SUPPLIER ENROLLMENT FORM - AFRICA Supplier Legal Entity Name: D&B Number:

VAT Registration Number:

(If applicable)

(If applicable)

Supplier Contact and Business Address: Name: Email Address:

Phone Number:

Address: Suburb/Town/City: Postal Code:

Country:

Supplier Bank and Account Information: Payments will be remitted to this bank account. All fields are required. Please contact your bank if you need help completing this section. Once payment is issued, a confirmation will be sent to the email address specified below. Branch code digit requirements: Nigeria - 9; Uganda - 6; Senegal - 4; Ghana - not required

Bank Name: Branch Code:

Branch Name: Address: Suburb/Town/City: Postal Code: Type of Account:

Country: Checking

Savings

Beneficiary Name: Email Address: Account Number:

Currency:

SWIFT/BIC Code:

(Senegal Only)

IBAN #:

Intermediary Bank: (Optional) Bank Name: Branch Name:

Branch Code:

Beneficiary Name: Account Number:

IBAN #: (Senegal Only)

SWIFT/BIC Code: Google Contact: Name:

Email Address:

@google.com

Payment Authorization I hereby authorize Google to initiate payments to the bank above and further warrant that I have the authority to authorize these transactions for the Supplier.

Name: Title: Signature:

Email Address: Date:

SAMPLE INVOICE

C A

B

Bill To: Google Ghana Limited 1st Floor, Physicians and Surgeons Building 54 Independence Avenue Ridge, Accra GHANA VAT No.: 124V038766

ABC COPORATION ADDRESS SUBURB/TOWN/CITY POSTAL CODE, COUNTRY FAX # VAT REGISTRATION #

Mail To: c/o Iron Mountain Accounts Payable - ACC N/O 147 Mlynske Nivy 73 Bratislava 821 05 Slovakia

Invoice Number

Invoice Date

1234567

D

Purchase Order Number

07.26.2010

12345

Description

Amount

Service/Goods Fee Service/Goods Fee

GHS 1.00 GHS 2.00

Service/Goods Fee

GHS 3.00

E

E VAT Rate (If Applicable): 10% TOTAL ABC CORPORATION Wire Banking Information: Acct #: Routing #: SWIFT/BIC Code: IBAN #:

GHS 0.10 GHS 6.10

F

LEGAL INVOICE REQUIREMENTS: A: Bill To Address: is located on the Purchase Order. This is the Google location purchasing the Goods and Services B: Mail To Address: this is the location to which invoices should be sent. Please send all invoices to c/o Iron Mountain, Acounts Payable - ACC N/O 147 Mlynske Nivy 73, Bratislava 82105 Slovakia C: Please ensure that your invoices have VAT reference number included D: Please ensure that invoices have a Purchase Order number specified. Obtain this from your Google contact E: If applicable, please ensure that both VAT rate AND amount is specified on your invoice F: Invoice should include a total of all goods and services and applicable VAT. Please ensure currency is specified Note: For timely payment, please ensure all required information is included; otherwise, we are unable to process the invoice and will need you to issue a new one.

supplier enrollment form - africa

All fields are required. Please contact ... Please send all invoices to c/o Iron ... F: Invoice should include a total of all goods and services and applicable VAT.

191KB Sizes 28 Downloads 349 Views

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