any change in corporate name, address, tax identification number, or banking details at least 10 days prior to the effective date of the change. Supplier remains responsible for all taxes, withholdings and regulatory obligations associated with payments received.

Certification and Authorization

The undersigned certifies that they are authorized to execute this Financial Supplier Accounting Profile on behalf of the Supplier and that the information contained herein is complete and accurate. Execution of this document constitutes Supplier's acknowledgment of the representations, authorizations, and obligations set forth above.

Sign Now