Download Vendor Master Maintenance Request

VENDOR MASTER MAINTENANCE REQUEST
All fields of information and vendor documentation must be completed to become an ATK vendor.
SUPPLIER SECTION
Company Name (Sole proprietors please list both individual and company name):
DBA (Doing Business As):
EIN or SSN:
W9 (Domestic)
Order Address:
Remit Address:
City:
City:
State:
State:
Country:
Country:
Postal Code:
Postal Code:
Contact Name:
Email Address:
Telephone Number:
Fax Number:
W8 (Foreign)
Attached
BUSINESS TYPE (CHECK ONE)
Sole Proprietor
C Corporation
S Corporation
Partnership
Trust/Estate
Other (Specify):
Limited Liability Company, Enter the Tax Classification (C = C Corporation, S = S Corporation, P = Partnership)
BUSINESS CLASSIFICATION (CHECK ALL THAT APPLY)
Large Business
Veteran-Owned
Small Business
Service-Disabled Veteran-Owned
Non Profit
Historical Black Colleges and Universities/Minority Institutions
Foreign/Other
Alaskan Native Corporations (ANC) and Indian Tribes
Woman-Owned
Government
Disadvantaged (Including Minority Owned)
Freight/Utility Companies
HUBZone
SBA Certification Date:
SBA Certification Number:
EEO Certification Form Attached (Required for New PO Vendors)
BUYER/REQUESTOR TO COMPLETE THIS SECTION
Sales Tax Status:
Exempt
Non-Exempt
Payment Terms:
1 1/2%, 15, Net 60
[J Net 45 Days (Default)]
New Vendor*
Change to Existing Vendor Number:
Add New Order Address* (Listed above)
Change Order Address Code* (Listed above)
Add New Remit Address* (Listed above)
Change Remit Address Code* (Listed above)
Reactivate Vendor Number (Attach W9)
Inactivate Vendor Number:
*Requires authorized signature prior to processing by Accounts Payable (A/P)
Database:
MSG Costpoint
SSG Costpoint
Other (Specify)
Requestor Name:
Telephone Number:
Date Requested:
Authorized Signer:
Signature:
Date:
AD-666 REV 12/12
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ELECTRONIC FUNDS TRANSFER
Please fill out this form and sign and date it.
ATTACH A VOIDED CHECK IF AVAILABLE
We will pre-note your new account within two weeks.
Your bank will receive a detailed payment advice.
Please list your banking information below. Note: EFT payments are not applicable for foreign vendors.
Supplier Name:
Supplier Address:
Supplier E-mail Address:
Bank Name:
Bank Routing Number:
Bank Account Number:
I authorize ATK to deposit into my account indentified as and held at the financial institution named above, and I authorize that such
account exists and that the financial institution can make deposits without responsibility for correctness of such amounts.
My authorization will remain in effect until I give written notice to terminate this authorization to ATK in sufficient time and manner as to
allow ATK to act upon it. In addition, either ATK or the financial institution can terminate this agreement by providing me with their
written notice at least 10 days prior to actual termination.
I have provided ATK with a copy of a voided check solely for the purposes of verifying my account number and the financial institution’s
routing number.
Signature:
AD-666 REV 12/12
Date:
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